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Sarah Pitters-Caswell

Your First Therapy Session: What to Expect and Why It Matters



Just about everyone who books their first therapy session wonders what will happen in the first session. This is normal! Fear, doubt, apprehension, and even excitement are some of the emotions that might come. The often dreaded anticipatory anxiety tends to get the adrenaline* going. Some questions that come up in anticipation are: Will this work? Did I pick the right therapist? What am I going to talk about? Do I really have a problem? Can I afford this?

 

Uncertainty can fuel emotions of self-doubt and anxiety. Taking care of yourself is the first step to feeling better, and the next step is showing up to your first session with all these questions. The therapist you chose is there to support you, answer your questions, and help you feel safe.

 

Every practice and clinic has their own way of conducting an initial session, but the general nature of it is usually the same. Initial sessions can vary in length ranging from 45 minutes to 90 minutes. It's best to check with your therapist for these details as sometimes initial sessions are longer than subseuqnt sessions.


At a private practice like Flexible Minds, you will receive a consent and an intake form before your session. We need your consent to begin therapy. Without it, we can’t start the work. Intake forms give psychotherapists a starting point. If you are painting, the intake form is a canvas for your therapists to work with. Depending on the practice, some intake forms may be more or less detailed.

 

Each therapist has a unique style and training; getting to know the therapist and how your therapist would like to work with you is essential. In the first session, your therapist will ask you many questions. It may feel like you're jumping topics often. This helps them clarify and decipher what you want to work on and where you want to go in therapy. Some specific areas the therapist might task about:

 

·      Previous work with other therapists, counsellors, social workers or coaches,

·      Medical history and medication,

·      Social support such as family, friends, groups,

·      What has helped in the past,

·      What do you think they need to know about you to work with you.

 

Some therapists will go through the logistics in the initial session. These items may include making sure you understand the importance of your privacy in virtual therapy, clinic policies or procedures, and the Personal Information Protection and Electronic Documents Act (PIPEDA). As psychotherapists, we want to make sure you feel safe and secure from the moment you meet with us. Other logistical information that is covered:

 

·      Confidentiality,

·      Payment and fee,

·      Cancellation policies,

·      Length of session,

·      Therapist credentials.

 

Always feel free to ask your therapist about any of this logistical information. You can also email your questions to your therapist.

 

Some of this information might feel repetitive, but clarifying it is integral to the process. Clarifying helps your therapist gather missing information, ensure you feel safe, and remember you can never talk too much. Your therapist will get specific with you and, if need be, interrupt you.

 

By the end of the session, your therapist will summarize what you two discussed and check in with you again about your feelings. They might discuss how they might work with you and get your feedback. Either way, you will feel that the session is coming to an end. Other final items your therapist may discuss with you:

 

·      Scheduling your next session,

·      Treatment options,

·      Treatment goals,

·      Possible assessments,

·      Next steps.

 

At this point, you might find that the therapist is doing most of the talking, and your brain might begin to process everything you shared. You are also encouraged to ask any questions here that you may have.

 

What happens after the first session?

 

Some individuals find they go over every detail they share, and others move on easily. You might question what you shared and whether it was necessary. Ruminating* can be part of the process. Bear in mind that you are just getting to know your therapist, and they are getting to know you. Here are some valuable tips to help you process your first session:

 

·      Jot down notes on your phone or journal to track what comes up after a session,

·      Go for a walk, 

·      Hit the gym,

·      Drink some tea,

·      Tell a friend you went to therapy.

 

Whatever you do, please do it for you.

 

One of the great things about therapy is that you control your care. You can decide when your next session takes place and what you want to address. Therapy doesn’t work overnight and sometimes feels like a roller coaster, but the work begins in your first session. One thing is for sure: you showed up for yourself.

 

Discover Flexible Minds therapists HERE

 

Glossary

 

*Anticipatory anxiety is defined as excessive worry about future events. It is what we feel when we have uncontrollable worry about the future, bad things that might happen, or the inability to successfully accomplish what we set out to do in the future.

 

*Adrenaline is a hormone produced by the adrenal glands to help us prepare for stressful or dangerous situations.

 

*Ruminating is when you are thinking deeply about something. Rumination can also be negative in the sense of repetitive thinking or dwelling on negative feelings, their causes and consequences.

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