I write this for the patients who, before our first session, send me long messages full of apologies and disclaimers. You don't need to apologise. You need to know what we're going to do together, so you can show up as you are.

If you can, take one or two of the screeners on this site (PHQ-9, GAD-7, ISI as applicable) and bring the scores. They are not necessary, but they save us time and let me start more precisely. Note one or two recent moments that captured the issue best — what was happening, what your body felt, what the mind said. That is far more useful than a perfect history.

I will start with what's bringing you in, not with intake forms. We will cover history, sleep, lifestyle, relationships, work, and any prior care. I will share my preliminary clinical picture out loud and check it with you. By the end of the hour you will have: a working formulation in plain English, a CR-based plan for the next two weeks, and a clear sense of what success looks like in 4–6 sessions.

Most patients feel a measurable shift inside the first two weeks — usually around sleep, breath and the volume of the inner critic. Lasting change typically takes 6–12 sessions. I will be honest with you at every step about what is and isn't working.