Building trust is not a warm-up before therapy, it is the therapy. In this conversation, Clinic Director Jessica Katze, LCSW, shares how she sets the tone from the first interaction, the small moves that communicate safety and respect, and the boundary work that keeps treatment effective for everyone.

Starting a therapeutic relationship

How do you set the tone in a first session?

I begin with the basics that matter. I introduce myself, confirm how to say your name, and ask your pronouns. Those small steps signal care and help you see me as a person, not only a title. I offer a quick preview of what today will look like, especially if it is a first visit, so you are not bracing for surprises. These first visits can include uncomfortable or very personal questions. I explain why we ask them and how the rest of therapy will feel different. You have choices from the start. If you are uncomfortable, you can say so, you can answer “yes” without details, and we can slow down and pace the work together.

What if someone is hesitant to come back?

I name it. If I sense hesitation, I will say, “This is voluntary, and you came for a reason. What moved you to make the appointment?” We revisit your goals, talk about what a second session could focus on, and keep it collaborative. If it is not a fit, we talk about that openly rather than letting you ghost the process you worked hard to begin.

Safety, consent, and pacing

How do you handle trauma questions without overwhelming someone?

Trauma work is paced and consent driven. You never owe me the whole story, especially not on day one. Choice builds safety, and safety makes therapy possible. If we touch a hard topic and you need to pause, we pause. You can keep answers brief, take breaks, or decide something is for a future session.

When are referrals or higher levels of care the right move?

We ask why we are considering a change, and whether it is the least restrictive, safest level of care. Sometimes the best help is a step up, for example partial hospitalization, intensive outpatient, or, when safety is at risk, the hospital. People can feel upset in the moment, especially with involuntary safety steps, but after stabilization it often strengthens trust. We acted to keep them safe for the right reasons, not because we were frustrated or punitive.

Reading the room and repairing ruptures

What tells you trust is building, or slipping?

Body language says a lot, even on telehealth. I track facial expressions, how someone shows up on screen, changes in energy or talkativeness, attendance and timeliness, and overall investment. I try not to assume. I will name what I notice and ask. “You are quieter than usual, how are you doing today?” Curiosity beats guessing, and it tells clients I am paying attention.

If something goes off track, how do you repair it?

First, I acknowledge it. Therapists are human. We misread, push too fast, or let judgment get cloudy. I will own my part and check whether you want to keep going together or explore a different provider. I stay steady, caring and neutral, so a tough moment does not become a second injury. I teach this in supervision as well. If you accidentally appear to take sides in a couples session, do not ignore it. Name it, apologize, and let the clients decide how to proceed.

Myths, expectations, and previous therapy

What misconceptions do you see from new and experienced clients?

I often see two clusters. Some people have been in a lot of therapy or higher levels of care and assume “this is how it always goes,” bringing understandable distrust that we need to gently unlearn. Others are brand new and expect a quick fix, three sessions and done. I reframe both. Outpatient therapy is collaborative and voluntary: we set shared goals and change takes practice between sessions. I am your partner, not a fixer. The skills you build should go with you when I am no longer in the room.

Boundaries between sessions

How do you stay available without burning out?

I set expectations on day one. Outpatient therapy is not a crisis service, so I explain how to reach me for scheduling and needs between sessions, and I share crisis resources for urgent safety concerns. I connect you with practical supports by providing referrals and information, while keeping our work focused on therapy. Clear roles help both of us, and they protect the relationship.

Advice for new clients

What should someone bring to their first appointment?

Bring the questions that almost kept you from booking and write them down so nerves do not erase them. Also bring the reasons you did book. If certain values, identities, or beliefs are central for you, say so early. Remember, you are interviewing the therapist too. Give it a fair try, talk openly if it is not a fit, and ask for a change rather than disappearing.

What matters most

What does “rapport is the treatment” mean to you?

I am both human and professional, centered, steady, and fully present. The small things count, learning your name, respecting your pace, noticing what is different today, and partnering rather than prescribing. When clients feel safe, they can heal, connect, and grow. My job is to protect that safety from the first moment, then repair and reinforce it whenever we need to.

Ready to find a therapist? New Directions Mental Health is here to help

If you are considering therapy, you do not need the perfect words or the full story. Take the next small step. Reach out, bring your questions, and we will set the pace together. 

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