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What to Expect During Your First Therapy Session | Kati Morton

COVID-19 has both helped and hurt patients seeking therapy. Virtual therapy has increased accessibility for those who might not have been able to afford it or fit it into their busy schedule. With the pandemic impacting the safety of clients and therapists most therapists were forced to transition into virtual therapy which increased access to fantastic professionals who were previously only available for in-office sessions, says Kelli Rugless, Psy.D., Licensed Clinical Psychologist and founder of Flourish Psychology Co. On the other hand, virtual therapy also has patients struggling with a lack of privacy. A lot of my clients are in closets, bathrooms, basements, outdoors, or in their cars to ensure their privacy. And the other drawback is that technology glitches can interrupt the therapeutic flow, she says. Itll be worth seeing which options your therapist is offering.

Ways To Calm Your Anxiety About A First Therapy Session

I hope you walk away from reading this post with a sense of hopefulness about your first therapy session. That you are empowered by knowing what to expect and how you can prepare and that you are put at ease by having some tips for getting ready to meet with your new therapist. So many clients have told me that after their first session, they feel like a weight has been lifted. Just knowing that they are finally on a path of having professional support makes them feel a little bit better right away. I hope you find the right therapist for you and that you feel this way, too.

For more informative posts about the counseling process, check out my other posts “What is Therapy and How Can It Help Me?”- Part One and Part Two.

Whens The Best Time To Look For A Therapist

“One of the things that people think about when they are looking for counseling is that they must be in mode, and I want you to understand … crisis mode is not necessary for you to seek out counseling. You can seek out counseling when everything is going well,” Alexander says.

She advocates for people to look at therapy as just another part of an overall wellness plan: “Look at counseling to integrate it into your overall health care routine to make sure that you’re a better person overall.”

And realize that, like with most health care professionals, there may be a wait time before you can get that first appointment.

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You Should Ask Your Therapist Questions Too

You have every right to ask your therapist questions about their work or experience. Keep in mind that they may not answer every question, particularly if the questions are personal.

Here are some of the questions you might want to ask your therapist at your first appointment:

  • What kind of experience do you have treating my particular issue?
  • How long have you been working in the field?
  • What kind of certifications or specialties do you have?
  • How long do you expect my treatment to take?
  • How often do you recommend we meet?
  • How do you measure a clients progress?
  • What is your policy for contacting you in-between sessions or during emergencies?
  • What should I do if I disagree with your opinion or approach?

Questions To Ask During The First Therapy Session

What to Expect at Your First Therapy Session

Mental treatment is as crucial as physical treatment. Therefore, one should not shy away from asking any question they have. Some of the most common and essential questions to ask the therapist are:

  • How can the therapist assure patient-doctor confidentiality?
  • How long will the sessions last?
  • How many appointments are expected to address the condition or manage the symptoms?
  • What happens during the sessions?
  • What is the therapists experience with patients with similar conditions?
  • Will the patients beliefs affect the therapy sessions?

Below, well look at some of these points in detail.

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What To Expect In Your First Counseling Session

Youre ready to take the first step to improving your mental health youre making an appointment to talk with a therapist. Now what?

Are there things you should do to prepare for your first session?

How long before you start seeing results?

And what exactly will go on behind that closed door?

If youre a bit anxious about your first therapy session, thats normal. To help put you more at ease, we reached out to one of our therapists to find out what you can expect on day one.

Some people thinking of starting therapy may feel like it will be scary, but its really not, says Lori Murphy, a counselor at Ohio State Total Health & Wellness.

Our job is to remain nonjudgmental, be very supportive, provide a safe environment and try to make you feel more comfortable about sharing uncomfortable things.

Murphy, a licensed independent social worker, counsels individuals, couples and families at the nurse practitioner-led primary care facility at The Ohio State University Hospital.

She outlines what a first visit to her office is like:

First, its not like in the movies

You wont spill your deepest secrets while lying on a couch. Chances are there wont even be a couch in the room. And if theres a conflict or concern deep down inside you, bringing it out will take time.

When preparing for your first session, it can be helpful to think about the primary issues that you hope to address. What thoughts or feelings are most bothersome? How would you like things to be different?

What Will A Therapist Ask Me In My First Session

First sessions focus on broad strokes: what brings you to therapy, your general autobiography, and how the therapist plans to treat you. Expect the therapist to ask about the specific problem that inspired you to seek therapy, what you hope to achieve over the course of treatment, a brief sketch of your life story, and any experience youve had with therapy in the past. He may also discuss his own therapeutic orientation, summarize what you shared, and provide feedback on the issues you shared.

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What To Expect During Your First Therapy Session

If youre new to therapy , its normal to be nervous about your first appointment whether its online or in-person. Heres what to expect, step by step.

Making your first therapy appointment is something to be proud of. It takes a lot of strength and self-awareness to admit that you may need help or that you have challenges to work through. But if youre new to therapy, its understandable if youre a bit nervous. The unknown can be scary.

While every therapist is different, there are a few things you can expect. And thats true whether youre going for a virtual session or an in-person appointment. Getting a feel for how the session may be structured and what youll talk about not only helps curb first-time jitters, it helps you get the most out of your time together.

So heres a breakdown of what to expect during your first therapy appointment.

Your Therapist Will Have Questions For You

What to expect in your first therapy session

Your new psychologist may ask you a variety of questions during your consultation. They will likely want to know:

  • what prompted you to seek treatment
  • your background
  • any past treatment youve sought
  • your goals for therapy

There may be some subjects youre not comfortable discussing yet. If so, its absolutely fine to set boundaries and communicate your limits to your therapist. Boundaries could be critical if youre living with trauma.

Therapy is a safe space and is designed to work for you. You get to set the pace.

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What Should I Expect From The First Therapy Session

The therapist should be well-trained in guiding the session effectively to help you reach your goals. Further, you could also tell them that youre feeling anxious and theyll help you ease it off. Therapists are understanding and non-judgemental. In the first session, they will usually ask you questions such as:

  • What made you seek therapy?
  • What are you struggling with? How are you coping with it?
  • Were there any recent stressful experiences or major changes in your life?
  • What are your current thoughts and feelings?
  • Have you ever been to therapy before? If yes, what was it like? What did you like about it and what did you dislike?
  • Do you have a family history of mental health?
  • Did you notice any recent significant changes in your appetite, sleep or behavior?

The therapist might also start discussing your goals with you as well as the treatment plan. Further, some therapists like to make a therapist-client agreement, where the nature of the treatment is clarified as well as the therapist-client relationship, including the necessary limits. They usually also discuss the recommended frequency of sessions. However, do not expect a diagnosis from the first session as its usually not adequately sufficient for a reliable conclusion to be made.

What Can You Expect For The First Therapy Session

Depending on the issue and the age of your child, the therapist may first want to meet with you alone to get some background information about the issues that your child is facing along with some developmental history. Other times, they may want to meet with you and your child together, or in the case of teens, possibly with your child alone.

Your therapist will greet all of you in the designated waiting area for your appointment. If you are a bit early, you can have a seat and wait until your therapist comes to greet you. Often they will be in a meeting with someone else before hand and will come to find you at your appointment time.

Once you go into the office and have a chance to get seated, there will often be paperwork to complete. The therapist will already have your appointment form containing the basic information, but may want to confirm some additional details. This can help to break the ice.

From here, different therapists will work in different ways. Some may have a structured questionnaire that they will go through with you to do a full assessment of the childs history, your concerns and the reasons that you are seeking therapy. Other therapists prefer to work in a less structured way, opening with some variation of Whats bringing you here? and letting the conversation flow from there.

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How Does Therapy Work

While your therapist may have a comfortable couch or chair for you to sit on in their office, no one is going to ask you to lay down and start talking. Your therapist has been trained to ask specific questions to help you start talking and working through certain events and emotions that may be impacting you on a daily basis.

But there isnt a one-size-fits-all approach to therapy. It takes on many different forms, depending on your needs and a therapists skills and training. A therapists job is to design a personalized plan to help you work through the issues that brought you to their office in the first place. They may accomplish this in many different ways. And, sometimes, a therapist may integrate more than one type of therapy into a patients treatment plan. Common types of therapy can include:

You Dont Have To Be In A Crisis

What to Expect in your First Therapy Session

Unfortunately, many people assume you need to be in crisis mode to reach out for support. But that isnt true. In fact, many therapists recommend seeking support even before you really start struggling. Preventative mental health treatment can give you coping skills to avoid certain symptoms from developing and lower the likelihood of them escalating.

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Is It Okay If I Cry During Therapy

Yes, it is perfectly okay to cry during therapy. Therapists are trained to deal with difficult emotions on a daily basis if you start crying, any competent therapist will respond in an empathetic, non-judgmental way. If you feel embarrassed about crying, its also okay to bring this up with your therapist he can help you explore why crying evokes shameful feelings. On the other end of the spectrum, many clients wish to cry in therapy but feel theyre unable to do so. Exploring this emotional blockage with your therapist, too, can be a productive way to make progress.

What To Expect From Your Therapist

Despite some misconceptions, a therapists job isnt to solve your problems for you.

They arent there to tell you what to do, or to tell the people whove hurt you just how wrong they were.

In fact, most therapists wont bother touching on the rights and wrongs of people in your life. Instead, theyll focus on helping you turn your focus to what you can and cant change ultimately: you, your choices, and your responses to events.

Depending on your reason for starting therapy, most therapists will spend time encouraging you to look inward.

This might mean talking through past trauma and developing strategies to help you cope.

Looking inward might require you to explore any phobias you have, and then work with your therapist to overcome them.

Or you may dive deep into your interpersonal relationships not to examine the faults of others, but to help you better understand your role in making relationships better or setting boundaries in order to protect yourself.

Whatever your case may be, youll find that therapists can be great sounding boards and provide excellent resources when needed. But their main goal is to help you learn how to better help yourself.

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They Might Ask For Insurance Or Financial Information

Its a good idea to have your health insurance information handy for the intake session. Your insurance information will help your therapist give you the most accurate information about coverage and costs.

If your therapist offers sliding scale options, they may also ask you for financial information so that they can determine your fee.

Your time is valuable and so is your therapists. Youll want to understand your therapists cancellation policy, late fees, and billing practices.

Remember Its Okay To Not Like The Therapist

How to Prepare for Your First Therapy Session

Its best to go through a few sessions with a therapist before deciding if youre going to continue seeing them but if its not working out, theres nothing wrong with that.

Therapy is a deeply personal experience, and you deserve someone with whom you can be comfortable and get along. Its a two-way street, so both you and your therapist have to be compatible for therapy to be successful. Its important to choose the right therapist for you, and if you know that things wont work with this therapist, theres nothing wrong with telling them youd like to change therapists.

Alternatively, you could end up feeling like you dislike the therapist because they made you acknowledge things about yourself that will lead you to do more work to achieve your goals. Its similar to how you may dislike your personal trainer for making you work hard, but you both know its for the greater good. Both you and your therapist have the same goals: your well-being. Your therapist may voice ideas that you may not like to hear, but just remember that the therapist is only here to help you, not hurt you.

If youre concerned about offending the therapist, dont be. They are professionals, and they will understand that you are doing whats best for you and your health, and they will support your decision they may even help you find a new therapist who will be a better fit.

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Youll Get Asked A Lot Of Questions

Get ready to really open up. Most therapists are going to ask about your goals, your values, your history . Theyre also going to ask about sensitive topics like abuse , suicidal thoughts, family history of psychological history, substance use/abuse, says Rugless. Its also okay if you hold some things back. The more you share, however, the better your provider is able to come up with an effective plan for you, she says. Your answers will be kept confidential because of HIPAA for the most part. Just like any doctor, you will sign an agreement that will outline the details of whats kept confidential. Its your therapists legal and ethical responsibility to report something that puts your well-being at risk.

Before Making An Appointment Ask For A Free Phone Consultation

Most therapists will offer free initial phone consultations to new patients. Take advantage of this and ask any preliminary questions you havelike how they work with clients, what their approach might be for whatever you hope to work with them on, and anything else thats important to you. Then go with your gut. Who do you feel the most comfortable talking to and feel you can open up to? Dr. Howes says.

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Should I Prepare For My First Session In Any Way

It may help you feel more comfortable to think about what issues you want to discuss, what relevant information you think the therapist should know, and what you hope to get out of your first session. If the office is somewhere youve never been before, it can be useful to plan out your route beforehand and calculate when you should start your trip. Before you go, make sure you bring your insurance information and any other relevant documents, and plan to get there a few minutes early so you can go over any necessary paperwork.


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