Wednesday, June 13, 2018

What to Expect at Your First Therapy Appointment

A lot of people might look into seeing a therapist, but the anxiety of what a therapy session could entail can prevent people from actually making an appointment.  Every therapist is different, but in general most therapists adhere to a similar plan for the first therapy session.  If you decide to make an appointment with me, here are some things you can expect for your first session:

  • The session will last approximately 50 minutes - 1 hour

It's pretty standard for a therapy session to go for about an hour.  If you think you need more time, let me know!

  • I will ask you to complete forms regarding general contact information

Yes, there is some paperwork at the beginning, but this is so I have all of your information on file and hopefully won't need to call you about small details.  I usually will send you paperwork before your first session so we can spend less time on paperwork and more time talking about you!

  • We will review confidentiality and informed consent

Confidentiality and informed consent are probably the two most important things that have to be covered at your first session.  I will let you know that everything you say to me stays only with me, that I will not be giving out your information to anyone without your consent.  That being said, I am also a mandated reporter which means I have to report things like abuse/neglect, or potential harm to yourself or others.  We will then go over what you can expect from the therapy experience.  This ranges from benefits/costs of therapy, my business policies, and how participating in therapy is your choice and you can choose to stop at any time.

  • I will gather information about your presenting problem

The main reason someone seeks therapeutic support is because they are experiencing some kind of problem.  I will ask you to tell me about what has been going on in your life and the current problems and good things that are going on.  I will let you know you can tell me as much or as little as you want, though the more information I have the better I can assist you as your therapist.  I will also ask if you have made attempts in the past to work on this problem and what worked or didn't work.

  • I will ask you to tell me about historical information regarding your upbringing, past medical or psychiatric problems, family history, and substance use history

I ask about your history because I want to better understand not only why you might be struggling with certain problems, but also strengths you have that can assist you in therapy. Again, I will say you can share as much or as little as you want to.

  • I will ask you to tell me more about other current problems, including medical, psychiatric, and social issues

Although I offer different skills and techniques in the therapy process, I still believe in holistic care which focuses on a client's biological, psychological, and social well-being.  Sometimes skills involving a presenting problem can be physical or relationship-oriented.  The more I know about your current problems, the more I can integrate skills that can benefit multiple issues at once.

  • We will set initial goals in terms of what you want to accomplish in therapy

Besides confidentiality and informed consent, the third most important factor of the first session (in my opinion) is setting your initial goals for what you want to accomplish!  Therapy is not just about talking, it's about implementing new skills and lifestyle changes in order to achieve the goals you set out for yourself.  We will figure out some initial goals together, and as your sessions continue we will review progress and create or change any goals that we need to.  I believe in working as a team, so you will be directing the goals you want and I will be helping you learn skills to achieve those goals.  

  • We will review next steps, and hopefully set up your next appointment!

In order for therapy to remain goal-oriented and productive, I will be asking you to practice skills or complete an assignment at home.  After your first session, I am probably going to ask you to start thinking of ways to work on your goals.  I might also ask you to journal about your thoughts, emotions, and behaviors.  Every client is different and I believe in client-centered care, so next steps are going to be different for each individual client.  If you feel like in this first session that you connect with me, or feel hopeful about working on your problems, then we will also set up your next appointment.  


As with every session, I strive to make sure you will feel comfortable, understood, and heard during your initial session.  Please feel free to tell me if at any time you feel uncomfortable or don't want to discuss certain topics.  I also keep in mind that therapy is a process, and therefore I might not learn everything about you during your first session.  That's ok!  In fact, it's very normal for me to learn more about you as we have more sessions together.  I will mirror the pace you are comfortable with and we will go from there.

I hope this post helps answer any questions or concerns you may have about what your first therapy session will be like.  If you have more questions, please do not hesitate to contact me:  803-875-1699 or ashton@ashtondobycounseling.com.