What to Expect at Your First Therapy Session
Most adults are familiar with the concept of therapy, but they aren’t really sure how it works — or what benefits they’ll get from it. Because it is such a personal experience, therapy tends to be something that most people don’t understand simply because they haven’t experienced it.
Maybe you’ve heard the stereotype about lying on a couch and sharing your feelings. Or maybe you’re afraid of sharing personal stories with a stranger. Whatever your thoughts, if you’re preparing to undergo therapy for the first time, you likely have a lot of questions about selecting a therapist and what to do in your first therapy session. Discover the details and what to expect at your first therapy session below.
Why Go to Therapy?
“Therapy” describes a series of treatments designed to help an individual process through trauma or mental health issues that may be negatively impacting their quality of life. Traditional therapy can be provided by licensed marriage and family therapists, psychologists, psychiatrists, social workers or licensed counselors. In some cases, therapy may be accompanied by prescription medication. In others, therapy may simply be a “talk-based” program designed to help a person work through a specific challenge they are facing.
Most people can benefit from therapy at some point in their lives, even those who are not experiencing a diagnosis of mental illness. Therapy provides an environment where patients can confidentially talk about challenges they are facing with a neutral counselor.
In most cases, individuals will pursue therapy for a specific reason. Perhaps they are struggling after the death of a loved one or experiencing problems in a relationship. Sometimes, a more formal diagnosis may be present, such as depression. But that doesn’t mean you have to be able to put your finger on the problem before you begin therapy. Simply feeling that something is “off” or “not right” is a good place to start.
You may benefit from therapy if you find that you are:
- Unable to connect with others
- Overwhelmed by your daily life
- Mentally exhausted
- Recovering from trauma, either physical or emotional
- Grieving the death of a loved one
- Experiencing strong negative emotions
- In the midst of relationship challenges
- Relying on alcohol, drugs or food to cope with difficult emotions and circumstances
Even if you don’t see your problem listed above, therapy can be beneficial. Individuals who simply feel they are stuck in a negative pattern of thoughts or emotions that impact their ability to live a normal daily life can benefit from sessions.
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 isn’t a one-size-fits-all approach to therapy. It takes on many different forms, depending on your needs and a therapist’s skills and training. A therapist’s 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 patient’s treatment plan. Common types of therapy can include:
- Cognitive behavioral therapy (CBT) emphasizes the relationship between behavior, feelings and thoughts by talking about problems, identifying solutions and teaching coping strategies.
- Psychoanalytic therapy focuses on identifying and working through painful feelings in the subconscious mind.
- Client-centered therapy places emphasis on unconditional positive regard through nondirective talk therapy.
- Gestalt therapy is designed to focus a patient’s mind on their present experiences.
- Existential therapy focuses on an individual’s self-determination and free will instead of the symptoms of their problem.
- Emotionally focused therapy (EFT) looks at emotions as determining factors for personality and therapeutic growth, and patients learn how to make sense of and regulate their feelings.
- Solution-focused brief therapy encourages patients to set goals to solve their problems within a set timeframe.
- Narrative therapy helps people reshape their life stories, putting a more beneficial — but still true — spin on their situation.
How to Make a First Therapy Appointment
Sometimes, people may be referred to a therapist by a doctor or other medical professional. Or they may seek out therapy on their own. However you decided to pursue therapy, your first step is to make an appointment.
When you schedule your appointment, you’ll be asked several questions, including:
- Do you want to attend therapy sessions in person or online?
- What kind of therapy are you interested in? Couples? Individual? Family?
- Do you have a preference for the therapist you see?
Many people struggle to answer the third question because those who are new to therapy often don’t know how to select the right therapist. Before you confirm an appointment, do your homework and learn something about the therapists in the practice. To determine which therapist is a good match, ask:
- Which therapists in the practice specialize in the issue you hope to address? Are they taking on new patients?
- What types of therapies do the therapists use? Are they primarily using “talk therapy,” or do they integrate other methods into their treatment, such as hypnosis, art or role-playing?
- What does each therapist charge? If the practice does not accept insurance, will they work with you to provide the documentation you need to submit reimbursement claims with your current insurance company?
- What is their academic background, and do they have any professional affiliations that will speak to their expertise?
Much of this information can be gleaned by spending some time on the practice website before scheduling an appointment. But if you aren’t sure how to interpret what you read online, it’s always a good idea to talk with the office staff. They know the therapists in the practice better than anyone else, and they can provide valuable guidance in choosing a new therapist.
One other important question to ask when you’re scheduling a first-time therapy appointment is, “How long is the first therapy session?” That can give you an idea of what to expect and how to work your first appointment around your schedule.
How to Prepare for Your First Therapy Session
Therapy is one of the most important steps you can take toward healing from mental illness, trauma or a struggle of some kind. But if you haven’t been to therapy before, you may find yourself becoming nervous prior to your first appointment. This feeling is perfectly natural, but don’t let your nerves keep you from taking this brave step! Learning what to do before your first counseling session can help you prepare and relax.
Before your first therapy session, spend some time thinking about your reasons for seeking out therapy and what you hope to get out of this experience.
There are also several practical steps you can take to prepare yourself to speak openly and freely with your therapist. For example, it’s a good idea to wear comfortable clothing. We also recommend scheduling your appointment for a convenient time when you won’t be rushing to or from another commitment. Having a few minutes before and after your appointment allows you the time to gather your thoughts and process what you’ve discussed with your therapist.
If you are scheduling your first couples therapy session, set mutual goals with your partner. Even if you have different reasons for seeking out therapy, discuss your goals for therapy and the outcome you’re hoping to achieve. It may even be helpful to talk about what you’re going to share — or not share — with friends about your decision to seek couples counseling. When you agree upfront on privacy and boundaries, it helps you avoid problems later.
What Happens in a First Therapy Session?
You’ve scheduled your first therapy appointment and the day is here. When you arrive at the office, you can expect to be greeted warmly at check-in. No need to feel self-conscious. Remember — you’re one of the millions of Americans who will experience the positive results of seeking therapy to improve their mental and emotional health.
So what is the first therapy session like? The experience is different for everyone, but you should think of this first session as the first step on a journey to healing. It can be intimidating to take that first step. But once you put one foot in front of the other, you’ll find it gets a little bit easier over time.
Once you’re seated in the therapist’s office, it’s time to begin your session. The first session will go a bit differently than subsequent sessions. It’s often referred to as the “intake session.” Your therapist will use this first session to get to know you, evaluate your needs and draw up a treatment plan to guide you in future sessions. Think of it as you would a consultation with a doctor or any other specialist you’re meeting for the first time.
What to Say in the First Therapy Session
Part of preparing for this appointment is knowing what you’ll talk about in your first therapy session. This session is designed to touch on a lot of different areas of your life. The therapist will spend time learning more about your background, including your spouse, parents, children or siblings. They’ll likely ask about your current employment status and your living situation.
Once they’ve asked a lot of questions about your background, your therapist will then ask several questions about your reasons for being there. You can expect them to ask:
- Why did you choose to pursue therapy?
- What do you feel is wrong in your life?
- What are your symptoms?
There is no “right” or “wrong” answer to these questions. But you should give thoughtful, honest answers to these questions to have a good first therapy session. Your answers to these questions will be useful to your therapist as they develop a treatment plan for you. Without all of this information, therapy may not be as effective as it could be. In a way, this covers what to bring to your first therapy session — honesty and openness.
Once they’ve asked all of their questions, your therapist may spend some time talking with you about what you’ve said and their recommendations for treatment. During this part of the session, they will discuss their recommendations for forms of therapy, patient confidentiality and length of treatment.
As they review these recommendations, keep in mind that these aren’t set in stone. Each person is different. What takes one person six weeks to process may take another eight weeks or ten. Your therapist is presenting you with goals and recommendations for treatment, but these can always be adjusted once you have a few sessions under your belt.
Remember that therapy is a process. You won’t just attend one or two sessions and “feel better.” With this in mind, you can more easily engage with your therapist as they begin to ask questions and learn more about who you are.
Once you and your therapist agree on your treatment plan, your first session will be complete. They will give you instructions for scheduling your next session. The second session is when you can expect to begin to dive into what brought you to therapy in the first place.
Although your therapist will likely ask you a lot of questions, this is also a good time for you to ask them questions, too. After all, it’s essential to understand what you’re committing to. If they don’t volunteer the information, it’s a good idea to ask your therapist questions like:
- How long does each session last?
- How long do you estimate that my treatment will take?
- Can you explain what I can expect at each session?
- How do you protect my confidentiality and that of your other patients?
Finding a Good Fit With a Therapist
One of the most important components of successful therapy is finding a therapist you feel comfortable with. It’s only natural for it to take a few sessions to become comfortable with your therapist, but if you find that you aren’t able to relax and work well with your therapist after a few appointments, you should look for another therapist.
How do you know if you’ve found a good therapist? Ask yourself these questions:
- Do they show compassion?
- Do they treat you as an equal?
- Do they check in with you as part of your therapy?
- Do they challenge you to meet your goals?
- Do they demonstrate acceptance and compassion?
If the answer to these questions is “no,” or you find that you just don’t feel comfortable with the therapist you’ve chosen, don’t get discouraged! Taking the time to find the right therapist is crucial. Allow yourself to speak up and advocate for the person you need.
What to Expect in Future Sessions
Once you’ve completed your initial intake session, the real work of counseling begins. During the first few weeks, you can expect your therapist to spend more time getting to know you and unpacking the issue — or issues — that led you to counseling. You may also have some homework outside of your sessions that is designed to build upon what you’ve discussed with your therapist.
So how long does it take to see change?
By your second month of therapy, you’ll likely have built a foundation that your therapist can build on to help propel you toward sustainable change and growth. This process will take time, but it’s worth it to see the results you’re hoping to get from therapy.
At the four-to-six-month mark, your therapist will evaluate where you are and look closely at your original goals. They’ll determine what kind of progress you’ve made and whether there needs to be adjustments to your treatment plan moving forward.
In some cases, you may have met your goals and decide to dial back or conclude your sessions. But, in other cases, you may find that you are just starting to make progress. Your therapist can help you revise and update your goals to determine how to continue the good work of change and healing.
Schedule Your First Session With Stanford Couples Counseling
At Stanford Couples Counseling, we offer a variety of services in Texas, including individual, couples and family counseling. We also offer clinical supervision and testing and assessments. Our collaborative group of experienced mental health professionals is committed to providing you with high-quality mental health services. Each of our therapists offers different specialties and certifications that allow us to provide comprehensive mental health services for a wide variety of individuals.