What is the process like?

Getting Started

Making the decision to see someone for counseling is a big step.  Let me walk you through the process to make it a little less stressful.

Phone Call aka “Consultation Call”: Before we meet, we will schedule a brief (10-15 min) phone call to check on logistics and fit.

    • Logistics
      • Do our schedules match up?
      • If you want to use insurance, am I credentialed with your insurance?
    • Fit
      • Am I qualified to work with the concerns you have?
      • Will my style fit your needs?
      • Is the situation appropriate for teletherapy?
      • See also: Specialties and Areas I Refer Out

Fit for teletherapy: Due to the nature of teletherapy, not all situations are appropriate. These are some examples of situations when I would not feel that teletherapy is appropriate:

    • If there are concerns about ongoing risk to self or others.
    • If there isn’t sufficient privacy or safety to engage in teletherapy (e.g., domestic violence, lack of privacy due to roommates).
    • If emotional management is so difficult you really need multiple sessions a week or an in-person provider to assist with grounding.
    • If there are complicated medication management consultation needs. In those situations, meeting with a provider in a clinic or managed care setting is ideal for frequent collaboration between providers.
    • If you travel out of the state frequently. Please keep in mind that a psychologist’s license is bound to a specific state. I need to know that you are within the state of Oregon at the time of the session otherwise I am acting outside of my license.

Online Paperwork: If it is seeming like a good fit, I will send you online paperwork to complete. This includes a questionnaire, informed consent and policy information, and billing information. Completion of paperwork does not constitute a therapeutic relationship since we are still deciding fit.

Paperwork and Insurance Review: I will review the paperwork as soon as possible after you have completed it. If you are planning to use insurance, I will check on benefits.

Scheduling: I will contact you by phone or email to let you know what I found regarding insurance benefits (e.g., copays/coinsurance, deductibles) and to schedule our first session.

First Appointment: All appointments are scheduled for 50 minutes. We will cover a lot in the first appointment.

    • You will receive a teletherapy link on the morning of the appointment. You can also find this link on the client portal page.
    • We will review confidentiality and policies right at the beginning of the first session to avoid confusion. Please ask any questions you have.
    • We will explore the broad history of your concerns.
    • Hopefully by the end of this first appointment, we will have a sense of what our goals will be. In most cases, you will leave the first session with at least one tangible step you can take to start working toward those goals.

Treatment Plan: Regardless of whether you are using insurance or not, I am required to work from a treatment plan. The  difference is that, if insurance is involved, the treatment plan has to be focused on symptoms or other very specific goals. We will try to complete the treatment plan by the end of the second session.

Follow-up Appointments: Once we establish goals, I will have a general plan set up to reach those goals; however, daily life might bring up additional issues you want to discuss. To get the most out of our appointments, it’s helpful to come to sessions with specific issues you would like to address. Keeping some notes or journaling between sessions helps us both see what’s working and what isn’t.

Course of Therapy: Often therapy follows a pattern referred to as the 3-Cs:

    • Calming Skills: Often the first issues we address are overt symptoms – such as panic attacks, poor sleep, irritability, or distractibility. There are reliable skills that you can learn quickly to have an immediate impact on quality of life. This stage also sets up the groundwork for additional steps.
    • Challenge Skills: Once calming skills are established, we will be looking at underlying interpersonal patterns, thoughts, or beliefs that contribute to distress. We will work on identifying these patterns with curiosity and self-compassion and then make subtle shifts so that you’re functioning more in-line with your values and goals.
    • Confrontation Practice: In most cases, internal distress leads to avoidance behaviors. In this stage, you’ll be pulling all these tools together to confront your avoidance by dealing directly with the underlying cause. This is the point where new habits get formed and confidence increases. We may be scaling back sessions around this time as well so you have more time between sessions to practice.

Now, in reality, these 3-Cs are usually melded together but I like to be intentional about skill building so that confidence grows steadily.

Ending treatment: We will review treatment goals every few months to make sure we’re heading in the right direction. As time goes on, sessions will be spaced further apart for you to have more time to practice what you’ve learned.

Once you feel you’re close to meeting your treatment goals, we’ll start to discuss ending treatment. I usually find that my clients do well with a 3-4 month treatment break and then a check-in appointment before ending completely – just to make sure that symptoms/concerns haven’t resurfaced.