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How to do a first therapy session
What should I expect in my first therapy session?
This can be called different things by different people and organisations, for example, an initial assessment, contract, or initial consultation. This is usually a shorter session; sessions are generally 50 minutes, and the therapist will usually be looking for and asking if you are the best fit for what you are looking for. To do this, they may ask, 'What are you hoping to get out of therapy?' or ask some questions about risk, like, 'Are you drinking too much alcohol or taking drugs.?'
A good therapist will try to share organisations that specialise in the area you are looking for to help you build resources, although this is not always possible. However, you can always ask the person you are speaking to if they would recommend anyone in a particular area.
Some counsellors will charge for this initial consultation, and others will not, but remember, your time is not free!
If you are searching for how to access therapy/counselling now, the initial consultation is the first step in accessing this.
This is the start of your journey; as a counsellor, I would look to you to be as comfortable as possible; if something would help, facilitate that, drop me or the therapist you chose a message about this.
How long will the first session last?
This varies between organisations and counsellors; I tend to send a diary invite for forty minutes; time is one of the boundaries that tend to be important to a working relationship, so I tend to stick to this.
Some people may find the first session a bit more of a challenge than other sessions, so I find it helpful to keep it brief make sure you feel able to connect on some level with me and get the ball rolling.
The other reason I tend to keep the first sesssion brief is we dont tend to remember to much from this session its not always helpful to have a long session, but to keep it useful some people take a few notes on a pad or thier phone for some of the resources that we might mention.
What information do I need to provide about myself during the first session?
Each session, in honesty, is really different, and as a professional, I will adapt to what you need in the here and now.
I will usually lay out some of the boundaries of that session, explain the type of therapy I have been trained in, the time we have for the session and the limits of confidentiality.
The information I may request would:
- How would you like to be contacted?
- Emergency contact details.
- If you have any aims or goals for therapy
- I will ask if you have had therapy before and the bits you found useful
I may ask some questions about safety:
- Are you taking medication
- Have you had thoughts about suicide
- Are you at risk from violence
(With this information, it will be to aid you in ensuring you have access to all the resources you can access).
Some clinicians may ask complete a GAD-7 or a PHQ-9, I have attached these for reference, they are a great way to monitor progress and some employee assistance programmes (EAPs), or insurance companies might collect these.
Will everything I say be kept confidential?
In essence yes, if i were accessing a therapist i would ensure that they are registered with the ICO (Information commisioner office). This shows an understaning of the law and show a commitment to information security.
There are limits to confidentiallity as I am sure you would expect, everything you say is in confidene, the exceptions are if you are at serious risk of harm to yourself or others, this might
How do I know if this therapist is the right fit for me?
We would not take on a contractor to do work in our home or hire a cleaner if we were not happy with them visiting our home.
The information we are going to discuss might not feel comfortable, but we might ask ourselves, do we feel safe with this person the feeling of safety might come from? Are they explaining their training? Are you feeling as though there is the potential to open up to this person?
What is the therapist's approach or therapeutic style?
The style is not always that important; it is worth looking at the reason you are approaching therapy and then searching for someone with experience in that area; if you are not sure why you are looking for treatment right now if you ask yourself what you want to be different in a year then match to this styling.
I might ask myself, I would love my business to thrive in a year. Therefore, I might look for someone who works with career counselling or expresses this as an area of interest. If I were saying I hope to be happier, I might look for someone with skills around low Mood or depression. If I want to test the water and see how I go, I might check with someone who enjoys short-term work.
Are there specific goals or outcomes for the therapy sessions?
This is for you to decide. In some ways, therapy can be for so many things that it is tough to list them all but they might be:
- Gain coping strategies around an area you find challenging
- dealing with loss, grief, or separation
- learning to cope with a specific situation
- develop self-awareness
- Meet your potential in some area
- develop communication skills
- a place to decompress your experience
How frequently should I expect to attend therapy sessions?
This is really an individual decision; if you are in a time where things are difficult to unpack, then this might be twice per week; if you are in a great place, this might be a once-per-month check where you continue your self-development, some clients check in when they need.
Some therapists might be adhering to a model that means that they refer a certain frequency, I don't always think this works; for example, it takes me some time to take in and process what has been discussed I might do this ad-hoc, but I do tend to notice the most progress when I stick to the same time each week at different periods in my life.
Sometimes, you might be accessing a brief model, and then, in my opinion, it would be best to access each week to reach the goals you set out.
What is the cancellation policy, and are there fees for missed sessions?
Sometimes, life can be challenging to fit everything in, and I try to be flexible and reschedule where I can. However, I do agree on the first session that this should be done twenty-four hours in advance; otherwise, the session should be paid for; on your first session, I would usually send a confirmation to check that you are still able to make this session if you miss the first session, I may charge you a half rate for the second session.
Can I share specific concerns or topics I want to focus on in therapy?
Yes, ththis is your space and a sacpece for you to discuss what you want. Some of the client i have worked with have sent the details in the intial contact email or form
How will the therapist assess and determine the best course of action for my needs?
Talking therapy is a collaborative process; you will decide this together; the counsellor may have some ideas, but these are just ideas for you to take or leave; in certain situations, we will make recommendations; the fundamental concept behind most therapies is you are the expert in you, the therapist is just here to facilitate you finding your resources or potential outcomes.
What is the role of the therapist, and what is expected of me as a client?
I think Carl Roger answers this best:
"In the therapeutic process, the client is encouraged to bring forth their authentic self, exploring thoughts and feelings openly. The expectation is not to meet external standards but to foster self-discovery and personal growth, creating a space where genuine reflection and expression can flourish."
The First session, what do you want from your counsellor.
Additional Information
How do we establish trust and build a therapeutic relationship?
This takes time; working with someone regularly brings your authentic self and being open to the process.
Are there any homework assignments or activities outside of the sessions?
This is something that you may want to do. You may also not want to do this; depending on the situation, this will vary; you will not be doing homework if you don't want to, and you should not be concerned if you forget to do this. Some group work might be super simple, like taking a moment to note how you feel in certain situations, or may be slightly more complex, like keeping a journal.
How do I handle uncomfortable emotions or moments during therapy?
The therapy process is learning to regulate these emotions and understanding them better. Once you have had a chance to express these, you may feel some release; other times, you will need to take some time to look after yourself.
What if I'm unsure how to express myself or don't know where to start?
This can be a challenge, but it's a great starting point. I am unsure how to express myself; the questions can flow from this point, like how long have you felt this way? We can then learn to start connecting the dots and making sense of this situation; therapy might not exist without this question.
Is it okay to ask questions about the therapeutic process itself?
Yes! Ask as many questions as you need; it's a sign of a great relationship being able to ask what makes you ask that!
How will progress be measured, and how often will we review it?
This can be measured in many ways and is probably particular to your situation. It may be straightforward like I want to get to this place in my career, and your progress can measure it. It might be slightly more complex, and I am a fan of measuring things on a scale of 1-10, for example.
What if I feel the need to end or pause therapy? How is that handled?
This should be your journey, and you are in control; there are many reasons to pause and stop therapy from reaching goals (as a therapist, I love when this happens time to, celebrate!) and other pressures such as financial. You can let the counsellor know; there may be a workaround if it's financial. For example, I would charge a lower rate if one of my clients left their job.
Are there any specific self-care recommendations between sessions?
Self-care is core to being well and productive. You would not cut wood with a rusty saw; your body and mind are your tools. Keep them sharp and looked after; then they will look after you!
