Sazi Wald, MSW, LSWAIC
New to therapy? Start here!
Welcome! Mega kudos to you for seeking help and guidance. This post will explain a little bit about therapy and explore what you can expect during your first session and thereafter with me.
First of all, every therapist is different! There are many types of disciplines, all sorts of levels of experience and licenses, and a million different philosophical ideas and backgrounds that each individual and therapist brings to what is called the therapeutic alliance. The therapeutic alliance is the relationship that the individual and therapist have together.
My background is eclectic and rather than boring you with the details (like I almost did). In short, I focus on the principals of balance, unconditional positive regard, and acceptance, leaning heavily on the behaviorist ideas that taking different actions leads to different thoughts and feelings. It is one thing to get lost in talking and thinking about ideas of infinite possibility and it is another to practice infinite possibility.
Initially reaching out:
When you email or call me I will try to get back with you within one to two business days (I am usually pretty quick). Regarding email, you can tell me as little or as much as you want. Some people send short stories and some people write a sentence. I don't mind either way! In any case, I will likely set up a free 15-20 minute consult with you.
The free consult:
This consultation helps us both decide if we are a good fit for an initial appointment and if there is anything else that I can connect you with. During the free consult I will ask you a little bit about what brings you in to see me. We will chat about what to expect and answer any questions that you may have. I will often ask about your history with suicide or homicidal ideation/intent/attempt/completion, hospitalizations, along with how intense your symptoms are to make sure that my level of care is right for you. If we are a good fit, then we will set up the intake.
Between consult and intake:
If you decide to schedule an intake, then you will be given a link to your client portal. On that portal you will be able to sign your consent forms and fill out some psychological screeners (usually GAD7, PHQ9, AUDIT, DSMV Cross Cutting Tool Level 1, and ACES) and an intake form. You can skip over any question you like, these screeners help me loosely identify if you may have any pressing physical or psychological health risks that I should be aware of initially.
Intakes are the initial appointment and last for 70-90 minutes. Your initial paperwork is reviewed prior to your first session so you will not have to worry about repeating anything, instead we can dive deeper.
When we begin, I will go over the consent form that you have already read highlighting confidentiality, supervision, consultation, and things like that. During the session you will be asked a bunch of personal questions because you have known you your whole life and I have only known you usually for about 20 minutes prior to intake. :) As always you do not need to disclose anything you don't want to. We then explore things that you can start with outside of session to get you moving towards your goals.
I will often ask you to sign releases of information to other health care providers such as your doctor or even acupuncturist to coordinate your care. This helps me insure that I am not missing any other important health areas that we may be able to work through in our sessions and vice versa. I will always let you know before I speak with a provider what I will disclose and ask to receive. You can always revoke a release at any time!
Whether you are coming to this appointment in-person or virtually, feel free to bring food, a comfy blanket, whatever makes you feel comfortable!
In between intake and the next appointment:
As I like to tell my clients, I am not a wizard. Not only do I not have a magic spell or power to compel you any which way, I do not disappear into a puff of smoke in-between sessions. If you have any questions or things come up, you can message me over your client portal, email, or call me. I do not offer crisis services, but sometimes when people start therapy they like to check in for a minute or two if they are having an extra bad week.
The "regular" therapy sessions:
The appointments following the intake are where the rubber meets the road. The more you put into therapy the more you will get out of it. Each session lasts for around 50 minutes however each day may be a bit different. We are humans and life is not a linear journey. There may be ups and downs. Typically during session we talk about things that are going well and things that are blocking you, we can process traumas or old patterns, practice mindfulness and cognitive skills through worksheets, art, and talking and then you leave with new experiments to try in your day-to-day life.
Goodbyes look different for everyone. Sometimes it is sudden, sometimes it is slow, sometimes it is deliberate, sometimes it is an accident, sometimes it is forever, sometimes it is temporary. I ask that when we come to the end of our treatment together that we have a final appointment even if it is a "final for now." It is vital to practice these goodbyes even if they are temporary. It is important to get clarity in transitions whenever we can and give respect to the work you have completed.
A common question:
I often get asked, "how long does therapy take?" To that I say, it depends! Some people just need solution-focused brief therapy which goes over 5 sessions. Others might do well with 26-weeks of straight manualized CBT or 10 weeks of Behavioral Activation. Some people have what they need after one session. There are folx that need long-term support over months or years. For others they may come in once a month to check in and get some new skills. Some people have many things they want to uncover and process, others want to alleviate one pressing issue.
One thing I can tell you for sure is that I will always check in with you. You will always know as much as I know about the winding road and forks we are navigating. My philosophy is typically one of putting in what you put in. If things do not seem to be shifting or there is a prolonged period where there is less self exploration and more talking about the weather, then I will always call it out. I will not keep you in therapy if you do not want to be in therapy and I will not suggest you continue if it does not appear to be helping. However, I will always do my best to help you find what you need to get where you want to go.
This is your care! The privilege of walking with people through countless different types of hardships is the best gift I could ever wish to both give and receive. Thank you for taking interest in walking a bit of your journey with me.