What emotion does this word bring to you?
Maybe you would not admit it out loud, but be honest with yourself for a moment. How do you feel about that?
Our cultural stigma around therapy may be slowly changing for the better. I consider therapy one of the most helpful instruments in my personal healing and growth. It is a safe place, where I credit much of my strength today to the hard work within that room. Many of my friends rave about the impact of therapy in their lives.
Still, to some it is considered a place for weaker people or perhaps for those with “bigger issues” than maybe you’ve ever had. Perhaps for some, the thought of setting up an appointment and walking through the doors, paying someone to do whatever they do is too much.
Wherever your thoughts may land when the word therapy is spoken - that’s okay.
But - if you have never been to therapy before your assumptions may just be wrong.
In order to provide some understanding and maybe some comfort for anyone considering trying therapy for the first time [or anyone completely sure it would never work for them], I’ve written down briefly what a first session in therapy might look like. Every session will look different, but yours may look something like this.
*This reflects my experiences in general, private practice therapy.
Initial Phone Call
When you have found a counselor or practice you would like to try, you can simple call to schedule your first visit. You may talk briefly to someone in the company for 5-10 minutes on the phone. This is to set up the first appointment, select the therapist you would like to meet, and possibly have a quick chat about why you’d like to come to therapy.
Sometimes there is no initial phone call and appointments are set up through email or the website.
You may be asked to come 15 minutes early to fill out new client paperwork, or to print it at home and bring it with you. Typically you will fill it out in the waiting room. Here is a brief overview of what could be in the paperwork:
Client Info: Just like at your doctor’s office this will be your name, age, address, occupation - the basics. This could also include information about why you have decided to pursue therapy.
Health History: You may be asked to fill out a health history form, this could be physical health and/or mental health, this can include family info as well
Insurance Info: This may be included with the client info form, but will request your insurance information for billing purposes
Confidentiality: This paperwork will explain confidentiality within your therapy room
Release of Information: Sometimes there will be a form, that upon your consent will enable your counselor to release information to a family member or other professional.
Meeting The Therapist
The counselor will come grab you from the waiting room, introduce themselves and walk with you to their therapy room. The room where therapy is held is usually decorated in a peaceful, welcoming way. There might be an awkward moment if you walk in and see too many seating options. Sort of like when you go to the doctor and the nurse takes you back - I never know whether to first sit on the chair or on the table. Your therapist will quickly direct you to the couch or chair prepared for you.
The counselor will sit and take the paperwork from you. They may scan over it in front of you. Perhaps you will uncomfortably chuckle together about how, oh my goodness their uncle also when to your alma mater back in the day. How funny. And you can just let go of the discomfort and agree that it is indeed a small world. Your therapist may start with housekeeping items or dive right into a session.
Therapists often start by talking about confidentiality and what that means within your sessions. You are free and encouraged to ask questions about this.
A therapist next may bring up his or her background, specializations and method of counseling. When they mention a theory they use in practice, ask them more about what that means. No one will understand what it means unless they went to school for it, so if you are comfortable, ask them to educate you.
They may ask if you have any questions for them. Think about this session as you interviewing them for the job of your counselor. Feel free to ask them questions. Don’t worry if you can’t think of any!
This next part will be the juice of your first session. It will be shorter than usual, but you will have the chance to talk about you. No pressure. If you don’t know what to say, the therapist will have plenty of questions for you.
They may start with these:
“Why are you here?”
Tell them why you came. If you have a concrete reason, great! If your partner said you should and you finally obliged, great! If you have no idea why you are there for the first time - that is okay! You don’t need to have a complete coherent answer. Counselors ask this so they can understand how best to help you, not to quiz you.
“What do you hope to get out of this?”
Again, just be honest. This experience is about you. They just want to know about your hopes for your health!
“Tell me about your family.”
Family of origin plays a big role in why we are the way we are. When you offer information about your family and childhood, you are coloring the picture for your therapist and offering them valuable information about how to support you.
As your session wraps up, you may feel like you didn’t get anywhere. If you choose to return, you first few sessions may feel that way. Often when you meet with a new therapist, it takes a few weeks to lay a foundation. It may seem slow, but all of the information a counselor collects is important to them as they begin to understand how they can best support you.
At some point the therapist will bring up payment. You likely already filled out paperwork regarding your insurance. He or she will explain how billing your insurance works if applicable. They will talk about what to expect each time, assuming you return, regarding payment. Each practice handles payment differently, but they will make it clear upfront and you can expect to pay the same way moving forward. One counselor I had would bill my insurance, then charge me the co-pay with my card on file, emailing me the receipt. Another therapist had my card on file and would have me sign a receipt at the end of each session. Another would charge my card at the end of every session.
Often times when people see a therapist regularly, they have a recurring slot on a therapist’s schedule. You can discuss this option with your therapist. You are also free to talk about other means of scheduling. Most of the time, you are able to schedule as you see fit or as your schedule opens up. Therapists are happy to work with your schedule.
Any good therapist would much rather you find a good fit for yourself than to work with them if you didn’t like your experience. If you weren’t sure there was a good fit with this counselor, that is completely fine. Counselors experience schedule and client change frequently. Don’t sweat it! Choose what is right for you in therapy.
You are not required to schedule again. It is completely acceptable to tell a therapist you will call them to schedule again if you feel up for it and leave it at that. They will not bug you about it. The ball is in your court!
Counselors are masters at seamlessly transitioning from deep conversation to lighthearted goodbye. When the time is up, your counselor will let you know and graciously lead you on your way!
Counseling may strike a different chord in us all. I find that sometimes a disdain for therapy can come from misunderstandings about it. Ultimately, therapy is a space for you. Therapists are professionals who are trained to apply evidence based methods for emotional and mental wellness - for you. It can be expensive, it can be hard to find the time, but - it is a golden resource that is available when you are ready for it.
Have you ever attended counseling? If not, have you thought about it? I would love to hear your experiences below.