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What to expect: before, during, and after

What actually happens in a first therapy session. Clear enough to feel prepared.

If you like to know how things work before you commit to them, this page is for you. There are no inkblots, no hidden rules, and no expectation that you arrive knowing exactly what to say. Here is what the first session usually includes for individual therapy, couples therapy, Discernment Counseling, and hypnotherapy.

Start with the free 15-minute consultation The consultation comes first, so by the time you book a session, none of this is a leap of faith.

Before you arrive

By the first session, we're not strangers.

Everything starts with a free 15-minute consultation: phone or video. You tell me what's going on in plain language; I ask a few questions and give you an honest read on whether I'm the right fit. If I'm not, I'll say so and point you toward someone better matched. No obligation either way.

If we go ahead, you will receive intake paperwork electronically before the first session, including practical details, history, and consent forms that spell out confidentiality and its limits. Doing this ahead of time means the first hour is spent on you, not on forms. Then you show up, to the Rockville office or a secure video link, as you are. There's nothing to prepare, no right way to start, and no quiz on why you're really there.

The hour itself

A focused conversation with a person who's paying real attention.

Most first sessions move among three kinds of conversation, though not always in this order.

Starting point

What brings you in

You talk, I listen. Actively, with questions that help you say what you actually mean rather than the rehearsed version. What brought you in, what you've already tried, what's at stake. If you don't know where to start, I'll start us; that's my job, not yours.

Building the picture

Making sense of it together

I ask about history, patterns, and context, not to catalog you, but because problems make more sense in their setting. Expect me to reflect back what I'm hearing and check whether it lands. You'll get a feel for how I think, which is data you should be collecting too.

Where we might go

An initial direction

Before we finish, I will usually offer an initial read on what may be happening, how I would suggest approaching it, and what the next phase of the work could look like. You may leave with something to notice, reflect on, or try before we meet again, along with space to decide how the fit felt.

By service

The first session, tailored to what you're coming for.

Individual therapy

The shape described above: your story, sense-making, and a proposed direction. I will not leave you wondering indefinitely what we are doing or why. You are welcome to ask about the direction of the work, question the method, or tell me when something is not landing. Clients who think carefully about the process often do especially well with me.

Individual therapy →

Couples therapy

You come together, and the first session is about understanding the relationship: how you met, what has changed, and what each of you hopes could be different. I take both partners seriously and work to understand the relationship from both sides. That does not mean assuming equal responsibility for every problem or avoiding difficult conclusions. It means the picture should come from the relationship itself, not simply from whoever makes the stronger case. Early sessions follow a Gottman-informed assessment so we can understand both the larger history and the patterns unfolding between you now.

Couples therapy →

Discernment Counseling

Discernment Counseling is not couples therapy. It is a short-term process for couples on the brink when one partner is leaning toward leaving and the other hopes to preserve the relationship. The first session lasts about two hours. We begin together, spend much of the session in separate individual conversations, and come back together at the end. The goal is not to solve the relationship problems yet. It is to build greater clarity and confidence about one of three directions: remain as things are for now, move toward separation or divorce, or make a committed effort in couples therapy.

Discernment Counseling →

Hypnotherapy

The first session is mostly conversation, understanding the habit or pattern, what feeds it, what's behind it, because hypnosis aimed at the wrong target is just relaxation. One client put it well: "I was amazed by how much time he spent talking to me, trying to get to the bottom of the problem before hypnotizing me." When we do begin hypnosis, you'll know exactly what it is and isn't: focused attention, fully aware, always in your control.

Hypnotherapy →

For people who like to understand the process

Therapy should not be a black box.

You do not need to become a perfect therapy client. You can ask why I am focusing on something, tell me when an idea does not fit, or say when you want to approach something differently.

A process you can participate in

I will usually have a reason for the questions I ask and the direction I suggest. When it helps, I will explain what I am noticing and why I think it matters.

We may spend time understanding the past, working with what is happening in the present, trying something experiential, or focusing on a concrete problem.

The method can change as our understanding becomes clearer. That is not the same as working without direction.

We can talk directly about the work itself, including what fits, what does not, and what may need to change.

Over time, you should have a clearer sense of what we are trying to understand or change, without forcing every session into a fixed formula.

Common questions

Before your first hour

What if I don't know what to say?

Then you say that, and we're already having a real conversation. Arriving without a polished opening statement isn't a problem. Drawing people out is the part of this I've practiced for twenty years. Some of the best first sessions start with "I don't even know why I'm here, exactly."

Will I have to talk about my childhood?

Only where it earns its place. History matters when it explains a pattern that's running your present. Attachment, self-criticism, the rules you learned about feelings. But archaeology isn't the method; change is. Some of the deepest work we do barely visits the past at all, because automatic patterns often shift fastest through present-moment, experiential work.

What if I get emotional, or can't?

People respond in different ways. You may feel a lot, very little, or find that the words come before the feelings do. None of that means you are doing therapy incorrectly. You do not need to produce a particular emotional response or explain everything perfectly. We can begin with whatever is present.

How quickly should therapy start helping?

Honestly: most people feel something useful early, relief at being understood, a clearer picture of the problem, often in the first session or two. Durable change takes longer, and the timeline depends on what we're working on: a focused habit may move in weeks, while attachment patterns are a longer arc. What you should never feel is adrift. If you're months in and can't say what we're working toward, that's a conversation I want you to start, and one I'll start if I notice it first.

What if we realize a different service fits better?

The first session can sometimes clarify that a different kind of work would fit better than the service you originally requested. We can discuss that before a treatment frame is firmly established. Once individual or couples therapy is underway, changing between those roles requires more care because information learned in one frame can affect neutrality in the other. Discernment Counseling is different: couples who choose the reconciliation path may transition deliberately into couples therapy. Any recommendation to change course will be discussed directly, including the clinical reasoning and whether a referral would be more appropriate.

Step one

Free 15-minute consultation, phone or video. Fit check, honest answers, zero obligation.

Step two

Intake forms arrive electronically: done before the session so the hour belongs to you.

Step three

The first session: in Rockville or by video anywhere in Maryland. Then you decide. Fees & insurance →

You now know more about the first session than most people ever do. The rest you learn by having one.

Schedule your free consultation