Whether you’re just beginning to think about counseling, or you’ve already booked your first therapy session, you’ve probably started to wonder, “What is therapy like?” Most people wonder what to expect from therapy before they start attending, and it can be extremely nerve-wracking for some.
A basic understanding of what happens in your first therapy session can be very helpful for providing a foundation and calming nerves. While every practice and therapist is different, there are some similarities you can prepare for.
Your First Therapy Session
First of all, know that your first therapy session is going to be different from the rest—and not just because it’s new for you. You and your therapist need a first “intake” session to get acquainted ... and there’s some housekeeping to take care of.
Check-in and wait. If you’re attending therapy in-person, it will probably start like most medical appointments. You’ll arrive a few minutes early, check in, and wait in a general waiting area. If you are joining your appointment online, you will be sent a welcome email with a link to join the video session at the time of your appointment.
Fill out some paperwork. Before your first session, you’ll have some paperwork to fill out that may cover insurance information, medical history, current concerns, etc. This paperwork will be sent via email through a secure client portal or will be available to fill out right before your first in-person session. If you have any questions, you can always ask the Care Coordinator who helped schedule your appointment. If you are uncomfortable answering any of the personal questions, you can wait and talk to your therapist about them.
Meet your therapist. Your time in therapy will be as successful as your relationship with your therapist. If you “click” with a therapist, you can communicate well, be open and honest, and trust what they tell you. Your therapist will ask questions to get to know you better and just engage in conversation
The first therapy session is less about treatment and more about getting acquainted—with the practice in general (via paperwork) and with a particular counselor.
Some questions the therapist might ask during a first session include:
Why are you seeking counseling?
What symptoms are you experiencing?
Have you attended therapy in the past?
What have you done, or are you doing, to take care of your mental health?
What do you want to get out of—or what do you hope to accomplish in—therapy?
They will also probably ask about your medical and mental health history, as well as your family’s physical and mental health history.
Confidentiality in Therapy and Counseling
In most cases, a therapist will not and cannot talk about anything you share with them or the practice. Your medical and mental health history are completely secure.
There are a few specific instances, however, when every therapist has a “duty to warn” or is considered a “mandated reporter.” The duty to warn is outlined by the American Psychological Association as a therapist’s responsibility to breach confidentiality and file a report with a legal authority, if a client poses a threat to themselves, the counselor, or a third party. Additional requirements for duty to warn vary by state.
Similarly, “mandated reporter” describes a required role of any professional who works with vulnerable people (usually children). These professionals, including counselors and therapists, are required to break confidentiality and file a report when abuse is suspected or observed.
Tip: Prepare Questions for the Therapist
At some point during your first therapy session, your new counselor will probably ask if you have any questions. Don’t be shy! It’s important for your therapist to get to know you during this first session, but it’s just as important for you to learn about them.
Some questions you might want to ask could include:
What kind of training, education, and/or experience do you have?
Do you specialize in any specific therapies or in working with any specific issues?
Do you have specific experience with my issue(s)?
When would you be required to break confidentiality?
How many sessions do you think we will need to resolve my issue?
What should I expect during our sessions? / What type of therapy do you think is best for me?
What should I plan to do between sessions?
There are no right or wrong answers to most of these questions, but it will give you a chance to hear from the therapist and get a better idea of what to expect in normal sessions. Your therapist may even offer much of this information before you ask.
As you find or think of questions that you want to ask, write them down and bring them to the first session. It’s easy to forget what you wanted to ask when you’re sitting across from someone you’re meeting for the first time.
Popular Therapy Methods
Your therapist might talk about different methods or make a recommendation for what they think would be effective. They won’t expect you to know the details, and will gladly answer all of your questions, but it can help you feel more comfortable if you have a basic understanding of popular therapy methods before your first sesion.
Humanistic or client-centered therapy is founded on the idea that every person has what they need inside of themselves already. It is the therapist’s job to listen with empathy and gently guide the client into their own discoveries.
Cognitive-behavioral therapy (CBT) is based on the idea that both thoughts and actions shape emotions. It is the therapist’s job, then, to help the client recognize patterns in thought and/or behavior, and intervene to help the client course-correct to a more helpful thought or action.
Psychodynamic therapy is what comes to mind when many people think about therapy. It focuses on unconscious motives and influences, as well as the impact of early childhood experiences. It is traditionally a very long course of therapy.
Behavioral therapy is an active type of therapy based on the idea that your behaviors develop from past experiences. You won’t spend much time talking about the past, though. A behavioral therapist will use action and activity to desensitize you to an irrational fear, for example, or to help you develop an aversion to something you want to avoid.
There are other forms of counseling and therapy, and if your therapist recommends something else feel free to ask what it is, how it works, what it assumes, and why they think it’s right for you.
Therapy Duration
As you consider what to expect from therapy, you may find yourself wondering how long it will “take.” This is a good question to ask your therapist, but be aware that it’s a very hard one to answer.
Depending on the issue(s) you want help with, the type of therapy, your connection with the therapist, and more, resolving an issue through counseling could take a few weeks or a few years! A counselor may be able to give you a rough estimate by the end of the first session, but it will be an estimate and it will change as you begin to work together.
Note: Many insurance plans only cover a certain number of therapy sessions per year. Check with your insurance company before your first therapy session, and, if it’s going to be a factor in your continuing therapy, let the therapist know immediately.
How to Choose the Right Therapist (for You)
Choosing the therapist that’s best for you is a very important task. People sometimes assume that if a therapist is educated and experienced enough, a personal connection doesn’t matter. However, study after study continues to prove this wrong.
Therapy is most effective when the client and the counselor get along. Here’s how to find a good fit:
Consider what kind of person you would be most comfortable with. Admit all your biases, here, without guilt or shame. Would you rather talk with a man or a woman? Older or younger? Is it important that you and the therapist share the same ethnicity? Religion? Be real about who you can be open and honest with, and whom you will be able to listen to.
Ask for and read recommendations. Ask your local networks or start Googling, and read reviews. There is no guarantee that a therapist is going to be good for you just because they were helpful to someone else, but it is a start.
Schedule a phone call before you set up a first session. Tell the therapist why you’re considering counseling and ask about their experience, etc. You can sometimes tell a lot about a person from a phone call.
Consider the first two or three sessions a warm-up. You may know after that first therapy session whether or not this therapist is really the one, but not always. If you’re not sure, give the therapist one or two more sessions to really get into therapy, and then see how you feel.
If you meet with a therapist and don’t think the person is a great fit, you can always request to work with someone else—and you don’t need to feel bad about it! If you can talk to the therapist about why you don’t feel like the relationship is a good fit, they may be able to make some changes or get you connected with someone you will be able to work more effectively with.
If you hate the idea of having that conversation with your therapist, you can always ask an administrative staff member at the practice to transfer you to another therapist. They and/or the new therapist may ask why you requested a change, but it’s just so they can better serve you and other clients.
I promise, most counselors have had this conversation with a client before. And most therapists really do just want to see people doing well, even if that means working with another counselor. No good therapists would have you fail or go on suffering just because you felt bad for ending the relationship with them!
After Your First Therapy Session
You might find that you feel tired or drained after your first therapy session. This is very normal. It’s an intense, all-new experience, and it really can take a lot out of you.
With that in mind, check in on how you’re feeling about every aspect of that first session. (This is a good journaling exercise.)
How do you feel about the therapist you met with? Did you “click”? Any concerns? What did you like best? Least?
How did you feel about the session itself? If you’re feeling disappointed, remember that the first session is much different from subsequent sessions. If you’re feeling uncomfortable or let down, don’t give up quite yet.
How do you feel about the method of therapy you will be using? Do you agree with its premise? Are you hopeful or suspicious?
You may also have “homework” from your therapist after the first session. If so, be sure to do it well.
What is therapy like?
It’s a difficult question to answer, because it varies so much. In general, though, know that it’s okay to feel a little awkward about a new experience. Bring a list of questions you can ask, to make sure you leave with the best understanding you can get about the therapist, the method, the practice, etc.
If you’ve been considering counseling, don’t wait any longer. Find a few therapists in your area and start sorting through them. Make it your goal to call at least three within the next week, to start narrowing the list.
And if you’re anywhere in Texas or Florida, the therapists at Neema would consider it an honor to talk with you. You can meet our team of counselors online, contact us, or schedule a free consultation.