Congratulations! You’ve decided to improve your life through therapy. That is a huge step toward healing and bettering yourself, one you should be very proud of. But say you also have some reservations about the process… that’s understandable! And while we probably can’t completely rid you of these reservations or nerves, we can help to lessen them, by running through what your first session will look like. Wendela Marsh, therapist and board-certified behavior analyst, is here to explain everything you can expect from filling out paperwork to getting to know your counselor.
Covering the Basics
First and foremost, you’ll have to fill out the necessary paperwork—just as you would at the doctor’s office—and then cover the basics of confidentiality. Marsh explains how exactly this might unfold, starting with the initial meeting, which ideally should’ve happened prior to this first session:
“Your first therapy 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.
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. 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 therapy, if your therapist 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.”
Getting Down to Business
Once you’ve taken care of all the paperwork and discussed confidentiality, it’s time to get down to business. “Your therapist will want to spend the first session getting to know you,” says Marsh. Potential questions may include:
- What brought you to seek therapy at this time?
- What are you hoping to accomplish through therapy?
- Do you have any concerns about what therapy might be like, or questions you’d like to ask?
These 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 also 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 therapy 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 their office feeling more confident about your decision to begin therapy and ready to get to work; however, if those nerves aren’t completely absolved, that’s okay too. It’s called a process for a reason!