The First Therapy Session – What To Expect

The First Session

If you have scheduled a first session with a psychologist, you have already had to jump over a number of hurdles – acknowledging that support could be helpful, calling a stranger and telling them about yourself, finding time in your schedule to come in, and deciding to spend money on working on your well being.

Now here you are, ready to go to the appointment but feeling a bit anxious as you wonder about what the next hour will look like.  Here is some information about what to expect in that first session.  It tends to look different from those that follow, as it is more focused on information gathering and less on being therapeutic.  Unfortunately you aren’t likely to find solutions to what bring you in on the first day, but it is a way for you and the therapist to understand your concerns more fully.  Every therapist may handle this a bit differently,  but most first sessions will include these components.

  1. Paperwork, Forms, and Signatures.  You may receive these by mail or email prior to a session, in a waiting room before the session starts, or at some point during the session, but most therapists will want you to fill out some paperwork.  Often there is some sort of information sheet that includes basic information about you (address, phone numbers, emergency contact, etc) and may ask you some questions about what brings you in or what you are experiencing.  In addition you will usually be given a HIPAA privacy notice, and some sort of consent to services.  Some therapists will have additional measures they wish you to fill out too.
  2. Payment, Cancellation and other Policies:  Often payment and office policies are discussed prior to the first session when scheduling or in the consent to services that the therapist provides you in writing.  One way or another, these things will typically be touched upon by the end of the first session.
  3. What is private?  At the start of the session, the therapist will explain what you can expect in terms of privacy.  They will also let you know what situations they are legally required to report information about (see my FAQ page for what information has to be reported).  They may also tell you a bit about the type of treatment they provide or what you can expect from the session.
  4. What brings you in?  Therapists will typically start by asking you a bit about why you are interested in counseling and what brought you in at this point in time.  They may ask lots of questions to try to fully understand what you are experiencing, how long it has been going on for, how it affects other areas of your life, and how you have been coping with it.
  5. Let’s take a look at your history?  To truly try to understand what you are experiencing now, the therapist will ask you questions about your past.  They will likely ask you about your family, romantic partners, and friendships.  They may want to know what school was like for you growing up or how you feel about and interact in your work environment.  They may ask you about how much you drink or use other substances, and whether you have had any medical problems or surgeries.  They may ask you questions that seem like they have nothing to do with what brought you in, but this is all part of trying to get as thorough an understanding of you as possible.
  6. Goals.  Often a therapist will ask you about whether you have a clear sense of what you wish to accomplish in counseling, but you don’t have to have the full answer.  A lot of the time goals become more clear as you go.
  7. Questions.  Feel free to ask the therapist questions you have about how therapy works, concerns you have about policies, etc.

Sometimes these tasks can take more than one session and they may look a little different depending upon your therapist’s style, but hopefully this gives you a general sense of what you might expect when walking into a therapist’s office for the first time.


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