What to expect in your first Thriveworks psychiatry session

What happens during your first psychiatry session

Your first session will run about 60 minutes, while follow-up psych sessions are typically 30 minutes. Whether you’re meeting in-person or online, the process is essentially the same. Here’s how it breaks down:

Step 1: Quick introductions

About 2 minutes

Your provider will kick things off by welcoming you in and sharing a bit about themselves. While you’re probably eager to jump into what’s been bothering you, they’ll first need to confirm a few details, like your name, date of birth, and your location (if you’re joining virtually).

That last part is important for a couple of reasons. For starters, your provider is licensed to practice in your state, and the care is considered to be happening wherever you are, not wherever they are. So if you’re outside that state (even just temporarily), they can’t legally treat you that day. Also, knowing your exact location means they’d know where to send help if you ever needed more support than they can provide through a screen.

Step 2: Setting clear expectations

About 5 minutes

Before we can get into the reason for your visit, your provider will walk through a few policies and guidelines relevant to your care. Spending a few minutes going over all of this helps set expectations about how psychiatric care works at Thriveworks and what to do if your needs change.

Here’s what you’ll go over:

Confidentiality

Your provider will explain that what you talk about is private within your care team at Thriveworks. That means what you say may be shared with people involved in your care and with billing and administrative teams, but it doesn’t go anywhere else without your permission. Knowing you’re speaking in confidence allows you to be open and vulnerable, which is essential for your care to work.

There are a few exceptions where a provider is required to share information, mostly to keep someone safe. These include:

• Concerns about abuse or neglect
• Situations where someone is at risk of serious harm
• Certain legal requirements like a court order

If any of these come up, your provider will be open with you regarding what needs to happen.

Informed consent

You’ll sign a consent form in your Thriveworks account before your first session, and your provider will walk through the key points so you know what you’ve agreed to. That includes what mental health care involves and your rights throughout your care: You can ask questions about your treatment or our policies anytime, and you can choose to stop care whenever you want.

Between-session support

Next, your provider will discuss how you can reach out between sessions if you need support. Our providers are not on call, so if you’re ever in a life-threatening crisis, it’s important to get immediate help by calling or texting 988 or going to your nearest emergency room.

Cancellation policy

Your provider will also go over our cancellation policy so you know what to expect if you need to reschedule or miss a session. In short, we ask for 48 hours’ notice if you need to cancel or reschedule. Canceling less than 48 hours before your scheduled session (or not showing up) may result in a $135 fee.

Level of care screening

Lastly, your provider will ask a few questions to make sure that this type of care is the right fit for what you’re experiencing right now. Telehealth and outpatient psychiatry work well for a lot of concerns, but not everything, so they may ask questions about:

• Any history of an eating disorder or substance use disorder
• A recent psychiatric hospitalization
• Current thoughts of suicide or symptoms of psychosis

If your provider identifies that you need more support than this setting can offer, they might recommend a different level of care, like an intensive outpatient program or, in urgent situations, immediate care at the ER.

The goal here is to ensure you’re connected to the right resources to meet your needs.

Step 3: What brings you in

About 3 minutes

With that housekeeping out of the way, it’s time to share what brought you here. Your provider will ask what you’re dealing with, what’s bothering you, and what made you decide to reach out for psychiatric care now.

This part may feel brief, and that’s by design. Your provider wants to hear the heart of what you’re experiencing, and you’ll have the chance to go deeper in this first session and future sessions. So don’t worry about crafting a perfectly clear or concise response. Whatever reason you have for seeking care is valid.

Step 4: Getting the full picture of your health

About 40 minutes

Mental health doesn’t exist in a vacuum. Your provider wants to hear about all the facets of your life that can impact your mental health and well-being. The clinical term for this is a biopsychosocial assessment, but don’t expect an exam—it’s a conversation.

Compared to a therapy intake, this conversation puts more focus on the medical side of things. Your provider will ask things about:

• What currently brings you in: Any symptoms and how they’re impacting you, your current stressors and supports, and any other relevant information about your life at this moment
• Your mental health history: Previous mental health diagnoses and treatments, including hospitalizations or outpatient services
• Medications and supplements: What you’re currently taking (not just for mental health), as well as any psychiatric medications you’ve tried in the past (and how they worked out)
• Your current health status: Any medical conditions you may have, history of head trauma, allergies (including to medications), and your current height and weight (which is relevant for some medications)
• Your family history: Any known family medical and psychiatric history, including medications that may have been helpful for family members

This may seem like a lot to cover, but the questions are all designed to help determine a safe and effective treatment plan for you. If you already filled out your pre-session forms in your Thriveworks account, you should be able to breeze through this section pretty quickly with just a few follow-up questions if needed.

You’ll also be asked directly if you’re having any thoughts of self-harm or suicide, or if you have in the past. Being honest about any suicidal ideation doesn’t mean you’ll be sent to the hospital. It means your provider has the full picture and can help you find the right support. If risk is identified, you’ll work together on a safety plan.

Throughout this conversation, you’ll also discuss what medication might look like going forward. If you’re already taking something that’s working, your provider will likely start there. If you’ve never taken medication before, or you’re not sure what’s worked for you in the past, they’ll talk you through their recommendations and why they’re making them. You’re also welcome to ask any questions, including about what to expect or any potential side effects or risks.

Step 5: Wrapping up and discussing your treatment plan

About 10 minutes

As you near the end of the session, your provider will check in about how you’re feeling. They’ll want to make sure you felt heard, comfortable, and safe, so if anything didn’t land right or if you have concerns, now is a great time to voice them. Finding the right fit between patient and provider matters a lot for your progress, so if this doesn’t feel like the right match, your provider will be happy to connect you with someone else.

Finally, you’ll wrap things up by discussing your current treatment plan, which might include:

• Continuing an existing medication
• Starting a new medication
• Ordering bloodwork to make surea certain medication is safe for you
• A referral for therapy

Or, if you both need more time to decide the best course of action, the next step may just be checking in again soon.

Before you finish, you’ll schedule your next appointment at an interval that you and your provider deem most appropriate. Then, after your session, you’ll receive a welcome email with resources to use between sessions.

If your needs go beyond what this level of care can provide, your provider will explain what they recommend instead (such as a higher level of outpatient support or, in urgent situations, immediate care at an ER), and will help set you up with the right support. The goal is always to get you the most appropriate care for your situation.

How to prepare for your first psychiatry session

Getting ready for your first session doesn’t require much, but a few simple steps can help you feel more prepared and get the most out of your time.

Complete your required forms

Prior to your session, you’ll need to fill out the consent form in your Thriveworks account covering confidentiality, policies, and what to expect from care. Your provider can’t begin the intake process until this is done, so doing it ahead of time means more of your session is spent in conversation.

You’ll also complete a form covering your medical and psychiatric history, current medications, and any current health issues. This paperwork gives your provider a baseline to work from and lets them confirm information instead of collecting it from scratch during your session, which leaves more time for the actual conversation.

There are also two brief screeners for you to fill out:

• Patient Health Questionnaire (PHQ-9): A nine-question survey that looks at the number and severity of depression symptoms you might have experienced over the last two weeks
• Generalized Anxiety Disorder Assessment (GAD-7): A seven-question survey that looks at your level of anxiety or worry over the last two weeks

These screeners give your provider a starting point and a way to track how you’re doing at future visits. Filling them out honestly helps them get a clearer picture faster, so your first session can be more targeted to your unique situation.

A credit card on file will also be required for any copays, self-payments, late cancellations, and no-shows (with the exception of Medicaid and certain partnerships).

Gather your thoughts

Before your session, take a moment to reflect on:

• What’s been most challenging for you lately
• Any medications you’ve tried before (for your mental health or otherwise) and how they worked for you
• What you’re hoping to get out of this session, whether that’s a prescription or just a better understanding of what’s going on
• What questions you have for your provider

You don’t need perfect answers. Just having a general sense will help you make the most of your time.

Find a comfortable, private space

If you’re meeting virtually, find a quiet spot that helps you feel most at ease, whether that’s your couch, your car (parked, not driving), or even in bed with your dog. Just make sure you’re in a private, stationary spot with a strong internet connection, and that you’re physically located in the state where your provider is licensed.

You’re ready for this

You already took the biggest step by reaching out for help. Now you know exactly what to expect from your first session. While the structure of this first session is different from the ones that follow, that’s by design to lay the necessary groundwork for healing to happen. Your provider will take it from here and, together, you’ll start to craft a clear path forward.

Frequently asked questions (FAQs)

How long will my first psychiatry session be?

Your first session will run about 60 minutes, while follow-up psychiatry sessions are typically 30 minutes.

How much of the first session is paperwork versus actually talking through what brought me in?

The bulk of your first session will be spent in conversation, not going over paperwork. Any required forms are to be completed beforehand in your Thriveworks portal. During the first session, your provider will also briefly cover some required administrative information, like confidentiality, cancellation, and other policies.

Why is the first psychiatry session structured differently?

Your first psychiatry session is more information-gathering than the ones that follow. Your provider needs a complete picture of your health, history, and current medications before making any treatment decisions, so they’ll ask more questions upfront than they will in future sessions. Today is about making sure your first step is the right one.

Will my provider share anything about themselves?

Yes, though it’ll be brief. Your provider will share their name and credentials, and maybe a little about their background, before turning the focus to you. The bulk of your first session will be spent on you, not them.

I already did an intake for therapy. Why am I answering the same questions again?

If you’ve been referred from therapy, your psychiatric provider has access to your therapy notes, so this should go faster than starting from scratch. They’re mostly confirming what’s already there rather than collecting it all again. That said, expect some additional questions, especially about your physical health and current medications, and possibly more depending on what brings you in.

Is everything I say confidential?

Almost everything you say is private within your care team at Thriveworks. There are a few exceptions where your provider is required to share information, mostly to keep someone safe. These include concerns about abuse or neglect, situations where someone is at risk of serious harm, and certain legal requirements like a court order.

Your psychiatric provider may also talk to your pharmacy about your medications, and, with your signed release of information, coordinate with other providers involved in your care. That’s a normal part of managing your treatment safely, not a breach of confidentiality.

If I’m a minor, will my provider tell my parents everything?

No, not everything. Your provider will keep your parents informed about your prescriptions, your progress, and any important concerns, but they’ll also protect conversations that should stay confidential. If there’s a safety concern, your provider will be open with you about what needs to be disclosed.

If I say I’m having suicidal thoughts, will I be hospitalized?

Sharing doesn’t automatically mean hospitalization. If you’re in immediate danger, your provider will help make sure you get the level of care you need, which may mean the hospital. But in most cases, your provider’s goal is to help you develop the skills, tools, and supports you need to stay safe without it coming to that. Being honest about what you’re experiencing helps your provider give you the best care possible.

What if I don’t actually know what’s wrong or why I’m there?

That’s completely fine, and it’s actually common. If you’re not sure what’s going on or haven’t tried anything for your mental health before, your provider will ask more questions to help figure out where to start. This might include what’s been happening in your life, what you’ve tried to feel better, what’s helped in the past, and whether mental health medication has worked for anyone in your immediate family.

Will my provider tell me their read on what’s going on or offer a diagnosis?

Your provider will likely have some thoughts on what might be going on, and they may share a preliminary diagnosis with you. Psychiatric diagnoses are often established early since they can inform decisions about medication, but they are refined and can change as you go. Your provider will always let you know if their thinking shifts as they get more information.

Will I get a prescription during the first session?

Maybe, but not necessarily. Depending on what you and your provider discuss, you might leave with a prescription, a referral to therapy or higher level of care, or a plan to follow up before making any decisions. All of these are normal outcomes. The goal of your first session is to make sure whatever happens next is actually the right call for you.

Can Thriveworks providers prescribe stimulants or other controlled substances?

Yes, when your provider determines it’s clinically appropriate. Because these are controlled substances, there are specific telehealth requirements your provider will walk you through, and some states require an in-person evaluation before one can be prescribed. If that’s the case where you live, your provider can help connect you with a local Thriveworks office or point you toward other options.

What if I want a specific medication and my provider says no?

Your provider will explain why, whether it’s not the right clinical fit or something Thriveworks doesn’t prescribe. If you disagree, you’re welcome to ask questions, get a second opinion, or take time to think it over.

Will my provider make me take medication?

No. Your provider may recommend a medication or alternative option, but they’ll never force you to do anything. If you’re ever uncomfortable with a recommendation, feel free to ask questions, take time to think it over, or get a second opinion.

If I don’t feel a connection with my provider, can I switch?

Yes, switching to a different provider is absolutely possible, and your current one can help you find a better fit. You’ll typically do another intake session so your new provider can build their own clinical picture of you.

Will my therapist and psychiatric provider share notes?

Yes. If you’re seeing both a therapist and a psychiatric provider at Thriveworks, they’ll each have access to notes from your sessions. This makes it easier for them to coordinate your care, and it’s part of why Thriveworks recommends keeping both types of care under one roof when it’s a good fit for your needs.