Getting Started at Alafiora
A complete walkthrough of what beginning care at Alafiora actually involves: the pages worth reading first, the consultation, the intake session, ongoing treatment, and eventually how care ends. Every practical question a prospective client or their support network might carry into a first conversation is addressed directly, in one place, before that conversation ever needs to happen.
Deciding to look into care is already a meaningful step, and reading a page this thorough, even before reaching out, is part of that step. This page exists so that nothing about beginning care at Alafiora ever arrives as a surprise later: what to read first, what a consultation actually involves, what happens at the first session, what ongoing care tends to look like, and what happens when care eventually ends. Knowing the full shape of something in advance is part of how trust gets built, often well before a single session takes place.
Referral partners and organizations: this page is written for prospective clients. Referral sources and partner organizations submitting a referral, or exploring a partnership with Alafiora, are welcome to write to partnership@alafiora.com directly.
Alafiora
- Before Reaching Out: The Pages Worth Reading First
- What Happens Next: Two Ways to Begin
- Discretion in Scheduling and Correspondence
- Traveling Frequently or Living Between States
- Executive Assistants and Third-Party Scheduling
- Prospective Clients Who Are Sixteen or Seventeen
- After the Consultation: What Comes Next Depending on Fit
- Booking the Intake Session: What Happens the Moment It Is Scheduled
- Before the Intake: Paperwork and Screeners
- The Intake Session Itself: A Full Biopsychosocial Assessment
- What Ongoing Care Looks Like
- When and Why Care Ends: Alafiora's Approach to Termination
- Privacy, Reviews, and What Alafiora Will Never Ask a Client to Do
- Frequently Asked Questions About Getting Started at Alafiora
No section by that word. The menu holds the complete site.
Before Reaching Out: The Pages Worth Reading First
What to Read Before a Consultation or Intake at Alafiora
A Working Checklist, Not a Requirement
Nothing below is required reading, and no button on this page is ever locked or hidden based on whether these pages have been read first. The consultation and the first session both go further, and feel less like an introduction and more like real progress, when a prospective client already carries a working sense of who Dr. Esther Lapite-Garrett is, how the practice runs, and what it costs. The checklist below exists so that time in the consultation or the intake session can be spent on the client's actual life. This page and its linked pages already answer the practical questions.
None read yet, and nothing here is required.
All nine read. That is a thorough way to arrive, and the consultation or first session can now be spent entirely on your own life rather than on logistics.
Progress is remembered by this browser alone. Nothing is sent anywhere, no account is needed, and no page, button, or link on this site is ever locked behind it.
There is no version of reading these pages that commits anyone to anything. They exist so that a decision, whenever it gets made, gets made with full information already in hand.
Everything Else Worth Knowing
Nothing here needs to be read in order, and none of it requires a decision.
What Happens Next: Two Ways to Begin
Consultation or First Session, Both Legitimate Starting Points
How to Begin Therapy at Alafiora: Consultation or First Session
Once the pages above have been read, or even before then if the timing already feels right, there are two ways to move forward, and neither one is the correct choice over the other. Some prospective clients want to talk first. Others already know this is the right fit and are ready to begin.
The Consultation
What a Complimentary Introductory Conversation With Dr. Esther Lapite-Garrett Actually Involves
At this time, the initial consultation with Dr. Lapite-Garrett is offered at no cost. This is subject to change at Dr. Lapite-Garrett's discretion, and this page will always reflect the current policy at the time it is read.
A consultation is a brief, direct conversation, structured specifically to answer questions and to determine fit, in both directions. It is a space where a prospective client can ask anything on their mind: Dr. Lapite-Garrett's approach, her experience with a specific concern, how sessions are structured, or anything else that would make the decision to begin feel more informed. It is equally a space where Dr. Lapite-Garrett asks her own questions, gently and directly, to understand what is being brought into care and whether Alafiora is genuinely positioned to help with it.
Scheduling or completing a consultation creates no commitment. It does not commit anyone to choosing Alafiora, and it does not commit Dr. Lapite-Garrett to accepting every prospective client either. If it becomes clear after the conversation that another provider would be a better fit, whether because of specialty, location, level of care needed, or simple personal fit, Dr. Lapite-Garrett will say so directly and will help identify the kind of provider that would serve better, without ever endorsing one specific colleague or practice by name.
A free downloadable resource, for anyone whose questions do not come easily: not everyone walks into a first conversation with a therapist already knowing what to ask. Alafiora has created a free worksheet, Questions to Ask Any Therapist, built to help prospective clients, of Alafiora or of any practice, think through what actually matters to them before that first conversation happens. It includes practical, values-based, and clinical-approach questions, along with a QR code that saves Alafiora's contact information directly to a phone, so the resource can be used now and Alafiora's details kept on hand for later, regardless of which practice is ultimately chosen.
Free, and yours whichever practice you choose. No email address, no sign-up.
Beginning Directly With a First Session
For Those Already Confident and Ready to Start
For prospective clients who already feel confident after reading through the practice's pages, there is no requirement to start with a consultation at all. Clicking directly through to book a first session, the intake, opens Alafiora's secure scheduling page, where an intake slot can be selected right away. Once that appointment is booked, a portal invitation follows automatically, beginning the pre-intake process described further down this page.
Discretion in Scheduling and Correspondence
How Confidentiality Extends Into Booking, Reminders, and Billing
Discreet Scheduling for Privacy-Conscious Clients
Choosing how to begin is one decision. A separate, equally practical one is how that choice shows up on a calendar or in an inbox afterward. For many prospective clients, especially those whose profession, public visibility, or personal circumstances make privacy a genuine and practical concern, how an appointment is booked and confirmed matters as much as what happens once a session begins. Alafiora was built with this in mind, and the level of discretion applied to scheduling and correspondence is calibrated to what each individual client actually wants. There is no single fixed default.
Three levels of discretion are available, and any client can request the level that fits their circumstances:
- Standard confirmation. Appointments booked through Alafiora's practice management system generate a confirmation and reminder that names the appointment type plainly: an initial consultation or an intake with Dr. Lapite-Garrett, for example.
- Discreet calendar labeling. For clients who want more ambiguity in their own calendar or inbox, appointments can be scheduled as a Google Calendar invitation, covered under Alafiora's signed business associate agreement with Google Workspace, labeled generically (an appointment, a meeting) so it reads like any other entry in a busy schedule.
- Fully private scheduling. For clients who want no digital trace of the appointment reaching their own devices, Dr. Lapite-Garrett can maintain the appointment entirely on her own end, with the client tracking the time privately through whatever method they already use, and no confirmation, reminder, or invitation sent at all.
Across every level, one detail stays constant: any correspondence that does reach a client, an invoice, a confirmation, a reminder, always identifies itself as coming from Alafiora. The name itself was chosen with this in mind. Alafiora does not announce, in its name alone, what kind of care it provides. Someone glancing at an invoice or a calendar entry without prior knowledge of the practice would have no way of knowing it relates to psychological care, let alone which specific concerns brought a client there. Discretion is built into the practice's design at the level of its own name. Its policies carry the same discretion.
Traveling Frequently or Living Between States
What Busy Professionals and Executives Should Know Before Booking
Telehealth Across State Lines and Travel Scheduling
Discretion covers how an appointment appears. A related and equally practical concern is whether an appointment can even happen at all, given where a client actually is that week. Telehealth sessions can only take place while a client is physically located in one of Alafiora's licensed states, since psychological licensure is state-specific and care can only be lawfully provided where that license is held. Full detail on the specific states and cities currently served lives on the Where Alafiora Practices page.
For clients whose work or personal life involves frequent travel outside those states, this is worth planning around well ahead of time. In practice, this usually looks like scheduling a session shortly before departure and another shortly after return; a session mid-trip is not possible from a state where care cannot legally be provided. A brief, non-clinical check-in call, focused purely on logistics, is sometimes a useful bridge during longer absences.
Alafiora's cancellation policy requires at least forty-eight hours' notice. Unpredictable travel, a last-minute flight change or an unexpected trip, can create real friction for a busy professional trying to avoid a missed-session fee. This is one of the specific reasons some high-travel clients choose the concierge retainer described on the Rates and Fees page: cancellation fees are waived and built into the retainer structure itself, never assessed session by session.
Executive Assistants and Third-Party Scheduling
Booking on Behalf of a Client
Third-Party and Executive Assistant Scheduling at Alafiora
Travel raises the question of where a session can happen. For some clients, a separate question comes first: who actually handles the booking in the first place. Alafiora recognizes that many clients, particularly executives, public figures, and busy professionals, rely on an assistant or another trusted third party to manage their calendar. This is entirely workable, with one condition: Alafiora's client portal grants access to scheduling, personal identifying information, a client's own health information, and payment details, so a third party cannot simply be given portal login credentials.
Once a client has signed a release of information specifically identifying the third party and defining what they are authorized to handle, scheduling only, scheduling and payment, or broader involvement including treatment updates, that person can coordinate directly with Dr. Lapite-Garrett by email or by sending a calendar invitation. The scope of what an assistant or third party is told is entirely the client's own choice, and it can range from purely logistical (appointment times, nothing more) to more clinically involved, up to and including a collateral session where the assistant is present to understand a treatment plan directly. Whatever level a client chooses, the risks of disclosing protected health information to a third party, even a trusted one, are explained clearly before any release is signed, so that choice is fully informed.
Prospective Clients Who Are Sixteen or Seventeen
What Parents and Teens Can Expect
Therapy for Sixteen- and Seventeen-Year-Olds
Everything above describes how an adult client typically begins. A younger client follows the same basic path, with one addition. Alafiora currently serves individuals sixteen and older. A client who is sixteen or seventeen requires a parent or guardian's co-signature on the intake paperwork before care can begin. Beyond that requirement, a parent or guardian is typically included briefly at two points in the process: during the consultation, to share initial context and answer questions from the parent's perspective, and again for roughly the first ten to fifteen minutes of the intake session itself. Beyond those two points, the client themselves is the primary focus of care. What is and is not shared with a parent depends on the specific state's requirements around minor consent and confidentiality, along with what the client is comfortable disclosing.
All three of this practice's specialty areas, sexual trauma, love addiction and obsessive attachment, and compulsive sexual behavior, apply to prospective clients in this age range. A sixteen- or seventeen-year-old may bring a real version of any of them into care: compulsive sexual behavior that surfaced after school, an obsessive attachment pattern playing out at school, or sexual trauma experienced at home. Care for this age range covers the same three specialty areas as adult care, whether that client is a teen girl or a teen boy. What differs is how that care is paced and explained to fit a sixteen- or seventeen-year-old's developmental stage.
After the Consultation: What Comes Next Depending on Fit
From a Strong Fit to a Referral Elsewhere
What Happens After a Consultation With Dr. Esther Lapite-Garrett
Following a consultation, one of a few things typically happens. If Alafiora appears to be a strong fit, Dr. Lapite-Garrett will say so directly, and next steps toward scheduling an intake are discussed. If it becomes clear during the conversation that another kind of provider or a different specialty would serve better, referral information is offered, gathered specifically around what would help this particular person, without ever naming or endorsing one individual colleague or practice. Either way, a take-home flyer summarizing the practice's key information, already carrying Alafiora's contact details and QR code, is offered as a physical or digital reference to keep.
For clients who feel ready to move forward, whether directly after a consultation or by skipping the consultation entirely, the next step is the same: once an intake session is booked, a portal invitation follows, and the pre-intake process begins.
Booking the Intake Session: What Happens the Moment It Is Scheduled
From a Confirmed Slot to a Portal Invitation
How to Book an Intake Session at Alafiora
Clicking through to book an intake session opens Alafiora's secure scheduling page directly. Every intake session is conducted virtually, regardless of whether ongoing care later shifts to in-person or on-location formats. The moment an intake slot is confirmed, an invitation to Alafiora's secure client portal is sent, granting access to the paperwork and screeners described below.
Before the Intake: Paperwork and Screeners
Why This Step Genuinely Matters
Intake Paperwork and Screening Measures Before the First Session
Once the portal invitation arrives, a full set of intake paperwork becomes available: informed consent, fee and payment agreements, confidentiality and telehealth policies, and the other standard forms every client completes before care begins. Alongside the paperwork, a set of brief screening measures is provided as well: general assessments that give an early, honest picture of where a client currently stands, levels of anxiety, stress, and related concerns, before the first session even begins.
Completing this paperwork and these screeners ahead of time is strongly recommended, though not strictly required beforehand. Both will need to be completed at some point during treatment regardless, and in practice, that usually means during the intake session itself if they have not already been done. The reason this step is worth prioritizing in advance is simple: an intake session spent reading and signing paperwork, or working through baseline screening questions in real time, is an intake session with meaningfully less room for what actually matters, Dr. Lapite-Garrett coming to understand who a client is as a person. Clients who arrive at their intake with paperwork and screeners already complete get considerably more of that session's time and depth directed toward exactly that purpose.
The Intake Session Itself: A Full Biopsychosocial Assessment
Not a Formality, the Real Beginning of Care
What Happens During a Psychotherapy Intake Session
The paperwork and screeners above exist to clear the way for this session specifically. The intake session is where care genuinely begins, built around a full biopsychosocial assessment: a full, conversational process of getting to know a client at a real, foundational level. This typically includes:
- The client's life journey and personal history, told in their own words and at their own pace.
- Trauma history, where relevant, and the specific pain points bringing them into care right now.
- Relevant health conditions and psychological factors that inform how care should be shaped.
- Risk concerns, addressed directly and without alarm: any risk to the client themselves, any risk to others (which Dr. Lapite-Garrett is bound to address consistent with mandated reporting requirements where applicable), and the client's current level of emotional regulation more broadly.
- Protective factors already present in the client's life, whatever those happen to be.
- Spiritual engagement or belief, where relevant to the client's own sense of self and support system.
This is a deliberate, unhurried conversation. It is not a checklist to move through quickly. It is the foundation on which every subsequent session is built, and its depth is part of why paperwork and screeners are best handled beforehand, so this conversation itself gets the time it needs.
A Short Walkthrough of Everything Already Signed
How Every Intake Session Opens
Every intake session opens with a short, structured walkthrough: a brief presentation reviewing every document a client has already signed. This exists because paperwork signed in advance, sometimes days or weeks before a first session, is not always fully remembered or fully understood in the moment it was signed. This walkthrough is a summary. It does not substitute for the full agreements themselves, and every client remains responsible for having actually read what they signed. Its purpose is simply to make sure nothing about the working relationship ahead feels unclear or assumed.
What Ongoing Care Looks Like
Frequency, Flexibility, and a Collaborative Treatment Plan
How Often Therapy Sessions Happen at Alafiora
Toward the end of the intake session, conversation turns to what ongoing care will actually look like: the client's goals, which approaches and techniques are likely to be most useful given those goals, and how often sessions should happen going forward, whether that is once weekly, twice weekly, or another frequency entirely. This becomes a treatment plan, built collaboratively with the client, and it evolves as care continues. A client might be told, for instance, that a particular topic will be the focus of an upcoming session, so they can come prepared for it, and the plan adjusts as goals shift or new priorities emerge.
Every intake session happens virtually, though ongoing sessions do not have to stay that way. In-person and on-location formats are both available for clients who want them, with details on cost and availability covered on the Rates and Fees page.
Clients are given real control over their own schedule through Alafiora's client portal, where sessions can be self-selected around personal availability, adjusted in length depending on what a given week calls for, and set up as a standing weekly appointment for clients who prefer consistency. Homework and between-session assignments are entirely optional and entirely tailored: some clients want them, others do not, and care is shaped around whichever is true for each individual.
Retainer and Fee-for-Service Clients Receive the Same Clinical Care
What Actually Differs Between the Two
The depth and rigor of clinical care at Alafiora does not change based on how a client pays for it. Every client, regardless of payment structure, receives the same level of engagement, the same monthly tracking through brief screening measures to monitor how treatment is progressing, and the same responsiveness from Dr. Lapite-Garrett.
What differs is access and its cost structure. A fee-for-service client pays individually for each session, each consultation, and each additional touchpoint as it occurs, and remains subject to the standard forty-eight-hour cancellation policy. An Executive Concierge Retainer client, by contrast, receives a higher volume of built-in access, additional sessions, consultations, and involvement of collateral professionals or family members, without paying individually each time, and cancellation fees are waived entirely as part of the retainer structure itself. Full detail on what each retainer tier includes lives on the Rates and Fees page.
Between scheduled sessions, brief check-in calls are available for quick, practical matters. Where a between-session need turns out to be more clinical in nature, that conversation moves into an actual scheduled session. Meaningful clinical work always happens within the structure built to hold it properly.
When and Why Care Ends: Alafiora's Approach to Termination
What Prompts a Course of Care to Close, Named Directly
Ending Therapy: Alafiora's Termination Policy
Ongoing care assumes a relationship that continues. Just as much thought goes into how, and why, that relationship eventually closes. Termination, the clinical term for the end of a course of care, is something Alafiora addresses directly and early. It is not left unaddressed until it happens. This practice maintains a deliberately small caseload, and every client accepted into it represents a real, ongoing commitment of Dr. Lapite-Garrett's time and attention. Being direct about how and why care ends is part of respecting that commitment.
Full detail on Alafiora's termination policy lives on the Practice Policies page. In brief, care may end for a number of reasons:
- A client becomes unresponsive. If reasonable attempts to reconnect go unanswered, ethical practice standards require closing an unresponsive client's case. This keeps that client free to seek care elsewhere without being tied to an inactive file.
- A need for a higher level of care than Alafiora provides. If it becomes clear a client needs inpatient treatment, partial hospitalization, or an intensive outpatient program, none of which Alafiora currently offers, care is transitioned to a provider equipped to offer that level of support.
- A determination that Alafiora is not the right specialty fit. If it becomes apparent during care that a client's primary need falls outside Dr. Lapite-Garrett's specialty areas, a referral to a more appropriate provider is made.
- Unresolved unpaid fees. Where a client has outstanding fees and accommodations to resolve them have been attempted without success, care may end, consistent with Alafiora's financial policies. Unresolved balances may be referred to collections, and any fraudulent chargeback is reported as such.
- A genuine safety concern. Consistent with APA ethical guidelines, care ends immediately if a client's words or actions indicate an actual threat of harm toward someone else, whether Dr. Lapite-Garrett, a member of her family, or another person, distinct from the anger or distress that can appropriately surface in session. This protects both the client's access to appropriate care elsewhere and this practice's ability to continue safely serving others.
- Meeting treatment goals. Just as often, termination is a good outcome: symptoms have resolved to a non-clinical level, life circumstances have shifted, or a client simply feels ready to continue without ongoing sessions, a genuine milestone rather than a loss.
Ending Care in a Way That Honors the Work
Client's Own Language and a Personalized Close
Alafiora does not insist on clinical language for something this personal. Some clients prefer the word termination. Others call it the end of care. Others prefer something softer, like a temporary goodbye. Whatever language resonates with a given client is the language used with them. In the same spirit, the final session itself is shaped around what feels honoring to that specific client, whether that is a straightforward summary of the work and its most meaningful moments, or something more personal and creative, built around however that client likes to mark an ending.
After Care Ends: Closing the Caseload and the Standing Invitation to Return
Once care ends, Dr. Lapite-Garrett typically closes a client's caseload within about a week, completing any final requested item first, whether that is a treatment summary, a final review of homework or progress, or anything else a client specifically asks for before the file is closed.
Closing a caseload is not the same as closing a door. Alafiora holds firmly to the belief that once a client, always welcome back. A former client can always request a treatment summary, ask about returning to care, or simply reach out again, and when scheduling allows, former clients are given priority over new prospective clients for any opening in the caseload, because the relationship built during a first course of care is one Alafiora values continuing wherever a client wants that.
Privacy, Reviews, and What Alafiora Will Never Ask a Client to Do
No Solicited Testimonials, per APA Ethics Code Standard 5.05
Why This Psychologist Never Asks Clients for Reviews
Alafiora does not ask clients for public testimonials or reviews, in any form, at any point in care. This reflects APA Ethics Code Standard 5.05, which prohibits psychologists from soliciting testimonials from current clients or from anyone whose particular circumstances make them vulnerable to undue influence. A client is always free to share their own experience publicly or privately if they choose to, entirely on their own initiative, but that choice is never solicited, suggested, or expected.
Reading a page this thorough is not the same as being ready to talk about any of it out loud, and it does not need to be. It is common to read a page like this more than once before reaching out. Nothing about arriving here, or even finishing this page, commits anyone to anything beyond whatever the next single step turns out to be.
Begin a Confidential Conversation
Getting started with Alafiora can look like a brief consultation first, held in confidence within the legal and professional limits of confidentiality any licensed psychologist explains before clinical work begins, where questions are welcomed and nothing is assumed. It can just as easily look like moving straight into a first session, for those already certain this is the right fit.
For anyone not ready to reach out today, the specialty page on love obsession and limerence may be a useful next stop, and this page can always be bookmarked, or the QR code in the footer scanned, to keep Alafiora's information close until the timing feels right.
Frequently Asked Questions About Getting Started at Alafiora
Is the initial consultation with Dr. Lapite-Garrett free?
Yes, at this time, the initial consultation is offered at no cost. This is subject to change at Dr. Lapite-Garrett's discretion, and this page will always reflect current policy.
Is a consultation required before booking an intake session?
Not at all. Prospective clients who already feel confident after reading through the practice's pages are welcome to book an intake session directly, with no requirement to speak with Dr. Lapite-Garrett beforehand.
Can someone else, like an assistant, schedule sessions on a client's behalf?
Yes, and this is common among Alafiora's busy professional and executive clients. It requires a signed release of information identifying that person and defining exactly what they are authorized to handle, from scheduling alone to broader involvement in care.
What happens if travel takes a client out of state during ongoing treatment?
Because telehealth sessions can only take place while a client is physically located in one of Alafiora's licensed states, travel outside those states typically means planning sessions shortly before departure and after return, and not attempting a session mid-trip.
Is confidentiality protected even in how appointments are booked and billed?
Yes, and the level of discretion applied is calibrated to what each client wants, from standard scheduling through fully private arrangements with no digital trace at all, with every level still identifying correspondence as coming from Alafiora, never naming the nature of care directly.
What happens during the first session, the intake?
The intake is a full biopsychosocial assessment, a full conversation covering personal history, relevant health and psychological factors, risk concerns, protective factors, and goals for treatment, opening with a short walkthrough of everything already signed.
Is paperwork required before the first session?
Not strictly, though it is strongly recommended. Completing paperwork and screeners in advance through the client portal means more of the intake session itself can be spent getting to know the client. Less of it goes to reviewing documents in real time.
How does treatment actually get scheduled once care begins?
Through Alafiora's client portal, where clients self-select session times, lengths, and frequency, with the option of a standing weekly appointment for those who prefer consistency.
Does Alafiora ever end care with a client?
Yes, for a range of reasons, from meeting treatment goals to needing a higher level of care than Alafiora provides. The full termination policy is covered on the Practice Policies page and summarized on this page as well.
Can a former client come back to Alafiora after care has ended?
Yes, and this is a standing invitation, extended every time: Alafiora holds to the belief that once a client, always welcome back, and returning clients are given priority over new prospective clients when scheduling allows.
Will a client be asked to leave a public review or testimonial?
No, and this is required by professional ethics: consistent with APA Ethics Code Standard 5.05, Alafiora never solicits testimonials or reviews from current clients. Sharing an experience publicly is always a client's own choice, never something requested.
Every session at Alafiora is held by one licensed psychologist
Dr. Esther Lapite-Garrett is the founder and sole practitioner of Alafiora. There are no associates, no rotating providers, and no case handoffs: the person who reads a client's history in the first session is the same person still holding it two years later. She is licensed in New Mexico and Indiana, with additional state licensure underway.
Her training is doctoral-level, which typically extends several years beyond a master's-level license in assessment, diagnosis, and the treatment of complex, overlapping presentations. She keeps a deliberately small caseload so that depth is possible, participates in ongoing peer consultation and clinical training, and maintains her own personal therapy.
Whatever brought someone to this page today is never put on trial here
A consultation is a brief conversation with no obligation attached. Those already certain they are ready are equally welcome to begin directly with a first session.