In our initial meeting, our goal is to get a sense of why you’ve come for help. Sometimes that’s obvious – a partner left, a parent died, a job was lost, and so forth. But often it’s less clear: perhaps you’ve been feeling anxious for years but have decided to seek help just now. We try to get a sense of the forces at play in your life which might be responsible for the downturn, or for the sense of urgency. “What’s the problem,” and “Why now?” are two questions I have in mind in the first hour as we talk. I also want to get your sense of what sort of help you want, whether you just want assistance with thinking through a current crisis, or whether you’re looking for more extensive help with ongoing difficulties. I’ll be trying to figure out whether I can be of use to you, and you’ll be sorting out whether I seem to be someone you can feel comfortable talking with. We’ll also think about what the most useful form of treatment might be – should you take medication, how often should we meet, might couple or family therapy make more sense, should you have a consultation with a specialist in some other area, and the like. Usually this can be sorted out in the first meeting, although sometimes it will make sense to us to spend a bit more time together before deciding whether and how to proceed. And if you just decide that you don’t feel comfortable with me, there’s no charge for the session.