Psychotherapy: What to Expect In Your First Session

what to expect in your first psychotherapy sessionAre you feeling a little unsure about what to expect during the first psychotherapy visit? Is it your first time ever coming to see a therapist?

Many people feel anxious and uncertain about their first visit to a counselor’s office. This is a common feeling in psychotherapy.

Anxiety may be experienced and expressed in different ways by different individuals. Some people feel tense and guarded, finding it hard to relax. Sometimes, the relief of finally beginning to talk about a problem may result in an uncontrollable urge to cry. Some people talk rapidly. Everyone is different, and that’s okay. Knowing what to expect in a first session can help people to feel more relaxed.

There will be some initial paperwork:

When you come to my office for a first psychotherapy session, you will be asked to arrive 30 minutes early to complete initial paperwork, unless you have downloaded the forms from the website and completed them in advance. The paperwork needs to be finished before we can begin our session, so it is important to give yourself the time you need to complete paperwork so that it does not interfere with the time we will need for the first visit. The paperwork will include:

  • Administrative Forms: A basic client information form, Appointment and Financial Policies and Informed Consent to treatment
  • An initial questionnaire (to reduce time in asking these questions in the session)
  • A symptom checklist
  • Couple/Marital Therapy Policy if it applies
  • Credit card authorization form (filled out in the office upon arrival)

Once you are in the office:

I encourage clients to ask any questions, including those about my background, that would help them to feel more comfortable and get to know me. I briefly review the limits of confidentiality and the attendance contract. I will then ask a few questions regarding risk issues and other assessment issues. I reserve as much remaining time as possible for people to tell me why they are coming to counseling at this time and to discuss their current life situation.

I will ask questions as we go along, including each person’s perception of the problem if there are two or more coming to the session. At the end, I may give you another perspective of your problem to take with you, as well as a brief homework to help with goal setting.I have found in my work with couples,whenever possible, that an initial session of a longer length is often more satisfying for clients to feel as though they are getting into the issues in depth as well as some solutions.

Often people feel relieved after the first session once they have unburdened themselves of their problem and start to feel hopeful. Occasionally, people feel frustrated after a first session. I believe this is often the result of unrealistic expectations. When you are coming to psychotherapy and expect that change will occur in one visit, it is likely to be disappointing. Problems have been developing over a long period of time. Change does not occur overnight, and it takes time as well as your commitment to change for progress to occur.

And what to expect in the next few psychotherapy sessions:

During the next few sessions, we may talk about some of your early life experiences. I generally find, with individuals, couples and families, it takes me three to four visits to feel I know someone well and am more clear on the nature of your problems. As I get to know you and you get to know me, we become more clear about how to proceed in a direction that will be of most help to you. You will most likely feel similarly. I encourage clients to give psychotherapy at least that much time to feel comfortable and develop the direction of where you want to go and how to get there.