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Demystifying Your First Therapy Appointment: Expectations and Realities

Updated: Dec 29, 2023

Seeking therapy can be a daunting step, especially if it's your first time or you're transitioning to teletherapy. However, understanding what to expect from therapy can help ease any anxieties and empower you to steer your own course. In this blog post, we'll explore what you can anticipate from your first therapy session, delve into the initial sessions, and touch on the essential element of building rapport in teletherapy.

The Initial Session:

  • Paperwork and Administrative Tasks: In your first therapy session, you can expect to spend some time( and by some I mean a lot) completing paperwork, which may include consent forms, privacy policies, and insurance information. This administrative work is standard and ensures your therapist can provide you with the best care while protecting your confidentiality. Basically we will tell you what we are going to tell you, tell you what we have to tell you, and then review what we told you. In my practice I send administrative forms prior to our first session to allow the client to review, (actually read) and ask questions during our initial session.

  • Intake Assessment: Your therapist will conduct an intake assessment, which involves asking you about your background, current concerns, and reasons for seeking therapy. This helps the therapist understand your unique situation and tailor their approach to your needs. You may also see the word " Biopsychosocial" the biopsychosocial model, looks at how your physical health, mental health , and social factors all interact and influence your overall well-being. It's a way of understanding that our health and how we feel are not just about our bodies or minds alone but are also shaped by our surroundings and relationships. This approach helps healthcare professionals and therapists consider all these aspects when helping someone with their health or mental well-being. As a social worker we geek out over this holistic intersection. I've defined it a little more in depth below so if you are preparing for your first session or thinking about thinking about therapy these are some good questions, considerations to have.

Bio - This part relates to your body, physical health, and biology. It considers things like your genes, medical conditions, and how your body functions.

Psycho - This part relates to your mind, thoughts, and emotions. It considers your mental health, feelings, and the way you think about things.

Social - This part relates to your social life, relationships, and the world around you. It considers factors like your family, friends, culture, and the environment you live in.

  • Setting Goals/ Treatment Plan: Your therapist will work with you to establish therapy goals. These goals will guide your sessions and provide a clear sense of direction for your therapy journey. Be open and honest about what you hope to achieve. We may also refer to this as treatment planning. You may have heard buzz words such as SMART (Specific, Measurable, Achievable, Relevant, and Time-bound) ;but there are other types of goal setting schools of thought such as CLEAR goals. CLEAR goals focuses on making goals Collaborative, Limited in scope, Emotional, Appreciable (break down into smaller parts), and Refinable (open to modification),Vivid vision goals are also an approach, this involves creating a detailed and inspiring vision of your future, which can serve as a powerful motivator and guide for setting specific goals/ outcome. You know that Pinterest vision board... or maybe its backward planning ( it is what it sounds like.) or habit stacking goals or outcome performance goals... I could go on and on. You get the point. It is important to think about goal setting and what you want to achieve both from the initial session and the completion of therapy.

Next is your therapist "therapeutic approach", a question we are all still haunted by from our years in graduate school. Your therapist will likely explain their therapeutic approach or the modalities they use. They may use techniques such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), or psychodynamic therapy, depending on your needs and their expertise. Truth be told I'm still figuring out my " modality." I do not believe in a one size fits all approach, so when I am meeting with clients initially I have some ideas about interventions that may help meet their goals, but not every client gets the same recipe. Now I would say your therapist should be able to speak to their theoretical orientation even if its not quoting textbooks but just "hey this is who I am and what I believe in." If they can't / wont that may be a beige flag. Then we transition into the meat and potatoes of therapy process.

  • Building Trust and Rapport: Trust is the cornerstone of effective therapy. Building a strong therapeutic relationship with your therapist takes time, so be patient with the process. Open communication, honesty, and active participation will help foster trust and rapport. I end my sessions asking " question's, comments, concerns" and sometimes the comment is " yeah I really didn't agree on xyz you said." Which gives us a great jumping off point the next session. Obviously if it is a major issue I don't leave my clients hanging and just ghost them and sign off. Therapy is a sacred space, and for some of us the only place, EVER to feel safe. Emotional safety, reliability and secure relationships are built on the belief that the other person will consistently be there, fulfill their commitments, and provide support when needed. Which also means respecting boundaries, and conflict is often mistaken for poor/crossed boundaries. So disagreeing is good!

  • Confidentiality: It's crucial to understand that therapy is a confidential space. Your therapist is bound by ethical and legal obligations to keep your discussions private unless there's a risk of harm to yourself or others. Trusting in this confidentiality is vital for open and honest discussions.

  • Homework and Exercises: Depending on the therapeutic approach, your therapist may assign homework or exercises to complete between sessions. These tasks are designed to reinforce your progress and provide practical tools for managing your concerns.

Points to ponder regarding online therapy, now in my practice I am solely online so these tips below are the same standards I hold myself to on the other end of the screen.

  • Choosing a Quiet and Private Space: When engaging in teletherapy, select a quiet and private location for your sessions. This ensures that you can focus on the therapy process without interruptions or concerns about privacy.

  • Technical Requirements: Ensure you have a reliable internet connection and the necessary technology for teletherapy. Familiarize yourself with the teletherapy platform your therapist uses before the session to avoid technical issues.

  • Creating a Therapeutic Environment: Even in a virtual setting, it's important to create a therapeutic environment. Eliminate distractions, turn off notifications, and be fully present during your sessions.

So in closing embarking on a therapeutic journey, whether you're new to it or have prior history, is a brave stride toward enhancing your mental well-being. By gaining insight into what your initial session entails, embracing the continuous therapeutic process, and adjusting to the nuances of teletherapy, you can maximize the benefits of your therapeutic experience. Keep in mind that therapy is a shared voyage, with your therapist serving as a guide to help you achieve your objectives and nurture personal development. If you like what you read don't forget to click subscribe on my website for more, content, updates and exclusive offers.


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