How to Prepare For your First Therapy Appointment:

Whether or not you’ve previously done therapy, most clients are usually a little nervous about their first session of therapy, and it’s understandable to be. You are meeting with a stranger to talk about the most private parts of your life. Not only that, but in therapy the focus is entirely on you! In reality, it is not as scary as you imagine. Most clients find that their nerves decrease significantly by the second session, if not after the first five minutes.

 In this page I’ll lay out what both the initial and later therapy sessions may look like, and I’ll provide some tips on preparing for your first session.

What does the first session look like?

We’ll first go over some administrative topics such as my no-show and cancellation policy (24hrs), how to reschedule or cancel appointments, etc. I’ll also go over confidentiality and privacy policies and answer any questions.

Next, we’ll talk about your goals for therapy (more on this topic later in this page). I’ll then ask you to tell me about several areas of your life (relationships, health, professional, financial health, etc.) to get a better picture of who you are and what your life looks like. I’ll ask that you share any significant stressors even if they don’t seem entirely relevant to the reason you started therapy. Part of my role is to help you make connections that you might not have noticed beforehand. I’ll also want to hear about what areas of your life are going well as we can often leverage these strengths in your therapy goals.

I may also ask more questions related to mental health functioning, such as how you are managing anxiety, your typical mood, and any specific mental health concerns you may have.  

The first session can feel a bit like an interview. Your job is just to be as honest as you feel comfortable. Remember that you are also interviewing me to see whether you feel comfortable working with me. Please ask me any questions that would help you in determining whether we are a good fit.

What do the next sessions look like?

Later sessions are more collaborative than the first. We’ll discuss and explore your goals, changes in your life, progress (or lack thereof) with your goals, or reactions to previous sessions. Your goals may also change throughout our work together as you gain more insights.

A common misunderstanding about therapy is that it’s focused on advice on what to do. Therapy sessions with me are more like a conversation, maybe with a 70/30 split with you talking more than me. I tend to listen more than talk – on purpose. I believe a good therapist doesn’t somehow know their clients better than the client knows themselves (which is presumptuous at best). Good therapists are deeply curious, have a healthy amount of doubt in their own interpretations and don’t jump to conclusions. By remaining open-minded and seeking to truly understand my clients I help them to gain a deeper understanding of themselves as well. I’ll help you to explore your concerns in new ways, often asking questions to help you to go a bit deeper than you might have on your own.

A big focus in my therapy is also to help you to improve your ability to notice and understand your emotions. Emotions are an important source of information that often go overlooked in our externally focused world. I might slow you down and help you to talk about your internal experience more than you are used to.

At the end of the session, I might recommend something to try in between our sessions such as writing more on a topic we discussed. These are always meant as suggestions, not as homework. In my experience, the most effective practices my clients have used are ones they come up with themselves after considering something we discussed. My suggestions are meant for you to take and to apply to yourself in the way it works for you.

Some Tips For Starting Out

Write down your goals for therapy.

What do you want to see changed as a result of therapy? A helpful question to help you define your goals is, “if our therapy is successful, how would you know? What would look different in your life as a result?”

Keep in mind your goals for therapy will not encompass everything you want to achieve regarding self-improvement. Self-improvement is a lifelong process; we are never really done with it. So, focus in on the goals most important to you in this chapter of life. Keep in mind that your goals can also change in therapy, or you may finish one and decide you want help with another. Just write the goals that feel right for now. I would suggest no more than 3-5 goals max, the fewer the better to help you focus.

If you are really struggling to define your goals don’t worry! Sometimes we only have a vague sense of what isn’t working in life. I can help you to clarify this in session.

Prepare yourself to open up.

Therapy works best when clients are as open and honest as they can be about the problems they are encountering. Even still, it is normal to take your time to get to know the therapist a bit before you might open up about very difficult topics. Push yourself to be brave and open, but don’t feel pressured to share everything in the first sessions.  

If there is an important area you are not ready to talk about you can let me know. You might say something like, “I may need to talk about ____ in the future, but I’m not quite ready to go there yet”. I will respect this boundary and will give you room to bring it back up when you are more ready to discuss it.

Consider starting a therapy log.

You can use a notebook (or notes app) to record your therapy goals, process what you discussed in your sessions, record insights, and write down things you want to discuss in future sessions.