# First Session — What to Expect
A first meeting should feel steady, respectful, and useful. No pop quizzes, no velvet couch required (unless you want one). Here’s how we’ll spend our time:
## Before We Meet (10–15 minutes on your end)
* **Paperwork & consent:** I’ll send intake forms and informed-consent documents.
* **Brief screeners (optional):** Tools like the PHQ-9, GAD-7, PCL-5, or ASRS help us get a baseline.
* **Logistics:** Choose **in-person in Kerrville** or **secure telehealth (Texas statewide)**. Insurance is handled via **Headway** or **Resolute**, or **private pay**.
## Session Length
* **50 minutes** (the classic “therapist hour”).
## Step-by-Step During Session
1. **Warm welcome & ground rules (5 minutes).**
What therapy with me is like, confidentiality and its limits, how to reach me, and what to do in a crisis (911/988—therapy isn’t an emergency service).
2. **Your story, at your pace (15–20 minutes).**
Top concerns, what’s helped/not helped, key history, current stressors, strengths, supports, and what a “good outcome” would look like.
3. **Brief well-being check (5–10 minutes).**
Sleep, appetite, medications, medical factors, substance use, and a quick safety screen. If trauma is present, we go **slow and consent-driven**—stabilization first.
4. **A tool you can use today (5–10 minutes).**
We’ll practice 1–2 practical skills (e.g., grounding, paced breathing, thought-reframing) so you leave with something immediately helpful.
5. **Plan & next steps (5–10 minutes).**
We’ll set 2–3 initial goals, choose focus areas (e.g., anxiety, ADHD structure, trauma stabilization), agree on cadence (often weekly to start), and outline home practice that’s realistic—not a second job.
## If You’re Coming as a Couple
* We’ll meet together first, then usually **10–15 minutes each** individually to capture priorities safely. We’ll set shared goals, outline communication ground rules, and assign a small, constructive task for the week.
## What You’ll Leave With
* A clear understanding of how we’ll work together
* At least one calming or clarity tool
* First goals and a practical next step
* Scheduling and payment details squared away
## What to Bring (helpful, not mandatory)
* Current **medication list** and any relevant evaluations
* **Insurance info** (if using Headway or Resolute) or payment method
* For telehealth: a **private space**, stable internet, and **headphones**
My style is warm, direct, and structured: traditional professionalism with modern, evidence-based tools. We’ll clarify, focus, and move—steadily and respectfully—toward the life you want.