I do not sit behind my desk. Way too formal. I will bring my chair around and spend the first session in a very low key conversation to begin to establish a therapeutic relationship with your son or daughter. Most kids like to call me by my first name, and I am fine with that.

During this first session, I will sometimes begin to discuss the presenting issue but not always. Sometimes we just talk about their lives generally. What they like, how school is going, sports, hobbies, life at home, their friends, plans for the future, music, movies, etc…

I let them know that they can trust me to respect their privacy. This is very Important to adolescents. I review the HIPPA guidelines again, which usually gives them a reassurance that they can speak freely. This is an absolutely essential part in conducting therapy with an adolescent.

During this first session, I am also conducting a mental status examination.

The MSE are observations that relate to your child’s range of emotions, affect, judgement, memory, insight, speech, eye contact, motor activity, attention span, vocabulary, and mood.

I have a notepad, but I do not take many notes during a session. Taking notes tends to remove my attention and I find it a little distracting. ”Active listening and good eye contact is what I find to be more helpful. I do all of my writing after the session is over.