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?
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Although prepping for your first therapy session is a good idea, it’s not something people frequently do. “There is often 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 prepared for what’s to come and able to make the most of it.
Why Prepare for Your First Therapy Session?
There are a few advantages to preparing for your first therapy session:
— You’ll 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 you 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: Low-Cost Therapy Options for Every Budget.]
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 by who’s in your geographical area, although you’ll broaden your options if you’re open to telehealth appointments.
Online profiles for therapists should indicate whether they accept telehealth appointments, 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. 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 gender 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 focus on exploring your personal and family history in depth, such as in psychoanalytic therapy. Therapists often share the approach they use on their website or via online profiles. It’s OK if you don’t know in advance what approach to therapy you want. However, if you have a strong preference, it’s good to seek someone who offers that approach.
— Do you want someone who offers virtual or in-person therapy? Virtual appointments became popular during the COVID-19 pandemic, but many therapists have seen an uptick in the desire for face-to-face therapy as well.
[READ: How to Find the Right Mental Health Counselor for You]
It’s fine to ask friends, family or your primary care provider 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 that therapist is highly skilled. Plus, you’ll want to make sure you feel comfortable sharing with friends and family that you’re interested in therapy.
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, chief medical officer at SOL Mental Health in Denver, a virtual psychiatry platform. 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:
— Jot a few notes
— Take inventory of medications
— Review life history
— Prepare for paperwork
— Arrive early, with an open mind
Jot a few notes
Before you go, write down what’s bringing you to therapy. If you like to journal, you can write it down there, but it’s also okay just to use a notes app on your phone. Add new observations as they come to you.
While you’re doing that, have some goals in mind, Parikh advises. This may be challenging 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.
Review what you wrote down prior to your first appointment, Nosal advises.
Take inventory of medications
Write down a list of all medications you use, including over-the-counter drugs and dietary supplements. This information is valuable to a therapist in case a medication is affecting your 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 life history
Your therapist may find it helpful to know about your life history, including developmental milestones, old grades and report cards, your medical history and your work or school timeline. It’s also important to talk with them about any previous mental health issues, even if they aren’t what you’re experiencing now.
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.
Prepare for paperwork
The therapist may have you complete some paperwork at home before arriving for the appointment, but you’re likely to fill out additional paperwork at the office. They may ask you to show up a few minutes early to fill out information. Your paperwork may include a medical history as well as diagnostic surveys.
Arrive early, with 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. Commend yourself on taking the brave step to set up a therapy session, and keep an open mind about what will happen during therapy.
It’s helpful to arrive early, for both telehealth and face-to-face appointments. “Even if this is your 47th time in therapy, arriving five to 10 minutes early to telehealth to make sure everything is connected and ready to go is helpful,” Lacherza-Drew says.
Arriving a few minutes early to an in-person appointment gives you time to check in, use the restroom or get some water and even just shift your mindset so you’re ready for the session. If the therapist asks you to show up even earlier to complete paperwork, then plan to do that.
[READ: Types of Therapy: Choosing the Right One for You.]
What to Expect in Your First Therapy Session
Your first therapy session will go by quickly. 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:
— Cancellation policy. It’s important to know the office policies on when you can cancel without a fee. Many will request that you give them at least 48 hours notice.
— 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. Depending on your health insurance, you may have a separate policy for behavioral health. Give all of your insurance information to the therapy office beforehand, and ask what you’ll be paying so that you’re prepared.
— Legal and ethical obligations. Lacherza-Drew, who works frequently with teens, 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 also 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.
During your first therapy session, there are a few questions you may want to ask to get a clearer idea of 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 think back 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. Or, use an online mental health journaling app if your therapist recommends that.
Reflection is an important part of therapy, but Lacherza-Drew realizes that not every client will take the time to do it. For this reason, she’ll often ask clients when they return for their next appointment how they feel about anything that they discussed in the last session. 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 situation or your thoughts on the therapy.
Continue to practice some self-reflection after 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.
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 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.
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. There may be something the therapist is doing that they can do differently to help future clients.
How to Get the Most Out of Your First Therapy Session and Future Appointments
Here are a few things you can do to get the most out of your first therapy session and any future appointments:
— Keep an open mind. This is especially important as you get to know the therapist’s personality and approach through those first few sessions. “Be open to hearing things that might not be the most pleasant to hear, and be open to collaborating with your therapist,” Lacherza-Drew advises.
— Bring a notebook to jot down questions or observations. Or, use your phone to do so.
— Be honest in therapy. “Your therapist can’t help you if you aren’t honest, and then that’s a waste of time and your hard-earned money,” Lacherza-Drew says.
— Let your therapist know about any concerns and hesitations you have regarding therapy. “These are dynamics best worked through instead of avoided or ignored,” Varvaryan says.
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How to Prepare for Your First Therapy Session originally appeared on usnews.com
Update 03/21/25: This story was previously published at an earlier date and has been updated with new information.
