Content warning: This section of the guide references physical assault, implied sexual assault, self-harm, suicide, and euthanasia.

The book opens with a prologue—an excerpt from a Washington Post Magazine article entitled “D.C.’s Maverick Therapist.” The article introduces, thirdhand, the book’s main character: Avery Chambers, the eponymous “maverick therapist” who uses a “highly controversial” process. The excerpt also introduces Avery’s technique: She works with her clients over just 10 sessions, starting with “The Confession” (0).

The book opens with Avery’s point of view, told in the first person. Avery, a therapist, has been contacted by a new client, Marissa Bishop. Avery is meeting with Marissa and Marissa’s husband, Matthew Bishop, for the first time. Marissa and Matthew have one son, Bennett. Avery asks why the couple is seeking therapy. Marissa has something to confess to Matthew, but she’s nervous. When Avery asks if Marissa wants water, Marissa jokingly asks if Avery has something stronger. Avery replies by offering them tequila; they all take a shot. Marissa then goes into “The Confession”: “I slept with someone […]. Just once” (8).

Following Marissa’s confession, Avery observes the couple’s reactions: Matthew is angry, while Marissa seems afraid.