I wanted to write a short blog article to help potential clients feel reassured about what to expect in their first counselling & psychotherapy appointment for face to face and online therapy. Most new clients tell me that they have thought about coming to therapy for a long time, in many cases years, so I hope that this will help to demystify the concept of coming to therapy for the first time. Personally speaking I want clients to have a positive experience from their first session so that it helps normalise the idea of being in-therapy. If you have been thinking of starting therapy, don’t waste any more time, just go for it.
Many people consider therapy for between six months to two years before they make an appointment with me. The lead up to your first session can feel a bit daunting and nerve racking, the fear of the unknown and not really knowing what to expect but don’t worry too much. How do I start, what do I say, what will they think are common thoughts people can have first time around. Remember, every single therapist had first session nerves just like you! It’s really reassuring to know that your therapist will guide and lead you though your sessions every time, particularly your first session.
I like to break my sessions down into three parts which are an opening, middle and closing section. We know how difficult the first steps can be and meet new clients every day so an important part of our role as a therapist is to make you feel at ease and comfortable during each and every session.
What Should I Expect From My First Therapy Session
Most therapists will follow a similar process in the first session so this article outlines the process that I like to follow myself. The first session is very much an informal relaxed session of getting to know each other and a discussion around how we can both work together therapeutically with your particular presenting issue. What you can definitely expect to get from your first session is a safe supportive space to start talking about what ever it is you are going through. Below is a road-map of how I like to work through the first sessions.
Consultation Form. You will be asked to provide basic information such as medical conditions, GP details and contact details of a next of kin in the event of an emergency.
Introductions. I will introduce myself and my practice and what to expect from the first session to help put you at ease. Personally I take notes during sessions which I use as as a visual tool in therapy with my clients.
Explaining The Therapist Client Confidentiality Agreement. I will explain to you information about the our confidentially agreement and also the limitations of confidentiality and answer any questions you may have.
Sharing. This first session is really a safe space for you to talk about everything that brings you to therapy. I like to call it a session to just offload all your problems and worries. It can take some time to get used to taking about yourself but you will be amazed how quickly you can adjust and have plenty to talk about.
Identifying Problems. By the end of the session we will discuss some areas to focus on in therapy over the coming sessions and also discuss how many sessions to start off with. You may be asked to complete an assessment during the first session which will also help us narrow down some areas to focus on.
Closing The Session. I will spend five to ten minutes closing the first session and checking in with you to see how you are feeling or any thoughts and questions you might have. Many people are feeling much more relaxed as we come to the end of the first session and most report feeling relieved, happy, motivated that it is over after thinking about it for some time.
It is important to be realistic and not to expect to much from your first session. I think that many people expect to have life changing experiences in therapy and that they will walk out the door feeling fixed or better after just one hour. The reality is that most of the changes happen for the patient between sessions as they learn to practice what has been discussed in therapy and start to focus and reflect more on themselves. I regularly hear clients say ‘I tried therapy before and it did not work‘ and when we explore this more early in therapy, they may have attended just a handful of sessions, sometimes just one and had unrealistic expectations of the outcome. Therapy is where you come to talk about change, the next part is to actively learn how to change outside of sessions.
I can reassure you that your second session will feel easier to attend, as you know where you are going and what to expect. Ongoing sessions will feel like they have a nice natural comfortable flow as we get to know each other more and develop a relationship overtime. Therapy is a process of change, healing and personal insight. It is also learning to be vulnerable and open with another human being and using that connection with your therapist to help you to accept yourself, change and grow. All of which takes time.