What to expect from therapy the first time

What To Expect From Therapy

The First Time You Go

In deciding to try psychotherapy, you have already accomplished a difficult and challenging step: recognizing that a mental health, emotional, or relationship concern could use some support.

You may feel conflicted about going to therapy. Yet approximately half of the population will experience a serious psychological issue at some point in their lives. Life’s ups and downs can be sudden, novel, shifting, and outpace coping ability. Therapy has the potential to help you wade through challenges, get better, and heal faster. Psychotherapy can help you grow and strengthen through life’s challenges.

A good starting point is to explore what is working well in life, how would you like life to look, and what are your overall life goals? It can be helpful to jot down a few sentences or bullet points which may help you define what you hope to gain from the psychotherapy experience. This brief exercise may ease some of the conflict and focus treatment of therapy. I frequently state that “much of therapy is figuring out what you want, then helping you build the internal skills to get it.”

Therapy appointments start on time, and your therapist will greet you in the lobby. If you arrive early, you can relax on the lobby couches and take a few minutes to unwind. You will find the office is in a professional building, comfortable, and inviting. Your therapist will walk you to a private suite with comfortable seating, where you will have a conversation.

Therapy is different than talking to a friend. Therapy is confidential. A friend may share private information with family or a social circle, a therapist will not. There are exceptions to confidentiality, such as reporting child or elder abuse, or if someone is a danger to themselves or others. You can discuss any confidentiality concerns with your therapist.

There will be some paperwork which looks like disclosure statements and might be completed online or at your first appointment. It will review office policies and consent to treatment. Treatment is always voluntary and it is the client’s right to stop at any time, for any reason. The paperwork is an information packet to help orient you to the psychotherapy process and help you understand office policies, such as scheduling appointments. Your therapist will begin your first session by reviewing this information and provide an opportunity to discuss it or ask questions.

The therapist will then start a conversation, mostly about you. You can share what is comfortable for you. Therapy works best when you are open and honest. Your comfort may increase over time as more trust is built with your therapist. This first conversation will usually include dialogue regarding why you are interested in therapy, what is going on in your life currently, and some aspects of your history. It is important to repeat that you can share to the level that is comfortable for you. Your therapist, by profession, listens to people and the things that are important or challenging them. It can be comforting to know that your therapist will not judge your experience or feelings, and will listen to understand your concerns.

At this first appointment, you will get a sense of what it is like being in the room with the therapist. You can also ask questions of your therapist, such as their license, training, and experience working with the types of concerns you have. Your therapist will likely refrain from sharing personal or family information, and will focus the content on professionally relevant information. It is important to remember that not every therapist is a good fit for every client, and one of the success factors of therapy is feeling comfortable with your therapist. It is often helpful to know that therapists do not share specifics about their own personal lives, which is part of the process to help you.

You may be surprised at the emotional experience of sharing feelings or experiences in a new way. It can be emotional, evoke a sense of sadness and relief at this same time, or release some effort of holding feelings. Many people cry and laugh at their first appointment. The office is the place to explore these feelings, and is away from the pressures of the world. While some of these feelings may be uncomfortable, frequently a sense of relief is felt. There are benefits in being able to speak freely about what is on your mind and in your heart, and to be heard by a nonjudgmental person.

Your therapist may summarize or paraphrase what you have shared to ensure accuracy and set a plan. You may already feel a sense of relief having someone on your team. Therapy is a process and typically requires multiple sessions over time to create lasting benefit and change. You may identify a few concerns and develop a plan of treatment, highlighting what to address first and a schedule. You may be given a suggestion for home practice to explore thoughts and feelings, or perhaps to practice a technique learned in session. These are for your benefit and can aid you between sessions.

After this first session, you will have a sense of your therapist. This first session is really based on getting to know you and tailoring a plan that fits to meet your goals. Guidelines recommend 3 sessions to get a feel of the therapeutic process. Remember that therapy is a process and trust builds over time. Psychotherapy can be life-changing. Many people benefit from therapy. Many more could if they took that first step and decided to give it a try. It gets better, and therapy can help.

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