APEXMental Health Counseling
The Work
Survivors of domestic violenceVeterans and service membersSubstance use and addictionHigh performers running on emptyAnxiety, depression, and angerCouplesGrief, faith, and life transitions
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The Work

What the work actually looks like.

Not the theory. The first call, the first session, what a normal month is, how long people stay, and how you know it is doing anything.

The first call

Fifteen minutes, free, on the phone. You describe what has been going on in whatever order it comes out. I ask a few questions, and near the end I tell you plainly whether I think I am the right person for it.

Sometimes the answer is no, and that is a useful fifteen minutes rather than a wasted one. I would rather hand you two names of people who fit better than take an intake I have doubts about.

The first session

Sixty minutes, and more structured than the rest will be. I am building a working picture: what is happening now, how long it has been happening, what you have already tried, what the people around you are like, and what you actually want to be different.

You will not be asked to produce your childhood in chronological order. If something from a long time ago is relevant, it will come up on its own, usually because it is still happening in some disguised form on a Tuesday afternoon.

What you leave the first session with

A rough plan, in plain words, and usually one small thing to try. Not a treatment contract full of clinical language you will never reread.

What a normal month looks like

Weekly to begin with, because momentum matters more than people expect and fortnightly sessions often turn into thirty minutes of catching up. Once things are moving, every other week is common, and some people taper further from there.

Between sessions there is usually something small and specific to do. Not worksheets for their own sake. Therapy is one hour out of a hundred and sixty-eight, and the other hundred and sixty-seven are where the actual change has to happen.

How long people stay

Honestly, it varies more than anyone selling a program will admit. A focused problem with a clear shape can move in eight to twelve sessions. Something that has been running for twenty years and shaped how you pick partners takes longer than that, and anyone who promises otherwise is selling something.

What I will not do is keep you in an open-ended arrangement out of habit. If we hit a plateau, I will name it, and we will either change the approach or talk about stopping.

How you know it is working

Rarely as a mood lifting on schedule. More often it shows up sideways, and the people around you notice before you do.

  • The gap between the trigger and your reaction gets slightly wider
  • You recover from a bad day in hours instead of the rest of the week
  • You say the difficult thing once, at normal volume, instead of not at all
  • Something that used to take the whole evening takes twenty minutes
  • You stop rehearsing conversations in the car

When it ends

Deliberately, with a session or two set aside for it, rather than by quietly not rebooking. We look at what changed, what is likely to be the thing that comes back, and what you would do about it if it did.

The door stays open. A fair number of people come back for three or four sessions years later when something specific lands, and that is a normal use of this, not a relapse.

Focused areas Seven of them

Seven of these come up often enough to have their own page.

These are not the only things worked on here. They are the ones where enough people arrive with the same shape of problem that it was worth writing properly about each one.

Begin

Not sure which of these is yours?

That is an ordinary place to start, and it is a good use of the consultation call. Describe what has been going on and I will tell you whether I am the right person for it.