What to expect in your first therapy session
So, you’ve booked your first therapy session. Now what?
You’ve already taken a big step by booking this appointment, but you still might feel nervous about the process. The good news is, it’s perfectly normal to feel this way! If it’s your first time in therapy, you might be uncertain about what to expect during this time or if you would even benefit from therapy. Even if you’ve been to therapy before, it can still feel nerve-wracking to put yourself in a vulnerable environment. To help you get a better understanding of what to expect during this first session, we’ve created a guide to share what you can expect and let you know how you can prepare.
First things first, you might find it beneficial to jot down your own points of things you might want to bring up to your therapist. This could include your reason for coming to therapy, significant life events, or any goals you have. Doing this will help you feel more mentally prepared, and it will give your therapist a bit of insight into who you are. That said, it is also okay to not know what to say to your therapist, and they will be guiding you with good questions. What matters most is that you share with them whatever it is you are comfortable sharing.
The next step might differ depending on whether your appointment is in-person or virtual, but there will usually be some type of check in. If your appointment is in-person this would typically involve entering the building and checking in at the front desk. If your appointment is virtual this would involve joining the virtual meeting room. Once the therapist is ready for you, they will bring you into the room, either by physically guiding you for an in-person appointment, or by accepting you into the room for a virtual appointment.
A therapist’s office will vary based on their personality, style, and therapeutic approach. Just like you and any other client, every therapist is unique and brings their own characteristics to therapy. Regardless of what their office looks like, the therapist’s ultimate goal is to create a warm and welcoming mental environment for you.
While each therapist’s first session might vary a little in terms of structure and topics, there are a couple of basics you can expect. One important topic that must always be discussed is informed consent. Informed consent is an essential part of therapy to ensure that you, as the client, are aware of everything involved in therapy. Informed consent is an ongoing process, and your therapist should be checking in with you to ensure you understand the risks, benefits, and goals of your treatment. Typically, a therapist will send you a consent form prior to your first session so you have time to read it on your own and then during your first appointment the two of you can discuss it further.
Confidentiality, amongst other topics, is something that will be discussed during the informed consent process. Although a therapy session is meant to be a private space for you to share anything you’d like, a therapist does have a duty to report in some cases. In Ontario, a therapist must breach confidentiality if they believe there is an imminent risk of harm to you or someone else; if a child is in need of protection under the Child and Family Services act, 1990; if there are legal proceedings such as court orders or warrants; and if the regulatory college requires information for administrative purposes. If you are working with a student therapist, your information might also be shared with their supervisor for learning purposes. In this case, the student would do their best to omit identifying information and discuss your case in more general terms, as appropriate. If confidentiality is something you are concerned about, feel free to discuss it further with your therapist and they can give you more insight. The informed consent process will also involve things such as services provided, record keeping, session fees, and cancellation policies.
Once you and your therapist have gone over the informed consent process, it’s essentially time to get to your story. You might be asked something along the lines of “what brings you into therapy?” and this is an invitation for you to share what you have been going through. From there, the therapist will continue to try to understand your story and might continue to gather information by asking questions. The therapist may also begin to explore your hopes for therapy by asking questions such as ‘how will you know if we are moving in the right direction? What will start to change?’
The typical length of an individual counselling session is 50 minutes. If you are receiving couples or family therapy, the length will likely be longer, ranging from 60 to 75 minutes, respectively. If you are a verbal processor, your therapist may suggest longer sessions. At the end of the session, the therapist will discuss payment arrangements with you. These arrangements would have been discussed during the consult call, if applicable, and the informed consent process as well to avoid any issues or surprises. Finally, if all goes well and you feel that the therapist is a good fit for you, you will book another session together! The journey to improving your mental health and wellbeing has begun.