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In an initial consultation, I gather medical and psychiatric histories, noting therapies, medications, and treatments that have and have not worked in the past. Before, questionnaires such as the GAD-7, ACEs, PHQ-9, etcetera are completed to allow me the opportunity to have a better understanding of the presenting context going into the appointment. I explore what the treatment values are and work to develop a collaborative plan of treatment with the greatest likelihood of success. I believe it's best to look at the clinical picture and first take away aggravating factors (i.e., reduce excessive caffeine consumption if struggling with insomnia) and then resort to medications if more help proves necessary.