What to expect

What actually happens when you reach out.

The moment before you send a first email is usually harder than anything that happens after it. This page walks through the whole arc — from the initial call to the last session — so nothing is a mystery.

Step one — the 15-minute consultation.

You send a note through the contact form or an email, and John gets back to you himself, usually within a business day. The consultation is a 15-minute phone or video call — no cost, no forms up front. You'll say a bit about what's going on at home, what you've already tried, and what you'd like to be different. John will tell you honestly whether he's the right fit, roughly how he'd approach it, and what the next step would look like. If he isn't the right fit — because of specialty, insurance, or timing — he'll say so and point you toward someone who is.

Step two — the intake session.

If it's a fit and you want to move forward, the next step is the intake session. John budgets 90 minutes for it. This is a real appointment on the schedule, in the Siler City office or by telehealth, and it's the point where the clinical work starts. You'll get intake paperwork by secure email a few days beforehand — history, consents, and a Good Faith Estimate for anyone paying out of pocket. In session, John maps what's actually going on: the household, the timeline, what has been tried, what's underneath, and where the leverage is. By the end you'll have a general shape of a plan — not a script, but a direction.

The first few weeks.

Most families come weekly for the first stretch, in standard 50-minute sessions. That's because the work at the beginning has momentum — you're changing a pattern that has been running for a long time, and short gaps between sessions help the change stick. Each week we look at what happened in the last one, adjust one or two things, and you go back and try it. Progress is rarely a straight line. Some weeks the household calms; some weeks it flares before it settles. John will be direct about which one is happening and about whether we're actually moving.

How often you come.

Weekly for the opening stretch, usually four to eight sessions. From there many families move to every other week, and eventually to a check-in every few weeks as things become durable. Some cases stay weekly for longer — trauma work, active crisis in the household, or a period where a lot is changing at once. You are never locked into a frequency. What we're actually doing is titrating the intensity to what the work needs right now.

How you know it's working.

You won't feel dramatically different after two sessions. What you should start noticing in the first month is small things: a slightly longer gap between the trigger and your reaction; a bedtime that runs twenty minutes shorter; a conversation with your teen that didn't blow up. Real, durable change tends to show up around month two or three, and it looks less like a breakthrough and more like a Tuesday that wasn't as bad as Tuesdays used to be. If we're two months in and the ordinary week hasn't shifted at all, that's a conversation — not to blame anyone, but to figure out whether the plan needs to change or whether a different clinician or format would help more.

How endings work.

Therapy has an ending, on purpose. When the reason you came in is no longer the loudest thing in your week, we start talking about what wrapping up looks like — often spacing out to every three or four weeks, then landing on a final session where we name what changed, what you'll do if it starts to slip, and how to get back in touch if you need to. Nobody is dropped, and nobody is pushed to stay longer than the work needs. If something new comes up months or years later, you can come back.

Ready to take the first step? Request a free 15-minute consultation. Still have questions? See the FAQ or fees and insurance.