James Fitzgerald Therapy PLLC

This session format and agenda overview and outline is one we will follow after we have completed the consultation, intake sessions, and treatment planning sessions. It might take up to 3 sessions to determine if we are a good therapeutic fit, build rapport, and develop trust. The intake process may require 2 to 3 sessions. The treatment planning process may require 2 to 3 sessions.

If you have decided to work with me in therapy, you will be asked to meet with me on an agreed to frequency. You will be required to review and sign your treatment plan, you may also give me verbal permission to initiate treatment based on the program, and your continuation in therapy implies your verbal agreement. I offer this as an alternative if you are someone who gets overwhelmed easily with paperwork. I aim to make the process of staying compliant as stress free as possible.

I typically start out meeting with new clients at least once per week. My therapy program and universal treatment plan is not designed to be a short-term therapy, you might be involved in therapy for up to 12 months or longer. The length of time depends on your motivation to change, discipline to maintain the scheduled sessions, and your commitment to this process. I will ask you to practice new skills, write in a journal, and complete lessons in between session. I will ask you to watch videos, listen to podcasts, read books and articles, review handouts, and complete worksheets. You will be responsible for arriving at sessions prepared and ready to participate in sessions. I recommend that you keep a journal for reflection, and writing ideas or items you wish to discuss in therapy sessions.

We will adhere to the therapy program and universal treatment plan. We will complete evidence-based assessment tests, questionnaires, and surveys. We will follow SAMHSA guidelines for your health and wellness dimensions. I will respect ethical guidelines, and use evidence-based measurement tools to assess progress in therapy. The process of therapy and the therapeutic relationship should be based on mutual respect, consideration, empowerment, agency, autonomy, fidelity, responsibility, and cooperation.

I will hold fidelity to the individual models of therapy within an eclectic, integrated approach to therapy in our sessions, as much as possible. I will continue to assess for changes in your core beliefs, expectations, perceptions, thoughts, emotions, feelings, personality traits, and undesirable behaviors. I will continuously assess for achievement of therapy goals, and completion of the agreed upon objectives and interventions. I will follow up with you on the in between session work and skills practice. I may on rare occasions, discuss your progress in therapy with my consultation team in clinical meetings, without using any of your identifying information. I will keep accurate records of your progress, including in between session work status, and progress toward goal achievement.

Because many of my approaches have CBT in their foundation, every session will proceed the way a Cognitive Behavioral Therapy session is held. The times are an estimate, and allow for 60 minutes. However, the format is dynamic and fluid, allowing for more time processing, or more time with content, depending on your needs that day.

• Check-In: We will have a brief check in; I will ask about your current mood and physical health, any recent events or experiences you would like to discuss and process (10 minutes)
• Follow up: I will follow up from last session. We will review the in between session assignments. We may process assignment ambivalence, avoidance, skepticism, questions, comments, concerns, and begin analyzing the assignment. (10 minutes)
• Content: We may work on the objectives and interventions from your treatment plan, to move you toward your goals. We may complete assessment outcome measures to assess your progress in therapy (moving toward achieving your goals). I may share resources, or teach psychoeducation. We will engage in discussion. We may engage in some creative solution focused problem-solving or conscious decision-making. I will assist you with setting smart goals, that are future oriented and goal directed. (10 minutes)
• Processing: I may offer my reflection, insight, wisdom, and knowledge. I will share personal reflections and anecdotes, only when it benefits you and your progress. We may discuss billing, claims, payments, and account balances. We may engage in a review of your treatment plan and progress, and make changes as necessary. (10 minutes)
• Check-Out: We will conclude with a brief check out and a brief session evaluation. We will plan next steps. (5 minutes)
• Homework: I may assign masterclasses, videos, lessons, readings, mindfulness, meditation, and skills practice for in between sessions. (5 minutes)
• Schedule: We will schedule the next session, discussing frequency and convenience around our schedules. (5 minutes)

Please Note!

I would like to remain transparent and open at all times for my clients. So, I would like to share some of my technology policies and procedures with you. I am required to keep accurate records of our sessions (licensing regulations and insurance policies), that detail your presenting problems, toward a diagnosis, in therapy that is evidence-based, that meets medical necessity, with interventions tailored to your problems and diagnosis, and tracks your progress with measurable goals and objectives. This concept is called “The Golden Thread.”

Therefore, I have made the decision to use software driven by artificial intelligence (language learning models) to transcribe and dictate my sessions into documentation that meets the guidelines and rigorous standards of licensing regulations and insurance policies. This has benefits for both of us that cannot be measured but are apparent in the sessions.

In order to use this software, I must obtain your written informed consent, and your verbal consent before every session. The in-person sessions are recorded, processed in the software, and then the recording is deleted. Telehealth sessions currently cannot be recorded, however, Vermont state lawmakers are working on a resolution to allow it in this year’s legislative session. I am able to transcribe telehealth sessions with the software after the session with your consent. My electronic records system and client management software also has artificial intelligence features that allow me to write articulate and compliant documentation with just the details of a session.