Most men who call me have carried their secret for years. By the time they book a first session, they’ve usually rehearsed the conversation many times, and in most of those rehearsals it goes badly. They picture being judged, lectured or labeled.
That isn’t what a first session with a trained specialist looks like. Here’s what actually happens, so the hardest part, starting, gets a little easier. For clients in New York, these sessions are therapy. For clients elsewhere, my work is coaching and consultation.
What happens before the first session?
It starts with a short, free phone consultation. You describe what’s going on in your own words, ask how I work, and we decide together whether working with me is a good fit. Nothing is decided for you on that call, and you can share as much or as little as you like.
You can book that call online and phone me at the time you choose, or call or text me directly. If we agree to go ahead, I send you a video link for the first session. A phone, tablet or computer with a camera is all you need.
What happens in the first session?
The first session is about getting the full picture. I want to understand what brings you in now, what’s been happening, what it has cost you, and what you want to change. You’ll have room to ask your own questions too. By the end, we agree on what to work on first and how often to meet.
It’s a conversation, not an interrogation. Many men are surprised by how practical it feels. We talk about what’s been happening, and also about your work, your relationship, your health and what a good outcome would look like for you.
Most men leave with one or two concrete steps for the coming week. Recovery starts with action, not only insight.
What questions will a sex addiction therapist ask me?
Expect questions about the behavior itself, how long it has been going on, what you’ve tried, and what it has cost you. A good specialist will also ask about your relationship, your health, other habits such as drinking, your mood and your history, at a pace you can manage.
Typical areas I cover early on:
- What made you reach out now, and what happened recently
- Which behaviors you want to stop, and which ones you’re unsure about
- When it started and how it has changed over time
- What you’ve already tried, such as filters, promises, meetings or other counseling
- What it has cost you: time, money, sleep, work, health, your relationship
- Whether your partner knows, and how much
- Alcohol, drugs, gambling or other compulsive habits
- Your mood, sleep and stress
- Your family and personal history, when you’re ready
CSAT training includes structured screening tools for compulsive sexual behavior. There’s no written questionnaire in the first session, but afterward I usually ask clients to complete a detailed written intake. It helps us see the pattern clearly. It isn’t a label. You can read more about the credential in What is a CSAT?
Do I have to share every detail right away?
No. You don’t have to tell your whole story in the first hour, and graphic detail is rarely useful at the start. What helps most is honesty about the overall scope: the kinds of behavior, roughly how often, and what’s at stake. The details can come over time, as trust builds.
Some men test the water by describing only the “smaller” behavior first. That’s understandable, but it slows things down. If something feels too hard to say, tell me there’s more and you’re not ready yet. That’s honest, and it lets us plan around it.
Is it confidential, and are online sessions private?
Yes. What you share is confidential, within the legal limits that apply to every licensed clinician, and I explain those limits at the start. Online sessions add privacy of their own: no waiting room, and nobody sees you walk into an office. You do need a private room where you won’t be overheard.
A few practical tips for online privacy:
- Use a personal device, not a work laptop or work network.
- Use headphones, and choose a room with a door, or a parked car.
- Keep first messages by text or email brief, and save details for the session.
I don’t bill insurance, so no claim is filed on your behalf. More on fees, privacy and scheduling is in practical questions.
Should my partner come to the first session?
Often, yes, though it isn’t required. Many partners come to the first session, and starting one to one is fine too. If your partner has discovered something, they deserve their own support, separate from yours, from someone who is there for them. Couples work often comes later, once both of you have that support in place.
If your partner is struggling right now, ask me about support for partners on the consultation call. Many partners find it a relief to have a place that’s only theirs.
What happens after the first session?
After the first session, we agree on goals and a rhythm. Everyone meets at least weekly for the first year, many twice a week. Early work focuses on practical steps to stop the behavior and steady your life. Deeper work on what drives it comes next. If that isn’t enough, we can discuss a more concentrated option.
The early weeks often include writing down your bottom lines, changing the setup on your phone and computer, building a short list of people you can call, and, where it fits, starting a support group.
If your situation is urgent, for example after a discovery or an ultimatum, we may talk about an intensive program as a focused start. You can read more about individual sessions and how I work.
How do I know if a therapist is the right fit?
You should feel that the therapist understands this problem, isn’t shocked or judging you, and is clear about the plan. Ask direct questions about their training and experience. A good fit usually feels like relief mixed with discomfort: you’re finally being straight with someone who knows what to do.
Ask how long they’ve worked with sex and porn addiction, how they involve partners, and what happens if you slip. A good specialist will answer plainly.
Common questions
How long is a session?
Weekly sessions are about 50 minutes. The first session follows the same format, and we use it to get the full picture.
Do I need to be sure I’m a sex addict before I book?
No. Many men come in unsure. Part of the early work is looking honestly at what’s happening and what it’s costing you, without rushing to a label.
What if I feel too ashamed to talk?
Almost everyone feels that way at first. I’ve spent many years having these conversations. You can start with “this is hard to say,” and we’ll go from there.
Can I have sessions early in the morning or on weekends?
Yes. Sessions are scheduled in New York time, and early morning and weekend hours are available.
Take the first step
If you’ve been putting this off, a short phone call is a small first step. I offer a free, confidential 15-minute consultation. Tell me what’s going on, ask anything about how I work, and decide afterward. There’s no pressure to commit to anything.
If you’re in danger or thinking about harming yourself, call 911, or call or text 988 in the US. Outside the US, call your local emergency number or find a helpline at findahelpline.com.