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  • Jess Hadford-Crook, MA, LPC

What to Expect When Coming to Therapy for the First Time

Updated: Aug 19, 2020

Thinking about starting therapy for the first time? If you are anything like me, you don’t always like stepping into situations where you don’t know what to expect. Especially intimidating situations, and trust me, I know entering therapy for the first time can be intimidating! Here are a few things you can expect when heading to therapy for the first time. Keep in mind every therapist is different and every session will be different, but some generals may apply.

You do not have to lay on a couch. TV and movies often portray this wrong, like so many other things. You can lay down if that is how you are most comfortable, you may also sit, stand, walk around, dance, or sprawl out on the floor. Your choice!

You can bring in whatever you would like, whatever helps you feel more comfortable. Many clients bring in a water bottle or Starbucks. You may bring a sweater or blanket if you’re always cold, a notebook or journal, cough drops or candy. No need to worry about tissues, there should be plenty in the office for you.

At your first initial session, you will be asked to complete paperwork. Paperwork typically includes; contact information with a brief statement about why you are seeking services, a form covering fee’s and cancelation policies, a description of you therapists’ credentials and licensure, and HIPAA and privacy notifications. You can take as much time as you need to read through this and you may request a copy of the forms you sign if you would like.

Some time should be taken to discuss confidentiality with you so that you have a full understanding of how your information may be used and so that you know your rights as a client. Everything you share with your therapist is considered private and confidential information, with the exception of imminent safety concerns. All mental health providers are mandated reporters. This means that they make break confidentiality if there is a risk of you harming yourself or someone else, and child abuse is being reported. In maintaining confidentiality, some therapist’s may use white noise or sound machines to provide an additional barrier between their office and the waiting room. You may ask your therapist any questions about confidentiality as this should always be part of an open conversation.

Sessions typically last 50 minutes. This is to allow the therapist time to have some water, a snack, run to the restroom and prepare for their next session. Some therapists may be able to offer more of a buffer, feel free to ask if you need more time.

Your intake session may be a full hour. You are not expected to divulge everything in your first session. Building a relationship and getting to know each other takes time. Your therapist will likely ask you a lot of questions in the intake, often gathering information about current stressors, family history, medical history, and other background data. You may ask your therapist any questions you have as well.

Within your first few sessions, you should be discussing your goals for therapy. This should be a collaborative process with your therapist. As the client, you get to decide what you want to work on and your therapist should be offering helpful feedback on how you can achieve those goals. Goals also offer a helpful measure of change.

There are no right or wrong topics for therapy. You can discuss and explore whatever you would like. You might find that some sessions you share a lot and at other times you choose not to share as much, that is ok! You can choose to share as much or as little as you feel comfortable with.

Sometimes things get worse before they get better. You might notice you leave your session

with unresolved issues or feeling worse than when you came in. Therapy is a process and not a quick fix. You may also notice you feel tired after sessions. Therapy can be draining at times, and can be hard work. Stick with it, things will begin to feel better over time!

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