What to expect in a first therapy session
If you’re trying therapy for the first time, you may have questions about what the first meeting with your therapist will look like.
It’s not uncommon to have nervousness about a first therapy session. If you’re trying therapy for the first time, you’ve already done the hard work of recognizing you could use some support, researching a therapist, and maybe making that initial outreach. You may still have questions and worries about what that first meeting with your therapist will look like. Here’s a rundown to help you become a little more familiar with what to expect from the process.
Paperwork
It’s likely that before you get to your first session, you will have filled out some paperwork for the therapist. This paperwork will include standard documents consenting to treatment, specifying who, if anyone, your records can be shared with, and possibly some questionnaires about symptoms and medical history. The therapist may also ask for information about any prescriptions and your overall health.
You can expect this paperwork to also include information about fees and insurance. If using insurance, it’s important to verify mental health coverage with your insurance provider. Some insurances limit the number of sessions or provide coverage based on the company’s assessment of need for treatment. If you’re worried about limitations based on insurance, bring this up with your therapist. You can explore options to supplement therapy like group work or stress management programs. If you have any questions about the paperwork, the first session is a great time to ask those.
Getting to know you
Whether you’re seeing a therapist online or in person, the first session, or first couple of sessions, is an opportunity for you and your therapist to learn more about each other. The therapist will be exploring what’s bringing you to therapy. It’s also your opportunity to get to know more about how the therapist works and whether you’ll feel comfortable working with them.
The first session the therapist will also review things like billing, cancellation policies, confidentiality, limits of confidentiality, and what steps to take in a mental health emergency.
After you get through the red tape, your therapist will have lots of questions for you. Some people may feel pressure about what they’ll talk to their therapist about in their first session, but your therapist will likely have plenty of information and questions in mind.
Therapist questions during the first session might center around: what brings you to therapy, the history of that issue, and what’s motivating you to start therapy now. Your therapist might also ask about your family relationships, friends, your job or education status, or basic information about your sleeping or eating patterns. It’s also standard for therapists to ask whether you’re having any thoughts of suicide or if you’ve had them in the past.
It’s important to know that while your therapist may ask questions about your background, family, mental health history or lifestyle, you don’t have to discuss anything you’re uncomfortable sharing. It may take time for you to feel comfortable enough to open up about certain topics, and a good therapist will understand this and work to build trust and rapport.
Developing a plan
You’ll also spend time in these initial sessions discussing your goals for therapy with your therapist. These goals are based on what you want to gain from therapy. Your therapist wants to understand what changes you’re looking to make and how they might help you to get there.
You may not walk away with the solutions to your challenges in the first, or even first few, sessions. The initial appointments are focused on getting to know you and understanding your experience. This can be frustrating because it likely took a lot of time and energy to get into the first session. Realistically, it will take some time for you and the therapist to get to know each other before you may see the changes you’re looking for.
If getting a diagnosis is one of your goals for engaging in therapy, it may also be a few sessions before the therapist provides one, if at all. That said, not everyone meets the criteria for a diagnosis, and many people see a therapist without ever having a diagnosis from a mental health provider.
What to expect next
The first session may also leave you with a range of different feelings. Sometimes people are surprised to find, even if they didn’t share much, they may experience a vulnerability hangover, an overwhelming feeling that we’ve shared too much or been too real.
You might also be wondering if you’ll be coming back for a second session. Not every therapist will be a good fit for every client. You may know right away it’s not a fit. If you’re not sure, you might decide to try two or three sessions to see if your feelings become more clear. You can also bring these feelings up with your therapist.
If things aren’t progressing as you’d hoped, you may decide to change therapists or treatment approaches. A good therapist will understand this if you tell them and may be able to provide a referral for a better fit.
If your first try at therapy doesn’t work out, and you still feel you need support, please don’t quit. You’ll now have knowledge about what you like, what you don’t and will be in a good position to find a therapist who will meet your needs.