Getting started
Uncertainty is one of the biggest reasons people put this off for another year. So here is the whole thing, written out, including the awkward parts.
No forms to print, no symptom diary, no list of goals. If you have documents from a previous clinician they are welcome but not required. Turning up is the whole assignment.
Fifteen minutes, on the phone, at a time that works around your day. I will ask what brought you to look for a therapist now, what you have tried before, and what you would want to be different in six months. You can ask me anything you like, including the blunt questions people are often too polite to ask, such as whether I have worked with something like this before and how long it usually takes.
I do not take clinical notes on this call and it does not create a client record. At the end of it I will tell you one of three things: that I think I can help and here is when I have space, that I think somebody else would serve you better and here are two names, or that what you are describing needs a different kind of support entirely and here is where to start.
Fifty minutes. The first ten are usually admin and settling: confidentiality and its limits, fees, cancellation policy, and how to reach me between sessions. Then we talk properly.
I will ask about what is happening now, how long it has been happening, and what the shape of your life is around it. Work, money, sleep, relationships, substances, health, safety. Some of that is standard assessment and some of it is because context matters. If a question lands badly you are allowed to say so and skip it. Nothing in the first session is a test.
Towards the end we will name what we are working on, in your words rather than in diagnostic language. It might be "I want to stop dreading Sunday" or "I want to be able to hear criticism without disappearing for two days". That sentence becomes the thing we keep returning to.
This is the settling in stretch. Most people feel a lift somewhere in here that is partly real relief and partly the effect of finally telling somebody. It is genuine, and it is also not the same thing as the work being done, so I will gently say so rather than let you leave early on a high.
We start noticing patterns. What sets the thing off. What you do immediately afterwards. What you were taught to believe about needing help. I might suggest small experiments between sessions, though I am not a homework heavy therapist and I will not be checking whether you did them.
I flag this early because otherwise it feels like failure. Around here the numbing has thinned out and the new ways of coping have not fully arrived. People often report feeling more, not less, and occasionally consider stopping. This is one of the most common points at which therapy gets abandoned right before it starts to work.
If that happens I want you to bring it into the room rather than quietly cancel. We can slow down, change direction, or take a planned break. What I will ask is that we talk about it first.
Every six to eight weeks we stop and take stock deliberately. What has moved, what has not, whether the original sentence still describes what you want, and whether I am still the right person. That review is not a formality. Clients have used it to change direction entirely, to reduce frequency, to finish, and once memorably to tell me I had been far too gentle for three months, which was correct.
Practical
The Chelsea office is on West Twenty Third Street between Sixth and Seventh. Nearest trains are the F and M at Twenty Third, the One at Twenty Third and Seventh, and the C and E at Twenty Third and Eighth. There is a lobby desk, a lift, and a quiet waiting area with water. Arrive a couple of minutes early rather than fifteen, since the waiting area is shared.
You get a secure link by email the day before. It opens in a browser, no app or account required. Use headphones if you can, and pick somewhere you will not be overheard, even if that place is a parked car, which is a perfectly respectable therapy venue in this city.
Card on file, charged after each session. You will receive a receipt immediately and a superbill at the end of each month for out of network reimbursement. No packages, no prepaid blocks, no contracts. You can stop at any time.
Forty eight hours notice, no charge, no discussion. Inside forty eight hours the session is charged unless we can move it in the same week. This is not a punishment, it is how a small practice stays viable, and I apply it to myself with equal seriousness.
What you say stays in the room, with the legal exceptions every New York clinician has: risk of serious harm to yourself or someone else, suspected abuse of a child or vulnerable adult, and a court order. I will explain all of this in session one before you tell me anything.
Email for scheduling, answered within one business day. I do not do therapy by message and I am not an emergency service. If something urgent happens between sessions, use the crisis resources below and we will talk it through at the next appointment.
Nerves
People apologise in the first five minutes for taking up my time. They rehearse an opening line in the lift. They say "this is going to sound stupid" before saying something entirely reasonable. One client spent the first four minutes describing the weather, then burst into tears, then apologised for that.
None of this is a problem and none of it is unusual. You do not need to arrive articulate. You do not need to have worked out what is wrong, since working that out is the job we are doing together. Turning up with "I do not know, I just feel awful and I cannot keep doing this" is a completely sufficient starting point, and honestly it is one of the most common ones.
Fifteen minutes, at a time that suits you, and a straight answer about whether this is the right room for what you are carrying.