What is the first session like?

Prior to your first session, I’ll have you complete some intake paperwork via an online portal. During our first session, I’ll review the basics of what’s in the paperwork, get to know more of your background, and share some initial ideas for how we can work together. You’re also welcome to ask me questions about my therapy style. A majority of the session will be focused on collecting your life history and exploring your goals for treatment. At your second session, we’ll go over a treatment plan together.

What are the online portal & intake paperwork?

The online portal is handled through SessionsHealth. When you get started as a client, you’ll get an email to join the Portal. You’ll make an account, see consent forms to review and sign, enter contact and demographic information, then see a life history form and a payment form to fill out.

This portal is where you can manage your appointments and bills, contact me, get worksheets or other assessments from me during your treatment, attend telehealth appointments, and more. This video shows what the Portal looks like and how to navigate it.

What is a typical session like?

My therapy style tends to be active and collaborative. I view us as a team, working together to figure out where you can experiment with acceptance and change. Sessions often involve: reflecting on a recent stuck point or area of concern; exploring how that connects to a larger life pattern; exploring current life context, life history, or other factors for why this stuck point “makes sense”; experimenting (often in real time) with new ways to relate to the issue; and deciding how you want to move forward with this all in mind.

I often use a whiteboard while clients share; I write & draw out ideas as we process together. I also generally collaborate with clients on identifying what they can work on between sessions — this can involve trying out new actions, experimenting with mindfulness, tapping into values, or reflecting on themes / questions from session.

How long will I need to be in therapy?

This depends greatly on the person. For context, I often start people with weekly therapy, then taper to every-other-week, then eventually taper down to maintenance check-ins (every ~4 weeks) until they’re ready to graduate.

I’ve found that if a client is coming to therapy because they started struggling recently, and they were overall content with their “baseline” prior to this recent change, then roughly 3 months of therapy is a common timeline (approx. 6-8 sessions, spread out).

If a client is dealing with longer-term life issues or multiple issues interacting (examples: complex trauma, “severe” perfectionism, or moderate OCD interacting with ADHD), then the average length of therapy is around 6 months to 1 year. Some people may stay longer due to their specific treatment needs.

You have a lot written about ERP, do you do that with every client?

I work with a variety of presenting concerns and use several different therapy styles! I’d guess that about 20% of my clients have some sort of formal exposure process in place.

Among the other 80%, a majority of my clients do work consciously on trying out new actions between sessions (for example, a client having an assertive conversation that they’ve been avoiding), which could be considered exposure in an informal way?

What’s the difference between ADHD therapy and ADHD coaching?

Generally speaking, ADHD therapy is when you seek ADHD treatment from a licensed therapist (masters or doctorate level). Therapy for an ADHDer often includes a blend of self-reflection, self-compassion + shame-reduction, and active coping skills + goal setting around the ADHD concerns.

Therapists have years of training in a variety of mental health issues and we can factor in the interaction of ADHD with other variables (such as your life history, your current relationships, trauma, etc.). The downside is that therapists vary widely in their level of knowledge about ADHD, as well as their interpersonal style. Therapists, on average, are less directive than coaches.

ADHD coaching is a service focused tightly on coping skills, structure, and accountability. The upside to this is that ADHD coaches often seek training that gets into the “nitty gritty” of ADHD concerns and coping skills. The biggest downside is that the field is unregulated. There is no formal testing or licensure for life coaching or ADHD coaching, though there are private organizations who offer specific trainings and certifications. Another downside is that people who are solely ADHD coaches (and not also therapists) don’t have the training to help with co-occurring mental health concerns, complicated emotions, or severe life stressors that might be interacting with your ADHD. A good ADHD coach can nonetheless be helpful in tackling specific life goals or trouble spots related to your ADHD. It’s not uncommon for people to see both types of professionals at some point in their life.

I try to take a “coach-y therapy” stance for ADHD clients who want more hands-on help with their ADHD. However, I ultimately approach sessions from the mindset of a therapist :)

Do you “treat” Autism?

I don’t “treat” Autism as I believe it is a natural human variation that doesn’t inherently need treatment. I do support Autistic people in working on other issues (co-occurring ADHD, anxiety, OCD, trauma, self-understanding, etc.).

How will I pay?

I am able to run debit/credit cards through the electronic software I use for taking notes (the client portal). You’ll save a card on file as part of the intake process. I will run your card on the same day of your session.

If you feel uncomfortable with keeping a card on file, you can let me know and opt out. If you opt out, please be aware that I will need to type in your card information during the last 10 minutes of each session to swipe the card.