Common Questions

Many of the questions below are ones prospective clients, therapists, readers, and loved ones ask before reaching out. I hope these answers help you better understand my approach and determine whether we're a good fit.

What is Internal Family Systems (IFS)?

Internal Family Systems (IFS) is an evidence-informed psychotherapy model that understands the mind as containing different "parts," each with positive intentions. Rather than trying to eliminate anxiety, perfectionism, people-pleasing, or other protective strategies, IFS helps us understand why they developed and what they are trying to accomplish. As healing occurs, these parts often become less extreme because they no longer need to work so hard to protect us.

What happens during an IFS therapy session?

Every therapist practices a little differently, but IFS therapy is generally collaborative rather than directive. Sessions often involve slowing down, becoming curious about thoughts, emotions, body sensations, and protective patterns, and developing a relationship with the different parts of yourself. The goal isn't to force change but to help your internal system feel understood, allowing lasting healing to emerge naturally.

Is IFS evidence-based?

IFS has a growing body of research supporting its effectiveness for trauma, anxiety, depression, PTSD, chronic pain, and overall well-being. While research continues to expand, many clinicians appreciate IFS because it combines compassion, insight, and experiential work in a way that helps people understand themselves rather than judge themselves.

What is AuDHD?

AuDHD is an informal term used to describe someone who is both autistic and has ADHD. Although autism and ADHD can sometimes seem opposite in their presentation, many people experience both. Together they can influence executive functioning, sensory processing, communication, emotional regulation, attention, and identity in unique ways.

Can adults be diagnosed with autism or ADHD?

Yes. Many adults—especially women and people who learned to mask their differences—receive diagnoses later in life. A diagnosis doesn't change who someone is; it can simply provide a framework for understanding lifelong experiences and help guide more effective supports and self-compassion.

What is the difference between an IFS-informed therapist, an IFS Level 1 therapist, an IFS Certified Therapist, and an IFS Approved Clinical Consultant?

  • IFS-informed therapist – A therapist who incorporates IFS concepts into their work but has not necessarily completed official IFS Institute training. Their background and experience can vary widely.

  • Level 1 therapist – Has completed the foundational IFS Institute training and can begin integrating the model into clinical practice.

  • Level 2 therapist – Has completed additional advanced training in specialized topics or populations, deepening their understanding and application of IFS.

  • Level 3 therapist – Has completed the highest level of core IFS Institute training and continued advanced development in the model.

  • IFS Certified Therapist – Has gone beyond training by completing consultation, submitting recorded sessions for review, and demonstrating competency in using the model.

  • IFS Approved Clinical Consultant – Has completed additional training and evaluation to provide consultation to other therapists pursuing IFS certification.

While these credentials represent different levels of training, they don't automatically determine how effective a therapist will be. Experience, humility, ongoing consultation, the ability to build a strong therapeutic relationship, and the goodness of fit between therapist and client are equally important considerations.

Do you see children or families?

At this time, I primarily work with adults. While I often help parents better understand their children—particularly around ADHD, autism, emotional regulation, and family dynamics—I do not provide ongoing therapy for young children. My focus is helping adults better understand themselves, strengthen relationships, and develop new ways of responding to life's challenges.

Do you offer couples therapy?

While my primary focus is individual therapy, I have training in Gottman Method Couples Therapy and will occasionally incorporate couples work when I believe it is clinically appropriate. Much of my work focuses on helping individuals understand how their own patterns, attachment experiences, and protective strategies influence their relationships.

What therapy approaches do you use?

Internal Family Systems (IFS) is the primary model that guides my work. I am an IFS Approved Clinical Consultant and have found this approach to be deeply compassionate and effective.

That said, I believe no single model has all the answers. I also integrate concepts from attachment theory, interpersonal neurobiology, polyvagal theory, mindfulness, cognitive and behavioral approaches when helpful, Gottman Method principles for relationships, and current research on neurodivergence, trauma, eating disorders, and connective tissue disorders. My goal is to tailor therapy to the individual rather than asking individuals to fit into one therapeutic model.

How long does therapy usually last?

There isn't one answer that fits everyone. Some people seek therapy around a specific challenge and meet for a relatively short period of time. Others choose longer-term therapy to work through trauma, longstanding patterns, relationships, identity, or personal growth.

Rather than setting a predetermined timeline, I regularly collaborate with clients to discuss their goals, progress, and what feels most helpful. Therapy should move at a pace that feels both meaningful and sustainable.

How do I know if I have a good therapist?

Research consistently shows that one of the strongest predictors of successful therapy is the relationship between therapist and client.

A good therapist should help you feel emotionally safe enough to be honest, while also gently challenging you when needed. You should feel respected, listened to, and understood—even when discussing difficult topics.

No therapist is the right fit for everyone. It is okay to ask questions, seek consultation, or even change therapists if you feel your needs aren't being met. Finding someone whose approach aligns with your personality, goals, and values can make a tremendous difference in the therapy process.

How do I know if a therapist is experienced?

Credentials and training matter, but they don't tell the whole story. Consider asking about a therapist's areas of specialization, years of experience, continuing education, consultation, supervision, and the populations they work with most often.

For example, in Internal Family Systems (IFS), therapists may complete Level 1, Level 2, and Level 3 trainings, pursue IFS Certification, or become Approved Clinical Consultants. These represent different stages of training and professional development, but they don't automatically determine how effective someone will be. Clinical experience, ongoing learning, humility, and the quality of the therapeutic relationship are just as important.

Are you LGBTQIA+ affirming?

Yes. I strive to create a therapeutic environment where people of all sexual orientations, gender identities, and gender expressions feel respected, understood, and safe. My goal is not to tell people who they should be, but to help them better understand themselves, explore their experiences with curiosity and compassion, and make choices that align with their own values and goals.

Is your practice ADA accessible?

Because my practice is entirely virtual, many clients find telehealth to be an accessible option. If you need accommodations related to hearing, communication, technology, or another disability, I encourage you to let me know. I will do my best to work with you to provide reasonable accommodations that support your participation in therapy.

Do you work with people in non-traditional relationships, including polyamorous or consensually non-monogamous relationships?

Yes. I work with individuals and couples from a variety of relationship structures, including consensually non-monogamous and polyamorous relationships. My role is not to promote or discourage any particular relationship style, but to help clients explore their relationships in a way that is honest, healthy, and aligned with their own values. As with all therapy, our work is grounded in curiosity, respect, and compassion rather than judgment.

Absolutely. I actually think this page could become one of the most valuable on your website because it sounds like you while answering real questions people have. Below are answers written in your voice—warm, educational, and not overly salesy.

What happens during the first therapy session?

The first session is an opportunity for us to get to know one another. I'll ask about what brings you to therapy, your goals, your history, and what you've already tried. More importantly, I want to understand you as a person, not just a collection of symptoms or diagnoses.

There is no expectation that you share everything in the first session. We move at a pace that feels comfortable and collaborative, while also beginning to explore whether we're a good fit to work together.

How often do clients usually meet?

Most clients begin with weekly sessions. Meeting consistently allows us to build momentum, develop trust, and better understand patterns as they arise in everyday life.

As therapy progresses, some clients choose to meet every other week or less frequently depending on their goals, progress, and circumstances. Together we'll regularly discuss what schedule feels most helpful.

What if I've never been to therapy before?

Many people feel nervous about starting therapy, especially if they aren't sure what to expect. That's completely normal.

You don't need to know the "right" words or have everything figured out before coming to therapy. My role is to help guide the conversation with curiosity and compassion. We work together to make sense of your experiences, one step at a time.

What if I'm not sure therapy is right for me?

It's okay to be unsure. Many people reach out because they know something isn't working but aren't certain therapy is the answer.

Our first few sessions can help determine whether therapy feels like a good fit and whether my approach aligns with what you're looking for. My goal isn't to convince someone to stay in therapy—it's to help them find what is genuinely most helpful.

How do I know if we're a good fit?

Finding the right therapist is important. Beyond credentials and experience, it's helpful to ask yourself questions like:

  • Do I feel respected?

  • Do I feel heard and understood?

  • Do I feel emotionally safe?

  • Does this therapist's approach make sense to me?

  • Can I imagine building trust with this person over time?

Therapy works best when there is a strong therapeutic relationship. It's okay to meet with more than one therapist before deciding who feels like the best fit.

When is it time to find a different therapist?

Not every therapist is the right fit for every person, and that's okay.

If you consistently feel misunderstood, judged, dismissed, or unable to talk openly despite discussing those concerns together, it may be worth considering whether another therapist would be a better fit.

Sometimes growth feels uncomfortable—that's different from feeling unsafe or chronically unheard. A good therapist welcomes conversations about how therapy is going and wants clients to receive the care that best meets their needs.

Do you only offer virtual therapy?

Yes. My practice is entirely virtual.

Many clients appreciate the flexibility of telehealth because it eliminates travel time and allows them to attend therapy from the comfort of their own space. Research has shown that telehealth can be just as effective as in-person therapy for many concerns.

Do you provide superbills for insurance reimbursement?

Yes. While I am a private-pay practice and am not directly contracted with insurance companies, I can provide a superbill that clients may submit to their insurance for possible out-of-network reimbursement.

Because every insurance plan is different, I encourage clients to contact their insurance provider to understand their specific benefits.

Do you work with clients outside California and Michigan?

I provide therapy to clients located in California and Michigan, where I am licensed.

Therapists are generally required to be licensed in the state where the client is physically located during the session. If you're outside those states and interested in working together, consultation may be an option depending on your circumstances.

Do you offer consultation for therapists?

Yes. I offer consultation to therapists interested in Internal Family Systems (IFS), case conceptualization, working with neurodivergence, eating disorders, therapist development, and challenging clinical presentations.

As an IFS Approved Clinical Consultant, consultation hours may also be applied toward IFS Institute certification requirements.

Do I need an ADHD or autism diagnosis to work with you?

No.

Some clients have formal diagnoses, while others simply recognize themselves in descriptions of ADHD, autism, or neurodivergence and want to better understand their experiences.

Therapy isn't about fitting neatly into a diagnosis. It's about understanding how your mind works, reducing shame, and finding approaches that help you thrive.

Can ADHD and autism occur together?

Yes. It was once believed that someone could have either ADHD or autism, but not both. We now know that many individuals meet criteria for both conditions.

This combination, sometimes referred to as AuDHD, can create unique experiences related to executive functioning, sensory processing, emotional regulation, attention, communication, and identity.

What is masking?

Masking refers to the conscious or unconscious effort to hide or compensate for traits that might be perceived as different by others.

Many autistic and ADHD individuals spend years trying to fit in by copying social behaviors, suppressing natural responses, or working extraordinarily hard to appear as though everything is easy. While masking can help someone navigate certain environments, it can also be exhausting and contribute to burnout, anxiety, and a diminished sense of self.

Do you work with neurodivergent professionals?

Yes.

Many of my clients are professionals, business owners, healthcare providers, therapists, executives, educators, and other high-achieving individuals who have spent years succeeding outwardly while quietly struggling internally.

Success doesn't eliminate the challenges of ADHD, autism, trauma, or emotional overwhelm. Therapy can provide a space to better understand these experiences while building a life that feels more sustainable and authentic.

I genuinely think this page could become one of the reasons people choose you. It reflects your expertise without sounding like marketing, and it naturally reinforces themes that already run through your website, book, and social media: curiosity, compassion, neurodivergence, and helping people feel understood. Over time, you can keep adding to it whenever you notice a question coming up repeatedly.

Absolutely. I actually think this page could become one of the most valuable on your website because it sounds like you while answering real questions people have. Below are answers written in your voice—warm, educational, and not overly salesy.

What happens during the first therapy session?

The first session is an opportunity for us to get to know one another. I'll ask about what brings you to therapy, your goals, your history, and what you've already tried. More importantly, I want to understand you as a person, not just a collection of symptoms or diagnoses.

There is no expectation that you share everything in the first session. We move at a pace that feels comfortable and collaborative, while also beginning to explore whether we're a good fit to work together.

How often do clients usually meet?

Most clients begin with weekly sessions. Meeting consistently allows us to build momentum, develop trust, and better understand patterns as they arise in everyday life.

As therapy progresses, some clients choose to meet every other week or less frequently depending on their goals, progress, and circumstances. Together we'll regularly discuss what schedule feels most helpful.

What if I've never been to therapy before?

Many people feel nervous about starting therapy, especially if they aren't sure what to expect. That's completely normal.

You don't need to know the "right" words or have everything figured out before coming to therapy. My role is to help guide the conversation with curiosity and compassion. We work together to make sense of your experiences, one step at a time.

What if I'm not sure therapy is right for me?

It's okay to be unsure. Many people reach out because they know something isn't working but aren't certain therapy is the answer.

Our first few sessions can help determine whether therapy feels like a good fit and whether my approach aligns with what you're looking for. My goal isn't to convince someone to stay in therapy—it's to help them find what is genuinely most helpful.

How do I know if we're a good fit?

Finding the right therapist is important. Beyond credentials and experience, it's helpful to ask yourself questions like:

  • Do I feel respected?

  • Do I feel heard and understood?

  • Do I feel emotionally safe?

  • Does this therapist's approach make sense to me?

  • Can I imagine building trust with this person over time?

Therapy works best when there is a strong therapeutic relationship. It's okay to meet with more than one therapist before deciding who feels like the best fit.

When is it time to find a different therapist?

Not every therapist is the right fit for every person, and that's okay.

If you consistently feel misunderstood, judged, dismissed, or unable to talk openly despite discussing those concerns together, it may be worth considering whether another therapist would be a better fit.

Sometimes growth feels uncomfortable—that's different from feeling unsafe or chronically unheard. A good therapist welcomes conversations about how therapy is going and wants clients to receive the care that best meets their needs.

Do you only offer virtual therapy?

Yes. My practice is entirely virtual.

Many clients appreciate the flexibility of telehealth because it eliminates travel time and allows them to attend therapy from the comfort of their own space. Research has shown that telehealth can be just as effective as in-person therapy for many concerns.

Do you provide superbills for insurance reimbursement?

Yes. While I am a private-pay practice and am not directly contracted with insurance companies, I can provide a superbill that clients may submit to their insurance for possible out-of-network reimbursement.

Because every insurance plan is different, I encourage clients to contact their insurance provider to understand their specific benefits.

Do you work with clients outside California and Michigan?

I provide therapy to clients located in California and Michigan, where I am licensed.

Therapists are generally required to be licensed in the state where the client is physically located during the session. If you're outside those states and interested in working together, consultation may be an option depending on your circumstances.

Do you offer consultation for therapists?

Yes. I offer consultation to therapists interested in Internal Family Systems (IFS), case conceptualization, working with neurodivergence, eating disorders, therapist development, and challenging clinical presentations.

As an IFS Approved Clinical Consultant, consultation hours may also be applied toward IFS Institute certification requirements.

Do I need an ADHD or autism diagnosis to work with you?

No.

Some clients have formal diagnoses, while others simply recognize themselves in descriptions of ADHD, autism, or neurodivergence and want to better understand their experiences.

Therapy isn't about fitting neatly into a diagnosis. It's about understanding how your mind works, reducing shame, and finding approaches that help you thrive.

Can ADHD and autism occur together?

Yes. It was once believed that someone could have either ADHD or autism, but not both. We now know that many individuals meet criteria for both conditions.

This combination, sometimes referred to as AuDHD, can create unique experiences related to executive functioning, sensory processing, emotional regulation, attention, communication, and identity.

What is masking?

Masking refers to the conscious or unconscious effort to hide or compensate for traits that might be perceived as different by others.

Many autistic and ADHD individuals spend years trying to fit in by copying social behaviors, suppressing natural responses, or working extraordinarily hard to appear as though everything is easy. While masking can help someone navigate certain environments, it can also be exhausting and contribute to burnout, anxiety, and a diminished sense of self.

Do you work with neurodivergent professionals?

Yes.

Many of my clients are professionals, business owners, healthcare providers, therapists, executives, educators, and other high-achieving individuals who have spent years succeeding outwardly while quietly struggling internally.

Success doesn't eliminate the challenges of ADHD, autism, trauma, or emotional overwhelm. Therapy can provide a space to better understand these experiences while building a life that feels more sustainable and authentic.

I genuinely think this page could become one of the reasons people choose you. It reflects your expertise without sounding like marketing, and it naturally reinforces themes that already run through your website, book, and social media: curiosity, compassion, neurodivergence, and helping people feel understood. Over time, you can keep adding to it whenever you notice a question coming up repeatedly.

About Lisa Giles, LMFT

Lisa Giles is a licensed marriage and family therapist, IFS Approved Clinical Consultant, and author of MISUNDERSTOOD. She provides virtual therapy in California and Michigan, specializing in neurodivergence, trauma, eating disorders, relationships, and Internal Family Systems (IFS).