What to Expect in Your First Therapy Session

Taking the first step toward therapy can feel so scary, especially when you have never done therapy before. Because therapy can often be a very private thing, you don't often hear from others about what therapy is actually like. Learning a little bit more about that first session can make taking that first step a little bit easier.

So, what can you expect from your first session?

Getting Started

To start, I will welcome you in and do some brief introductions. If you are joining via telehealth, I will check to make sure that you are in a safe and confidential environment where you cannot be overheard. Your privacy is important to me! Then, I will tell you a little bit about my credentials, what you can expect from therapy, and how I will protect your privacy, including the limitations to confidentiality.

After we do some brief introductions, we will begin your intake. An intake is a big-picture overview of your life, your presenting concerns, the things that led up to your current concerns, and your background.

This can feel somewhat overwhelming at times, but I do my best to go at a comfortable pace and will always let you take breaks if needed. While the goal is to get to know as much about you as possible, I know that I will not be able to fully get to know you in just one session. Building a relationship takes time, and I am often still gathering information over the course of several sessions.

What Will We Talk About?

Some of the things we will go over in the first session include:

• Presenting concerns and history of presenting concerns: What is bothering you currently? How is your daily life impacted? When did these things start? This is where we will spend most of our time.

• Prior psychiatric treatment: Have you ever been to therapy before? What was that experience like? What did you like or dislike about it?

• Family psychiatric history: Are there patterns of mental health struggles or addiction in your family?

• Family life: Who are the important people in your family, and what are your relationships like with them? What was life like for you as a child? What is your relationship with your parents like?

• Social history: Who are your biggest sources of support? What does your community look like?

• Medical history: Are there any major medical concerns that could be impacting your mental health?

• Spiritual and cultural factors: Are there cultural factors that are important to you? Are you a member of a particular religion or faith tradition, and would you like that to be a part of therapy?

• Educational and vocational history: Where did you go to school? What is your highest level of education? Where do you currently work? Do you enjoy your job?

These are just some of the topics we may cover during the first session. We won't necessarily go through every question in detail, and what we talk about will depend on what is most important for you and what brings you to therapy.

At the end of the session, I always ask if there are any other important things to know about you that we missed or if you have any questions for me. Lastly, we will talk about your goals for therapy and what you would like to get out of our time together.

Do I Have to Tell You Everything?

One of the biggest concerns I hear from people who are new to therapy is wondering what they are "supposed" to say.

The good news is that you don't have to have everything figured out before you come to therapy. You don't have to know exactly what is wrong, have the right words to describe what you're experiencing, or have a list of goals prepared ahead of time. That's part of what I'm here to help with.

You also don't have to share something before you feel ready. Therapy is a process, and building trust takes time. My goal is to create a space where you can be honest and open while still moving at a pace that feels comfortable for you.

What Happens After the First Session?

After collecting the necessary information, we will discuss scheduling and find a time for a follow-up appointment. Most people schedule weekly or every-other-week appointments to start, but some people go as long as a month between appointments.

There isn't one schedule that works for everyone. We will find a rhythm that works best for you and your needs.

Starting therapy can feel intimidating, but you don't have to know exactly what to expect or have everything figured out before you walk through the door. My goal is to make that first step feel a little less overwhelming and give you a safe place to begin.

And of course, I am happy to discuss any concerns you may have prior to scheduling your first appointment!

You don't have to figure it all out alone.