Starting Therapy? Here’s what to expect.

Congratulations on taking the action to make your first appointment! This is a huge step. You should feel good about that.

When I first speak with a new client, usually they share that they have thought about seeking therapy for a long time. Many people will even describe picking up the phone to schedule their first appointment and then hang up. They describe being convinced they need therapy one day and feeling fine the next. Just like the stages of change, deciding to seek counseling is a process for many people. Entering your first session is a courageous first step.

All therapists & their techniques are different, but while the stereotypical couch might be absent, you can expect a comfortable place to sit during your sessions. Your therapist will want you to be comfortable so don’t be afraid to ask for that extra pillow if you’d like it or to fidget with your hands if you need to. Generally, sessions are just under an hour long, but your first session may be longer as you’re getting to know each other.

Once we get settled and work our way through any necessary paperwork, I usually explain confidentiality — that everything you tell me stays with me — and I share information about myself, my training, and my approach to therapy. I also share the importance of finding the right therapist. This is key — you must feel safe with your therapist and trust them for therapy to be effective. I typically recommend that an individual attend at least three sessions before deciding if therapy and the therapist are right for them, but I always discuss what options are available if I am not the right therapist.

Most people feel better after the first session.

They share that just beginning the process and taking the first step makes them feel better. However, this is not the case for everyone. Some describe that they feel worse as they are apprehensive about discussing painful emotions and memories, while others report they feel the same. That’s ok. Therapy can occasionally be a painful process as we work through difficult topics, but I encourage all my clients to stick with it and work through the pain to find growth and healing.

Typically, I will ask the client if they have any questions about me or the therapy process. If not, I ask what brought them in; often there is an event or trigger that prompts a new client to schedule their first appointment. I will also ask about goals for treatment and changes they would hope to see as a result of therapy.

After that I gather history about the client and their life. Questions might include:

• Your personal history and current situation.
• Your current symptoms (panic attacks, disinterest in favorite activities, etc.) and any previous diagnosis.
• Family history of mental health diagnosis

Therapy will work best if you are open and honest about your feelings. Don’t be afraid to share your concerns with the therapist, they are there to help.

Beginning therapy is a huge step to better yourself. Make sure to support and encourage yourself on this journey.

(This article written by Carol Pulley, co-founder of iTherapy and Licensed Psychological Associate.)