When you begin attending therapy with me, one of the first things we will do is talk about what prompted you to seek out therapy, or what we will call your presenting problems. Presenting problems are the concerns, challenges, behaviors, or symptoms that led you to seek help. Reviewing this list of common presenting problems, such as anxiety, relationship difficulties, feelings of sadness, or trouble sleeping, can give you a starting point for understanding what you may want to focus on during our work together. Sometimes it’s hard to put these issues into words, or you might feel uncertain about which problems are the most important to address first. By looking at a range of possibilities, you can start to recognize patterns in your own life and more clearly identify what you want to change or improve.

It’s important to know that this process is part of a person-centered approach to therapy. That means I won’t force you into a specific category or push you to accept a label that doesn’t fit. Instead, I’m here to help you explore your experiences, define your own goals, and make sense of your situation in a way that feels authentic to you. The idea behind a person-centered approach is that you are the expert on your own life. My role is to listen, understand, and support you as you clarify what matters most to you and decide what steps to take next.

By starting with your presenting problems and working through them at your own pace, we ensure that therapy respects your unique experiences and values. This process isn’t about fitting you into a treatment plan that already exists; it’s about creating a plan together, one that grows and evolves as you do. Through this approach, you have the freedom to discover not only the issues you’d like to work on but also what well-being and personal growth really look like for you.

In the context of a therapy plan, a presenting problem or set of presenting problems are the reasons someone would seek out therapy, usually consisting of: a biopsychosoclal snapshot, brief medical history, symptoms, behavioral definitions, somatic complaints, functional impairments, and other clinically relevant info.

Therapy is sought out for a variety of reasons, often prompted by symptoms and behaviors that significantly affect an individual’s life and relationships.

Anxiety Symptoms: Excessive worry, restlessness, fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbances. Avoidance of stressful situations, repeated checking or reassurance seeking, withdrawal from social interactions, decreased work or school performance. Strain in personal relationships due to dependency or withdrawal, decreased quality of life due to avoidance and fear.

Depressive Symptoms: Persistent sadness, loss of interest in activities, significant weight loss or gain, insomnia or hypersomnia, fatigue, feelings of worthlessness, difficulty thinking or concentrating, recurrent thoughts of death. Social withdrawal, neglect of personal care, reduced productivity, increased substance use. Damaged relationships due to withdrawal or irritability, poor performance at work or school, diminished overall health.

Trauma and Stress-Related Symptoms: Flashbacks, nightmares, severe anxiety, hypervigilance, mood swings. Avoidance of reminders of the trauma, aggressive outbursts, self-destructive behavior. Problems in interpersonal relationships, difficulties in functioning at work, social isolation.

Substance Use Symptoms: Craving substances, withdrawal symptoms when not using, continued use despite health problems. Using more of a substance than intended, spending a lot of time obtaining, using, or recovering from use, neglecting responsibilities. Strain on personal and professional relationships, financial difficulties, legal issues, health decline.

Eating Disorder (such as anorexia, bulimia, binge eating disorder) Symptoms: Preoccupation with weight and body shape, extreme dieting, binging, purging, excessive exercise. Secretive eating patterns, frequent checking in the mirror for perceived flaws, withdrawal from social eating situations. Serious health issues, emotional distress impacting social, occupational, or other important areas.

Personality Disorder Symptoms: Vary widely but can include difficulty with impulse control, emotional instability, distorted thinking patterns, problematic interpersonal relationships. Volatile relationships, manipulative or aggressive behavior, fear of abandonment. Frequent job changes, legal problems, recurrent interpersonal conflict.

Mood Disorder (such as bipolar disorder) Symptoms: Highs (mania) can include inflated self-esteem, decreased need for sleep, more talkative than usual, racing thoughts; lows (depression) include those listed under depressive disorders. Engagement in high-risk behaviors during manic phases, withdrawal and inactivity during depressive phases. Strained relationships, inconsistent job performance, significant emotional distress.