A surprising number of people cancel their first appointment. Not because they have changed their mind about wanting help, but because the unknown of the thing is worse than the problem that sent them looking. So here is what the hour actually consists of, in fairly boring detail.

Before you arrive

You will have had an email from me confirming the time. If you are coming to the rooms in Drummond Street, there is parking on the street. If it is a telehealth session, you will have a link and a short checklist.

You do not need to prepare anything. People sometimes arrive with notes, and that is fine, but it is not expected and it is not better.

The first ten minutes

Housekeeping, mostly. I will explain confidentiality and its limits, which is a conversation worth paying attention to rather than nodding through. Broadly: what you say stays between us, with a small number of legal exceptions relating to serious risk of harm and court orders. If you have a Mental Health Treatment Plan, I write a brief letter back to your GP, and I will tell you what goes in it.

Then fees, cancellation, how rebates work. Dull, but better said out loud than assumed.

The bulk of it

Then I ask what brought you here. That is the whole question, and you can answer it however you like. Some people have a clear account ready. Others say “I don't really know, I just haven't felt right for a while”, and that is an entirely workable starting point.

I will ask about when it started, whether anything was going on around that time, what makes it better or worse, how you are sleeping and eating, what your days look like. I will ask about family, work, and who you have around you. I will ask whether you have seen someone before and how that went, including if it went badly.

I will also ask directly about thoughts of self-harm or suicide. I ask everyone. It is not because of something you said, and it is not a trapdoor. It is a standard part of understanding where someone is.

You are allowed to say you would rather not talk about something yet. That is not a failure of the session. Knowing where your edges are is useful information for both of us.

The last ten minutes

I will give you my initial read on what might be going on and how I would think about working on it. Initial is the operative word. First impressions in this work get revised, often significantly.

We will talk about whether it makes sense to keep going, how often, and for roughly how long. Some things take six sessions. Some take considerably longer, particularly trauma and long-standing patterns. I will be straight with you about which one I think you are looking at.

What it is not

It is not a test, and there is no correct way to present. You will not be diagnosed with something alarming in the first hour and sent away with it. You are not committing to a course of treatment by turning up once.

Crying is common and not embarrassing. So is the opposite: people are often surprised to find they feel oddly flat and matter-of-fact while describing something painful. Both are normal.

If it is not a fit

Sometimes it is not, and that is worth saying out loud. The working relationship does more of the heavy lifting in therapy than any particular technique. If after a session or two it does not feel right, tell me, and I will help you find someone who suits you better. I would much rather that than have you quietly stop coming and conclude that therapy does not work.

If you would like to start, send an enquiry with a rough idea of when suits you. You can also read about fees and Medicare rebates beforehand if the cost is part of what is holding you up.