What Happens in Your First Therapy Session and How to Prepare

It is perfectly natural to be nervous for your first therapy session. First, know that I applaud your effort in making the appointment. That is a great first step!  

Scheduling that first therapy session can be difficult, even frightening. But you’ve done it, and you can congratulate yourself for taking that courageous step towards a healthier life. Still, you may have some concerns and fears. Allow me to allay those fears and prepare you for this first, important meeting with your therapist. 

As a psychotherapist in New York City with an orientation in psychodynamic and cognitive behavioral therapy, I help many individuals and couples overcome a variety of challenges, from depression, anxiety, and marriage and infertility counseling. I have found that when my clients know what to expect and have taken the time to prepare themselves for a successful session, we are able to accomplish so much more in subsequent meetings, leading to positive outcomes.

Let me share what you can expect from me in our first meeting. I will also let you know what you can do to prepare. Most therapists will likely follow a similar procedure. 

What to expect

When you arrive, you may have paperwork to complete; if so, I will let you know ahead of time. We may have already discussed your insurance coverage and any documents that you should bring to the first appointment, if any. 

I will begin with simple questions to make you feel comfortable. Then I will guide you through a series of questions to help me understand some background about you, your needs, and your goals. Questions I might ask:

  • What brought you in today?
  • What are your goals for therapy?
  • What symptoms are you experiencing? (anxiety, depression, problems with your spouse or at work)
  • How do these symptoms present themselves? (anxiety accompanied by panic attacks; marital problems resulting in explosive fights, etc.)
  • Have you had any therapy previously? What worked and what didn’t?
  • Is there any family history of these problems?
  • What helps now, if anything?
  • Do you have a support system, friends or family who are trying to help?
  • Are there any other important concerns or important factors in your life that I should know about?

These are the types of questions I usually begin with, although each individual is different and I may need to expand in different directions, depending on your specific need. As we proceed I’ll share with you what I have heard to confirm that I understand. Then I’ll offer my preliminary thoughts on what steps would be best to take in future sessions. We can discuss in a broad sense the types of strategies, patterns of thought, and a “toolbox” of tactics that will help.

How you can prepare

Now that you know what you can expect, you can prepare for a successful first meeting. Here are some strategies:

  • Knowing the questions I’ll ask, take time before the session to ask them of yourself and prepare honest answers.
  • Sometimes in our first session, you may have to delve into uncomfortable or painful memories that you might be hesitant to address. Going into those places more deeply will probably be necessary in future sessions in order for you to find the healing that you seek. But in this first session, before you know me well, you may be hesitant to share. Please be assured that I will keep all that you share in strict confidence; it is not only the law, it is the ethical and compassionate thing to do.
  • Recognize that we will collaborate to figure out the answers to your questions. It is my job to help you address the root causes of your situation and guide you as you make the discoveries and the interior changes necessary to be healed and whole again.
  • Prepare any questions you have for me.
  • Reserve some “me-time” before and after the session. Give yourself a little pampering ahead of time so that you are relaxed. After the session you may be a bit emotional, so you’ll need to wind down with something that you find peaceful. Make plans and clear your schedule to allow for this extra personal time.
  • During and after the session, ask yourself, “Are we a good fit? Do I feel comfortable sharing with this person? Do I feel like she understands my situation and has the experience to help me?” Not everyone clicks with a particular therapist. Personalities and styles need to mesh. But if you’re not sure the first time, give it a couple of sessions before looking elsewhere. You’ve taken a big first step; give it some time before starting over with another therapist.

These are just a few ways you can prepare for your first therapy session, no matter who your therapist may be or what your concerns and needs are. I sincerely hope you find the help that you need, whether it’s a matter of feeling stuck and needing guidance to find a new direction in life or a matter of deep trauma that requires more intense therapy. Find the help you need from a licensed, experienced therapist in your area who specializes in your issues. If you are in the NYC area, reach out to see how I can help you.

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