If you’ve never been to therapy before, your very first appointment can be intimidating, scary, or anxiety-provoking even. It is the expectations, lack of information, and/or negative thoughts and feelings about therapy (particularly the first session) that often cause hesitation or total avoidance of taking this important big step in your healing and self-development.
There are many unknowns regarding what happens when you walk through those office doors, sit opposite a total stranger, and divulge very personal details about your life and the issues you’re struggling with. Yes, he or she is a trained professional who you imagine has heard it all before, but this fact likely doesn’t reassure you entirely.
Therapy is often described as being this safe space where you can unload all of your insecurities, emotions, and stressors. It certainly is all of these things, but if you’re a first-time client, you haven’t yet had the opportunity to witness and experience the value and healing effects of it for yourself.
In this article, we’ll go over the details of what you can expect—from the moment you call to make your appointment, to sitting through that first 50-minute session. Knowing the ins and outs of what really goes on when you see a therapist may not completely eliminate your pre-therapy apprehension (or terror), but it will likely put you at ease and increase your confidence in the fact that you’re making a good—and courageous—decision to seek out the help and support you need.
Making Your Appointment
One of various scenarios can occur when you contact a therapist for an appointment. In many cases, you’ll get a secretary or receptionist who answers the phone, gathers your contact information, and sets the date and time of the initial session. However, don’t be surprised if this first point of contact is with the therapist him/herself.
Be ready to provide health insurance information, or, if you’re self-pay, this is when you’ll likely be informed of the fee per session. Some therapists have this information listed on their website. Lastly, you might be asked the reason for your visit and this question can be asked of you whether you speak to the therapist or an office secretary. You don’t need to go into too much detail here. In fact, you can keep your response at just a few words. For example, stating that you’re struggling with work-related stress, relationship issues, anxiety, grief, or sadness will usually suffice. Many therapists take appointments online through their websites or via text message or email, so if this is the case then you’ll have a bit more privacy throughout the scheduling process.
The Day Of: What to Expect As You Wait
The waiting room of a therapists office is typically very similar to that of your dentist or family physician except that therapy waiting areas tend to be less jam-packed with patients. Therapy appointments have very specific start and end times, so unless the therapist is running late, it’s unlikely that you’ll be waiting long. There are exceptions here of course. For instance, your therapist may not be the only provider in that particular office, in which case you might be waiting along with other clients who are there to see someone else.
For many first-time clients, the act of sitting in the waiting room can alone induce some discomfort—and self-consciousness—that you would likely never feel while waiting to see your allergist or chiropractor. If you feel this way, rest assured that it’s normal. We’ve come a long way as a society in terms of being more accepting, open, and vocal about mental health, but there is still some stigma attached to the act of seeking mental health treatment. So, if you find yourself looking over your shoulder in the waiting room or wondering what the person sitting across from you might be thinking—know that it’s human to feel this way and also, very typical of a first-time client. It might reassure you to bear in mind that anyone else present in the waiting room is also there for mental health concerns—or accompanying a loved one who is. So, you’re both on the same boat. Also, remind yourself that any clients sitting beside you, waiting their turn, are likely far too preoccupied with their own issues to really wonder about what you’re doing there.
Before you arrive to your appointment, you may be asked to fill out paperwork that’s provided to you via email or through an online form on the therapist’s website. However, some therapy offices may ask you to complete paperwork once you arrive to your appointment. Here, you may be asked the reason for your visit (even if you were already asked when you first made your appointment). Don’t overthink it because you’ll be discussing this with your therapist anyways. A short phrase—or up to a sentence or two—is fine. Some first-time clients are concerned with divulging too much in writing, concerned that anything they put down stays on their permanent health record. If you feel this way, keep the information in your paperwork brief and to-the-point and then discuss your concerns with your therapist. Remember, you are in control of what you share and of what you don’t feel comfortable sharing. Of course, the more information you provide, the better your therapist will be able to help you, but it’s okay to go at your own pace. This applies to both paperwork and the actual therapy process.
The Day Of: Walking Into Your First Session
Your therapist might approach you in the waiting room and escort you to his or her office, but in some cases, a secretary or receptionist may show you in. If you’re feeling a bit (or very) nervous as you walk in and take a seat at what will likely be a chair or sofa, use these moments to take a deep breath and tell yourself that you will release all control. This doesn’t mean that you should go into your session with a passive mindset or that the therapist should be in control. Nowadays, clients are encouraged to take a very active role in their treatment. When I say release all control, I mean: Stay present; let go of any need you might have to anticipate what will happen once your session begins; any desire to present yourself in a certain way; or any effort to hold back the emotions that may start to come out during the session. Allow yourself to be. Give yourself the space to express yourself; to be at a loss for words sometimes; or to not know how or where to begin. Any uncertainty (or fear) that you might feel before your first session typically comes from an inability to let go of control. Try to go in with the mindset of surrendering to the process so that you can step into this unknown situation without expectations, plans, or any idea of what may happen.
You and Your Therapist
The therapist might be waiting for you in the room—or, you might be waiting for him or her. If you do have a few moments to yourself, use the time to continue staying present. Look around the room and observe any artwork on the walls, paperweights on the desk or table in front of you with comforting quotes printed on them, or any books or magazines lying around. Take notice of the temperature in the room, any scent you can pick up, or the feeling of the chair you’re resting your back on. Doing these simple exercises will help you to stay present so you can stay out of your head and avoid over-thinking and anticipating the nature of the session you’re about to begin.
Your therapist will typically give you a warm and welcoming greeting. He or she will likely introduce themselves and sometimes, you’ll get a little background on their credentials and specialty. Every therapist has their own unique approach. There’s no set script when it comes to how they will interact with you. Some therapists may start with the well-known “What brings you to therapy?” question while others may begin with small talk, jokes, or other comments to develop rapport and help the client feel more at ease with the therapeutic process.
Two standard procedures that are pretty much guaranteed to occur during the first session, however, include: 1) Informing you of your confidentiality and privacy rights (including the exceptions to confidentiality) and 2) Conducting some type of intake assessment.
Your confidentiality and privacy rights will be given to you in writing, so you’ll be able to read through these forms that typically contain a lot of legal jargon. You can look this information up online before your appointment in order to get a more reader-friendly version, but basically, your therapist will inform you that everything you talk about during your sessions with him or her is confidential—just between the two of you. The exception to this is if you verbalize thoughts of hurting yourself or someone else. This line makes many first-time clients lean back into their chair and think, “whoa,” but just know that this is standard information that, by law, your therapist has to give you.
The intake assessment is just a term used to describe the process of your therapist gathering background information on you. For example, you may be asked questions about your occupation, marital status, family or living situation, medical issues, medications you’re taking, any history of mental health diagnoses or past treatment, family history of mental health problems, and information about your current mental health symptoms or concerns. How detailed and in depth this assessment is will vary based on a few factors. For instance, if your sessions are covered by your health insurance plan, your therapist may be required to conduct a more lengthy intake assessment. Other factors include your therapists unique style and preferences when it comes to the first session. Some therapists conduct a formal “Q&A” style intake while others will take notes as they informally ask you questions.
Overall, expect that your first session will be at least partly about gathering information about you. Your therapist will typically not dive into problem-solving, conflict resolution, or other treatment interventions during the first session because he or she has to get an idea of who you are and what issues, stressors, and needs you’re bringing to therapy. One thing that will likely be accomplished during these first 50 minutes is a plan for treatment or setting some initial goals for therapy. This step is what sets the stage for your future sessions. It is how you and your therapist agree on what you want to get out of treatment, what changes or progress you’d like to make, and what you’ll both work on together to help you reach your goals.
The large majority of clients leave the first session feeling both relieved (because it wasn’t nearly as bad or as scary as they had anticipated) and eager to get to work on their therapy goals. Your therapist will likely provide you with either a homework assignment or a thought or idea for you to reflect on related to what you discussed during this initial session. Many therapists will leave you with words of comfort, motivation, and reassurance that you’ll be able to get through your current struggles and that you’ll experience much learning and inner growth from therapy. Although your problems or life situation remains mostly the same after your first therapy session, you will leave with greater hope, knowing that you now have the support and source of guidance that you need to start your journey of change, progress, and healing.