First and foremost, congratulations. You’ve decided to improve your life by working with a counselor. This is a huge leap that can benefit you in many ways, and you should be very proud of yourself. That being said, it’s likely that you have some reservations about working with a mental health counselor, too. This is totally understandable. While we can’t promise to help you conquer these reservations and feel completely confident in this journey, we can help to lessen your nerves by running through what your first session will look like!

Wendela Marsh, Therapist and Board-Certified Behavior Analyst, is here to help us explain everything you can expect from filling out paperwork at your intake appointment to meeting your counselor and building a successful therapeutic relationship:

What Should I Expect at an Intake Appointment?

In the initial stages of counseling, you must first complete an intake appointment. As with any other doctors appointments, this will involve filling out some necessary paperwork, answering basic questions, and covering the basics of confidentiality. Marsh explains how exactly you can expect this to unfold:

  1. Filling out paperwork: “Your first counseling session doesn’t have to be awkward or uncomfortable. (Don’t worry, your therapist will not make you lie down on a couch.) Hopefully, you have already made a connection by getting to know your therapist online and during a consultation meeting or phone call, to see if you are a good fit. During the first session, you can expect to fill out paperwork, just as you would the first time you go to a new doctor or dentist. This will range from your family history and medical history to your insurance information. Fill it out as completely as you can, to give your therapist a good background and a feel for where you are coming from.”
  2. Answering basic questions from your counselor: Once you’ve filled out this paperwork, your counselor will run through it with you and maybe even ask you some of the questions to make sure they understand your needs. “When you finally sit down across from your therapist, they will probably ask you again many of the same questions you answered on the paperwork. This is normal; they want to clear up any potential misunderstandings and hear some of your history from you, yourself, rather than just reading about it,” Marsh explains.
  3. Discussing and understanding confidentiality: “They will also discuss confidentiality and the limits of confidentiality. If you are an adult, they must not share your personal information, or anything you share with them, with anyone else. There are a few exceptions—if they are part of a therapeutic team that regularly discusses patient needs for the purpose of providing optimal services, they will ask you to sign a waiver of confidentiality within that team for only those purposes. If you were referred by your physician or another therapist, they will ask you to sign a release so they can thank the referring doctor and let them know that they have accepted you as a client.”

During the course of your counseling, if your counselor believes that you may be a danger to yourself or others, they may be legally mandated to report the danger; how that is done depends on federal, state, and local laws and the ethical guidelines of their profession. For children under the age of 19, it may be that some information will be shared with the parents, as needed, and the counselor is legally required to report all suspected child abuse to the proper authorities.”

Your intake appointment will cover all of the normal bases of meeting with a new healthcare provider. It is an essential step in receiving counseling, and it will give you a better feel for the counselor you’ll be meeting with!

What Should I Expect at My First Counseling Session?

Once you’ve taken care of all the paperwork and discussed confidentiality, it’s time to get down to business and discuss why you’ve decided to begin counseling. “Your therapist will want to spend the first session getting to know you,” says Marsh. Potential questions may include:

  • What brought you to counseling at this time?
  • What are you hoping to accomplish through counseling?
  • Do you have any concerns about what counseling might be like, or questions you’d like to ask?

These questions and those of the like are designed to help your therapist gage where you’re at as well as where you want to be—and enable your progression to that desired destination. So long as you discuss, agree on, and map out a treatment plan, as explained by Marsh: “The first session is the time to plan for future sessions. Frequency will depend on both the therapist’s recommendation and availability, and your own preference, scheduling conflicts, and financial constraints. You will probably not be asked to come in two or three times a week; on the other hand, just once a month may be too long between sessions. It can be difficult to remember everything that happened in the last month to report how effective the counseling has been, and momentum is lost. Typically, once a week, or every two weeks at longest, is a good schedule for most people.”

In sum, “at the end of the first session, you should feel as if you and your therapist know each other a bit better, that you are comfortable working together, and that you have a plan going forward.” Hopefully you leave your counselor’s office feeling more confident about your decision to begin counseling and ready to get to work; however, if those nerves aren’t completely resolved, that’s okay too. It’s called a process for a reason!

Counseling Near Me

If you’re looking for a counselor or therapist near you, consider working with a mental health counselor at Thriveworks. Our counselors have the necessary skills, training, and experience it takes to help you find greater happiness or success. Additionally, they specialize in offering different types of counseling including cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT). You can schedule an appointment today at a location near you, or book an online counseling session.