Getting Started
How do I start treatment with Dr. Julian?
Step 1: Free Phone Consultation
Fill out the contact form and I will reply back to you within 1-2 business days to schedule a time for us to talk. On this call, I’ll ask you to share with me a little about what has been going on that led you to seek support. I’ll tell you how I typically approach problems like yours and what treatment might look like, and I’ll answer any questions you have about my approach, my background, logistics, or anything else.
Step 2: Scheduling and Paperwork
Once you decide that you’re ready to move forward, we will schedule a first appointment. In most cases, I am able to schedule a first appointment within 1 week of the consultation call. I will set up your chart in my electronic health record system (Sessions Health), and send you consent forms and questionnaires to gather information about your history and symptoms. You will also receive a “logistics” email directly from me that has information about when your appointment will take place, who should attend the appointment, the Google Meet link where all appointments will take place, the Good Faith Estimate, and information about payment and fees. Your paperwork needs to be completed 24 hours before your first appointment in order to allow me to review it before we meet.
Step 3: The First Appointments
The first appointment is a time for me to gather detailed information about your history, your development, and the symptoms you’re seeking support for. For young children, this is a parent-only session to allow you to speak candidly about your child’s challenges. For older children we may have children join with parents at first, and shift to child-only or parent-only as appropriate. Older teens and young adults typically meet alone with me. As I gather more information, I may send a few additional questionnaires to you to get more detailed information about specific kinds of symptoms.
For younger children, the second appointment is typically a parent-child play observation session. In this session, I ask that you set up the camera in an area of your home where you typically play with your child. I will introduce myself to your child, and let them know that I would like to watch them play, and I will turn my camera off while they play so that I’m not a distraction. Imaginary play, building, art projects, or other kinds of interactive play are typically great choices to allow me to get to know your child and how they interact with you. After about 20 minutes of play, I will give a signal to the parent to help their child clean up, however they typically do so. Once the toys are cleaned up, we will shift to a drawing activity. For this activity, you will be asked to have two pieces of paper and something to draw with (crayons, markers, pencils, or whatever you prefer) on hand. I will give instructions about what I would like you to draw, and I’ll turn off my camera while you complete the task. Once you’re done, I’ll come back on camera and ask your child about the drawings. If your child is able and willing, I often ask them some other questions at this time as well—questions about their family, daycare or school, and different feelings they may have. At the end of this appointment, I always check in with parents to see if the version of their child that I saw today is representative of how they typically are at home, or if anything is atypical that I should be aware of.
Once I have gathered enough information through interviews, questionnaires, and observation, I provide feedback to you about how I am understanding the problem, and what kind of strategies are likely to help. I will also share with you any diagnoses that fit, and any additional services like occupational therapy, speech therapy, or psychiatry (for medication management) that might also help to address the problem.
If you have requested a comprehensive mental health evaluation (available for children ages 0-8), I will share a written report with you that includes all the information I have gathered from interviews, questionnaires, and observations, along with a thorough list of recommendations including therapeutic approaches, parenting strategies, and other services that may be beneficial to them.
From here, we can shift to the treatment phase.
Step 4: Therapy
Once the evaluation phase is complete, we move into the treatment phase. For most clients, once per week treatment is appropriate at the beginning. Some clients choose to stay at once per week throughout the duration of treatment, while others space out to every other week or once per month as their symptoms improve. If once per week treatment is not feasible, please reach out and I will advise you about whether a one-time parent consultation is likely to be helpful in your situation.
The treatment phase can look different depending on what problems are being addressed. For many young children, the core of treatment is parent sessions. In these sessions, we talk through challenges they’ve encountered with their child that week, try to understand what the child might have been thinking and feeling in the situation and what factors contributed to their reaction, and discuss what strategies might work to address the problem. For clients experiencing anxiety or OCD, we might talk about how anxiety works, or practice facing their fears (e.g., practicing being far away from a parent within their home, or touching something that feels contaminated). For other clients, we might talk together about challenging things that are happening in their lives, or how to practice and prepare for something in the future.
Step 5: Payment and Superbills
At the end of your first session, you will get a text message from my payment processor, Ivy Pay. This message will request that you upload your credit card information in order to pay for your session. Your credit card information is stored securely, in a way that does not allow me or anyone else to see your full credit card number. At the end of each future session, I will be able to charge your card without you having to do anything—but you will always get a text message notifying you that your card was charged. At any time, you are able to switch what card is on file within Ivy Pay.
At the beginning of each month, I will send you a superbill for the previous month’s sessions. A superbill is a document that contains my information, the date of service, billing codes, diagnosis codes, and the amount you paid for each session. If you have out-of-network reimbursement available through your insurance, this is the document you would submit to them to get reimbursed. If you choose not to submit the superbill to your insurance, your health information (diagnosis, appointment information, etc.) remains private with you; I do not submit documentation to your insurance company on your behalf. For more information about insurance and billing, including questions to ask your insurance company about potential reimbursement, see HERE.