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What can I expect in my first therapy session?

Approaching your first therapy session can be a source of mixed feelings, all of which are totally normal. You might be feeling anxious and unsure of what to say and how to say it, or how it will feel opening up to someone in such a personal way. This is especially true if you are just starting therapy. You might feel a bit excited, ready to get the process going and be on your way to improved mental health. It might also be a pretty solid combination of both. If you have been in therapy before, and are starting with a new therapist, you may feel nervous about whether your new provider is a good match.

However you feel about walking into your first therapy session, it certainly helps to know a bit more about what you can expect to happen so that you can get mentally prepared in advance of your first appointment. Let’s take a look at some key aspects that are common to the first therapy session experience, along with several tips for making the most of it to help you prepare for your first counseling session.

What to expect during your first session

The first session with any mental health professional is typically an information-gathering event on both sides. There will be forms, disclosures and various initial paperwork to fill out (so, arrive early for your first visit to the therapist's office if you can) to establish your file at the therapy location. Once that’s out of the way, your therapist will call you in to the therapy area and you can begin to get settled. You’re in a safe environment - what you discuss with your therapist during therapy sessions is held in strict confidence.

The first therapy appointment usually begins with basic introductions and some general questions that will help your therapist assess your needs. Any information you’ve previously discussed in your intro call - such as theoretical orientation, overall treatment plan, and a brief summary of your therapy goals - will likely be reviewed with you now to deepen the introduction to the experience and check for understanding. Many therapists record therapy sessions either by taking notes on a pad or briefly typing on a computer - and perhaps even ask you for your permission to record audio if they feel that taking notes is distracting or uncomfortable for their client. This is for record-keeping purposes and for further analysis in between sessions.

Your therapist will also ask for more background details, your goals with therapy, your personal history, and your current situation during your first therapy appointment. They may also ask about the current symptoms of your mental health issues that you are experiencing and how they might be affecting your daily life or well-being or what your support network currently looks like. Therapy is a team effort, so both you and your therapist have to put in the work- your open participation in the process is essential to a positive outcome. The first therapy session is also your opportunity to get a feel for the rapport between you and your mental health professional - take note of your overall comfort level, first-time jitters aside. The therapeutic alliance is built over time, but at the outset, you should feel fairly comfortable that your therapist is listening with care and has made efforts to put you at ease, checking for understanding and expecting exploratory questions on your part.

Taking initiative in your first therapy session

Set some goals, but know they might change

Having direction throughout your journey is key to making progress with your therapist. Take some time before your first session to think of two or three high level goals. If you’re having trouble coming up with these goals just think “what would be a game-changer in my life right now?” Whatever answers you come up with can serve as great starting points!

Share these goals with your therapist during your first session, as they can be extremely helpful to give your therapist an idea of where you would like to go. Just keep in mind that these goals may change over time as you work through things.

The first meeting is also a good time to discuss frequency, and to let your therapist know how many sessions you can realistically attend. Your therapist would be able to give you a better idea of the length of therapy needed in order to achieve your personal goals or address specific concerns you may have.

Be open about your life and how you feel

If you’re nervous, anxious or feel uncomfortable, it’s okay to say so. Something helpful to keep in mind is that a mental health professional takes part in this process for a living and is experienced with these emotions. Many of their new clients also feel the way you do during their first session. If you work so hard to hide nervousness, it may be more difficult to feel safe and open up about what's really going on in your world. And this holds true for any emotions you may be feeling — angry, sad, lonely, manic, or whatever. Share that feeling with your therapist during the first session and it will help you to feel more comfortable talking with your therapist.

Be open and honest about your situation, because your therapist needs to know the full reality of what you’re dealing with so that they can properly and effectively help you through it. They’re not judging you, they’re there to develop a clear path to a better outcome for you. So if you’re minimizing or obscuring facts in order to avoid feeling judged, you’re passing up an opportunity to get the help that you actually need. You want to make sure that your therapist has an accurate depiction of your situations so that your course of treatment is in line with what’s really going on. If you are not feeling that your therapist is a good match, it is important to let your therapist know that as well, so that they may adjust their method of therapy, or refer you to someone that may be a better fit. Remember why you started therapy in the first place, and use that to motivate you to talk to your therapist honestly and get the most out of therapy.

Ask questions if you're ever unsure

Ask questions if you need to - the more you understand the counseling experience or how counseling works, the more comfortable you’ll be. There are no wrong questions a client can ask. You can ask about the therapy process, and ask the therapist to repeat anything you don’t understand. You might also ask things like, “what should I be doing in between our sessions,” “how long do you expect our therapy to continue,” “how often should we meet for optimal results,” “what else can I do to prepare for future sessions.” It might be helpful to keep a notebook of your own to jot questions answered and important points down for review later once the first session is complete and the feelings of nervousness have subsided. This will definitely help you in subsequent visits.

Managing your therapy expectations

Therapy is a process, and your relationship with any therapist is one that can take some time to develop. This is a normal part of the therapeutic process. It’s important to manage your expectations as you begin your therapy experience and understand that while you might feel relieved when your first session is complete, it’s not a quick-fix. Attaining your therapy goals takes consistent and open participation from both sides over time. Breakthroughs big and small are all equally valuable, and having realistic expectations for the process means that you respect the agreed-upon treatment plan and don’t assume that everything is going to be fixed within the first session. Similarly, don't worry if you are not feeling better immediately after the first session, therapy takes time and it may take a few sessions before you realize you are getting better.

With that in mind, the end of the first therapy session is a great time to set up your next appointment. Many therapists have busy schedules, and not all therapists will be able remember whether each client has their next session set up yet. By ensuring you have your next therapy session on the calendar before the end of the first therapy appointment, you can keep yourself accountable and make sure you are prioritizing your mental health.

Therapy is a successful tool for resolving problems - and you might find that you experience an enhanced level of empowerment due to taking part in something so constructive. The National Alliance on Mental Illness (NAMI) reports that studies have found individual psychotherapy to be effective at improving symptoms in a wide array of mental illnesses, making it both a popular and versatile treatment. Although you may not feel “fixed” in one session, you might feel a sense of relief that you now have a teammate on your journey to better mental health - and that alone is worth quite a lot.

I hope that this article helped you to know what to expect during your first session. If you’re in the Bay Area, Los Angeles, or anywhere else we serve and are looking to connect with the right therapist for you and your unique needs, look to reflect for a simpler way through the whole process. We believe that the most important factor in predicting successful therapy is a good fit. Our data-driven algorithm and experienced team match you with the best therapist suited to your needs. We also offer free intro calls so that you can start talking to potential therapists to ensure a good match before starting sessions. 90% of those who try reflect find a therapist they like, and 80% of reflect clients notice a meaningful change in their lives after six sessions - improved work, better relationships, sounder sleep, and more. Even with first-time jitters, walking in to your first session is a commendable act of self-improvement and we’re with you each step of the way to ensure you get the most out of your therapy experience.


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