You may know how to prepare to see a doctor for a new physical ailment, but how should you prepare for your first therapy appointment?
Although prepping for your first appointment with a therapist is a good idea, it’s not something people frequently do. “There is often times a mysterious element around therapy and especially about what to expect during the first session,” says licensed clinical psychologist Annie M. Varvaryan of Couch Conversations Psychotherapy and Counseling in Los Angeles.
However, therapists want to remove some of that mystery so you’re well-equipped for your first session.
Advantages to Preparing for Your First Session
There are a few advantages to preparing for your first therapy appointment:
— You save yourself time by knowing what you want to address in therapy. You’ll be less likely to walk out of the session and then remember something important you wanted to tell the therapist.
— Although it’s normal to feel nervous about therapy, doing some advance prep may put you at ease. It also helps give some sense of control about what will happen during the first session.
— Arriving to the session with some idea of what you want to get out of therapy can help you and your therapist establish a treatment plan with realistic expectations, says Barbara Nosal, a licensed marriage and family therapist and chief clinical officer at Newport Healthcare in Irvine, California.
[Read: What to Look for in a Therapist.]
Finding the Right Therapist
A logical first step to preparing for your first therapy appointment is to find a therapist who you think is a good match. You may be limited by what your insurance covers or what the therapist charges. You also may find yourself limited to who’s in your geographical area, although you’ll broaden your choices if you’re open to telehealth appointments.
Online profiles for therapists should indicate if you can schedule telehealth appointments with them, or you can always ask them directly if they do telehealth.
Beyond those logistics, try to have a vision in your mind of who you think you can open up to in therapy, advises licensed psychologist Nicole Lacherza-Drew, owner of Vici Psychological Care in Allendale, New Jersey. Some questions to consider when choosing a therapist:
— Would you feel more comfortable talking to someone around your age who can relate to you?
— Do you want to speak with someone who’s the same sex as you?
— Do you prefer a certain approach to therapy? Some therapists use approaches to change your thinking patterns, such as cognitive behavioral therapy. Other therapists may focus on exploring your personal and family history in depth, such as psychoanalytic therapy. Therapists often share the approach they use on their website or via online profiles.
It’s fine to ask friends, family or your primary care doctor for names of therapists who may be a good match, but remember that everyone has different needs. A therapist someone else loves may not be the right match for you, even if the therapist is highly skilled.
Some therapists offer a brief, free phone consult to give you a better idea of their approach and style. Use these to your advantage by reaching out to multiple therapists, recommends Dr. Arpan Parikh, a psychiatrist and senior director of clinical experience for Ro Mind, a digital mental health platform for anxiety and depression. Parikh likens the process to speed dating, so you can get to know more about each therapist and practice in short intervals.
How to Prepare for Your First Therapy Appointment
There are a few steps you can take in advance of your first therapy appointment to get prepared:
Write down what’s bringing you to therapy. If you like to journal, you can write it down there — but it’s also OK just to use a notes app on your phone. Add new observations as they come to you. Review what you wrote down prior to your first appointment, Nosal advises.
Have some goals in mind, Parikh advises. This may be hard to do if you’re new to therapy and you’re not sure what to expect. Still, you can start by considering how your mental health concerns affect certain areas of your life and what types of changes may be helpful to improve those areas.
For instance, maybe your goal is to change a certain negative behavior that you repeatedly have at work. Or, you want to stop picking the same argument repeatedly with a loved one, and therapy may give you clarity on why you keep having this argument.
Prepare a list of all medications you use, including over-the-counter drugs and natural supplements. This information is valuable to a therapist in case the medication has any effect on your changing mental health. Make sure to write down the dosage you use for each medication. Better yet, bring the medication bottles of any prescription drugs, OTC drugs or herbal supplements with you to your first session if you can, Lacherza-Drew suggests.
Review some of your previous life history. This could include:
— Developmental milestones, like learning to walk and talk.
— Old grades and report cards.
— Your medical history.
— Your work or school timeline.
This information will give the therapist a more complete look at your life and help you spot patterns that may be related to your current issue, Varvaryan says. For instance, you may review old report cards and realize you’ve always had trouble paying attention in class, which is something you’ve noticed more recently and want to address in therapy.
Tracking down this information in advance will ensure more accuracy than trying to recall it in the moment.
Be prepared to do some paperwork. The therapist may have you do this at home before arriving for the appointment or by showing up a few minutes early to fill out information.
Try to keep an open mind. You’ve likely seen portrayals of therapy on TV shows or in the movies, but your actual therapy may be very different, Varvaryan says. Commend yourself on taking the brave step to set up a therapy session, and keep an open mind about what will happen during therapy.
What to Expect in Your First Therapy Session
Your first therapy session will go by quickly, Lacherza-Drew says. With many therapists, you’ll spend part of your first session going over paperwork. This means the therapist will review what you wrote down and ask you questions about it, but it also means going over important policies. These can include the:
— Cancellation policy.
— Emergency contact policy. If you have a mental health emergency outside of your time in therapy, the therapist may tell you to call 911 or go to your nearest emergency room. Some therapists may say you can contact them if they are on call.
— Handling of insurance and payment.
— Legal and ethical obligations. Lacherza-Drew works frequently with teens and will let both the teen and parents know the type of information she can keep confidential versus what she is obligated to share with others, such as a person threatening to harm themselves or someone else.
Many therapists will use the first appointment to go over their own credentials and therapy style. They also will give you a chance to share a few more details about why you’ve come to therapy, and ask any questions you have. Don’t be shy about asking questions.
Some therapists will have a highly structured process to get to know you and review paperwork during that first appointment. Others will be more casual and may simply ask, “What brings you in today?” and guide the discussion from there, Varvaryan says.
With more therapy sessions now done virtually, you may wonder if your first virtual therapy appointment is any different than an in-person meeting. It’ll be the same for the most part, with the therapist reviewing paperwork and policies, Lacherza-Drew says.
During your first therapy session, there are a few questions you may want to ask to get a clearer idea on what to expect from therapy:
— How much experience do you have with my issue?
— What is your area of expertise?
— How would you describe your therapeutic approach/process?
— How do you typically treat clients with similar issues?
What to Do After Your First Therapy Session
Even if you’re busy, do your best to take some time to reflect on your first therapy session. Although much of your first session may have focused on paperwork and introductions, you can still reflect on anything you revealed during therapy and how that made you feel or what you thought about the therapist. Write down your thoughts in a journal, if you feel comfortable doing that.
Reflection is an important part of therapy, but Lacherza-Drew realizes not every client will take the time to reflect after therapy sessions. For this reason, she’ll often ask clients when they return for their next appointment about how they feel about anything that they revealed last time. This builds some self-reflection into the appointment.
Don’t expect to have all of your questions answered about your issue after your first therapy session and during that initial self-reflection, Nosal says. Still, you may gain some valuable insight into your current issue or your thoughts on the therapy.
Continue to practice some self-reflection after your subsequent sessions with your therapist to help you get the most out of your sessions.
How to Know If Your Therapist Is a Good Match
Your therapy will likely be more successful if you feel that you have a good fit with your therapist, Parikh says. That’s why trying to find a good match for yourself in advance, and then confirming the person is right for you in person or on a video call, is an important part of the therapy.
Still, not all therapists and clients are a good match. Listen to your gut. If you see yourself having trouble opening up to the therapist for whatever reason, you may have to find someone else.
Because the first therapy session spends so much time covering policies and paperwork, you may want to give the therapist at least one or two more appointments before making that judgement call, Nosal advises.
Sometimes, clients may confuse nervousness about the therapeutic process with not clicking with the therapist. That’s yet another reason to consider giving the therapist a little more time before switching, Varvaryan says.
If you still don’t think you have a good match, be straightforward with the therapist instead of canceling appointments and ghosting them. “You won’t offend me, and I won’t get mad,” Lacherza-Drew says. “My job is to help you, even if that means finding a referral (to another therapist) for you.”
It actually can be helpful for the therapist to know why you aren’t a good match, she says. There may be something the therapist is doing that they can do differently to help future clients.
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Update 06/15/22: This story was previously published at an earlier date and has been updated with new information.