11/03/2026
Therapists: A client sits down in her first session and says, "I have generalized anxiety disorder. My doctor diagnosed it in March, so I mostly want to know what the plan is." She worries about whether her younger child got off the school bus, whether the roof will last the winter, whether a work email sounded curt, and her husband driving home in the rain. Partway through, she mentions that during the eleven days her mother was in the hospital last winter, she did not worry at all and slept fine.
Many of us leave a session like that and look up the recommended treatment for generalized anxiety disorder. Her doctor gave her the diagnosis after hearing about the worry, as a name for what she reported. From the diagnosis alone, a therapist cannot know why this woman worries the way she does, what keeps the worry going, or what she may be preparing herself for. Two clients with the same diagnosis can need therapy aimed at very different things, so a therapist who learns more techniques for that diagnosis still has to guess which one fits her.
When a client arrives with a diagnosis, what do you find out about her before you decide what the treatment will target?
This week's essay follows her first session: The Client Who Came With a Diagnosis
https://sarahozolshore.substack.com/p/the-client-who-came-with-a-diagnosis
Sarah Ozol Shore, MS
Clinical Educator & Researcher
Free online seminar for clinicians, first Friday of each month, 12:00 pm Eastern: Why Good Interventions Fail: Assessing Regulation in Real Time. Register: https://www.sarahozolshore.com/clinicaltrainingwebinar
