I Made a Therapy Appointment, Now What?

What to Expect Before and During Your First Session"
By Dr. Jeana Griffith
Alight Counseling and Consulting, LLC

One of the questions I get asked frequently is “What happens during the first therapy session?”. I wrote this blog to help take some of the mystery and anxiety out of the first session. I hope it helps you to reach out and get the support you need.

Before the first virtual therapy session clients are typically sent some paperwork to fill out through a secure patient portal this includes: a consent for telehealth treatment, a payment form, a history of presenting problem and symptoms form, and symptom assessment questionnaires. These forms are filled out and returned to the therapist prior to the first session through a secure patient portal.

The first session is a time for you and the therapist to get to know each other better. It differs from future sessions in that the therapist typically asks more questions to understand your situation and develop a plan to best support you. The therapist will go over the information gathered from you to learn why you are seeking treatment. This will include reviewing the questionnaires you filled out beforehand and asking you some follow-up questions about your concerns, symptoms and what has helped you cope. They will also want to know how this issue is impacting your daily functioning. For example, is your concern impeding you from doing things you enjoy, is it inhibiting you from going to work or other obligations. Your therapist will also want information about your medical, substance use, mental health, and family history. They may also ask about your employment status, living situation, and current support resources.  In summary, the first session gives your therapist a good overview of what’s going on, so you can work together to set goals and come up with a plan that works for you.

The first session is also a good time for you to ask your therapist some questions such as “What is the therapists’ approach to treatment?” “How many sessions might I need?”. You might also ask about the therapists’ experience working with clients with similar issues as yours.

During the first few sessions, you are also assessing if you feel comfortable with this person and if you think they are a good fit for what you need. Ask yourself: Do I feel comfortable discussing my concerns with this person? Are they attentive to me and my needs? Do they keep cutting me off when I am speaking? Are they professional? Are they knowledgeable about my concerns?

Please know that it is common for people to feel anxious or nervous before and during the first session. Be kind to yourself and know that sometimes it can take a while to adjust to the therapy process and that you may feel more comfortable opening up to a person over time. Whatever you are feeling during this session and future sessions, know that your therapist is there to support you. Be honest and open about what you are feeling so that the therapist can best support you.