What to Expect during the Initial Consultation

The first step in any therapeutic journey is recognizing you need a professional ear to listen to your story and then seeking out the therapist that seems to be a good fit for your unique journey. The second step (and arguably the hardest) is showing up to the first session willing to start the work necessary to make the changes you want to see in your life actually happen.

I’m here to dispel some of the anxieties around that first session and tell you about the six main elements of an initial consultation you should expect and prep for.

#1 Paperwork

Every initial consultation will start with some key documents to be filled out. The most important one is your consent for treatment. You sign this document to basically say that you know you are about to take a ride on an emotional roller coaster and you aren’t going to sue your therapist for making you cry. Whether you are a crier or not…at some point down the line you are going to cry and you aren’t going to like it. Just remember you signed that paper saying you were okay with that.

There will also be some paperwork outlining your fee,  an agreement stating that you aren’t seeing more than one therapist, an explanation of confidentiality, and various other regular document stuff that you would see on paperwork in any doctor’s office.

#2 Have Some Questions

Having some questions for your therapist is important because you should know that the person you are about to tell all your dirty laundry too is actually going to help you wash it and put it away. These questions help you decipher if the therapist is the right fit for your specific needs. Some basic questions that any therapist should be able to answer are:

  • What theoretical approach do you use?
  • Where did you get your degree? What is your degree in?
  • Do you normally work with individuals, couples, kids, teens, and/or families?
  • How long have you been seeing clients?

#3 What Should The Therapist Know About You

The therapist you see is going to ask you a lot of “get to know you” questions in that first session because…well…they are trying to get to know you. What they ask and how they ask it may differ, but they are looking for key ingredients that contribute to why you are coming into session. This aspect of the initial consultation often continues throughout the first 3-6 sessions because every individual has unique backgrounds that contribute to their story. Finding out how every piece fits into the puzzle can take a good amount of time. Which reminds me…go at your own pace. Some clients spill their guts in the first session because they just want to get it out and over with. Others don’t reveal key ingredients until 3 months in when they feel like they have made progress on some small goals and now want to battle the big underlying reason they are coming to therapy. Wherever you fall on the spectrum, let your therapist know in your own way how much you feel comfortable sharing.

#4 Feelings

There are going to be feelings and emotions galore. You may cry for the first time in weeks or maybe you’ll finally exhale that deep breathe you’ve been holding in for so long. Whatever emotions you have been holding onto will come out in that session, and that is okay! Don’t apologize for being a human being. Honestly, you letting your feelings out makes our job a thousand times easier. Therapists welcome any and all feelings in the therapy room whether it is the first session or the last. So get use to letting them out, and stop telling yourself that showing emotions is a negative thing.

#5 Building Trust

You’ll often hear therapists say they are “building rapport”. This means they are gaining your trust. If you are going to be open and vulnerable with this person you are going to have to be able to trust them. This takes time, but you can often feel by the end of the first session if you are going to be comfortable talking to this person for an hour each week. If the therapist makes you feel uneasy in anyway or you feel they are quite a good fit for your needs, let them know. Therapists hate when you ghost us just as much as the next person. So let us know that you aren’t feeling that it is a good fit, and ask for any possible referrals to other local therapists. I promise not to take offense.

 #6 Commitment

Therapy is a long term commitment. This is the one way that mental health isn’t like physical health. You can’t take a pill twice a day for a week, and expect all the baggage you’re carrying to disappear. Even when medication is necessary, it often takes a month or more for you to start seeing the benefits. That is why I always remind my clients that therapy is something to settle into. Whether it takes 3 months or 3 years is up to you and what you are willing to work on, but at the end of the first session, you probably won’t have all the magical answer to fix your problems. Some therapists even believe things will get worst before they get better. That is the process however. It is a lot of hard work to get your mental health to a good place, especially if you haven’t tended to it before. So get comfortable, locate the closest tissue box in the room, and get ready to learn somethings about yourself that you never knew before.

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