What a Session Looks Like
Good psychiatric care depends on what happens inside the appointment. This page walks through how I structure a first visit and follow-ups so you know what to expect before you book, during the session, and between visits.
Everything here reflects how my practice actually runs. If something is unclear after reading, the contact page has a way to reach me with questions before scheduling.
Getting Ready for Intake
Once you book, you will receive intake paperwork through the patient portal. This includes a brief history form, consent documents, and a private-pay payment setup. I recommend completing the forms at least 24 hours before the appointment so I can review them beforehand.
If you have had psychiatric care in the past, gathering a few documents ahead of time makes the first visit far more useful: a list of current and prior medications (with doses, approximate dates, and how each worked or did not), recent lab results if you have them, and the names of any therapists or primary care clinicians currently involved in your care.
None of this is required to show up. If you are newer to psychiatric care and do not have records to pull together, that is fine. We will build the picture in the first visit instead.
The Initial Evaluation
Initial evaluations run 60 to 90 minutes. The structure is consistent but not rigid - the time divides roughly into four phases, and we adjust as needed based on what the conversation surfaces.
We start broad. Your reasons for seeking care now, what has been happening in your life over the last several months, relevant medical and developmental history, and how mental health shows up in your family. This is also where I ask about substance use, sleep, trauma history, and safety concerns - not to check boxes, but to understand context.
We move from background to the present. What symptoms are you noticing? How do they interfere with work, relationships, or daily function? What have you already tried, and what did or did not help? Past medication trials get particular attention here.
I share what I am seeing: how the pieces fit together, what diagnostic framework makes sense, and where there is still uncertainty. This is a conversation, not a verdict. If something does not match your experience, we work with that rather than around it.
We agree on next steps. That may include starting or adjusting medication, ordering labs, recommending therapy, or taking time to gather more information before deciding anything. If medication is on the table, I explain what I am recommending and why, what to watch for, and how we will know if it is working.
Follow-Up Appointments
Follow-ups are typically 30 to 60 minutes. The right length depends on what is going on: early medication changes and complex cases benefit from the full hour, while stable check-ins can be shorter.
Each visit starts with a brief review of how you have been since the last appointment, including any side effects, sleep, mood, and relevant life context. We then look at the current plan - what is working, what is not, and whether anything needs to change. Medication adjustments are explained, not dictated: if I am changing a dose or switching agents, I walk through the reasoning and what I expect.
Frequency varies. When a treatment is new or changing, visits run every two to four weeks. Once things stabilize, monthly or quarterly follow-ups are typical. I do not push a fixed cadence - we set the interval that matches the clinical picture.
How to Reach Me Between Appointments
Most questions can wait for the next visit. When something cannot - a worrying side effect, a refill, coordination with another clinician - there are clear channels for getting in touch.
Non-urgent clinical messages go through the patient portal. I aim to respond within two business days. Messaging is intended for clarifications, minor side effect questions, and brief updates - not a substitute for a visit when a real conversation is warranted.
Refill requests are handled through the pharmacy or portal. I typically send refills that cover the interval to the next scheduled visit. If you are due for follow-up and a refill request comes in without an appointment on the books, I will ask you to schedule before refilling.
With your consent, I am happy to coordinate directly with your therapist, primary care clinician, or other specialists. This is most useful when a medication decision touches on something they are also managing - for example, an SSRI interaction with another prescription, or a medication change that affects ongoing therapy work.
This practice is not set up for emergency coverage. If you are in crisis or experiencing a mental health emergency, call or text 988 (Suicide and Crisis Lifeline), go to the nearest emergency department, or call 911. The emergency resources page lists additional options in the Puget Sound region.
Ready to book?
Evaluations are scheduled online. If you want to ask a question before booking, the contact page has a way to reach me.