Demystifying Your First Therapy Session

The Courage to Seek Therapy

There are over 300 million people who seek out therapy services each year. If you are one of those 300 million, I wholeheartedly congratulate you. Seeking out therapy is not an easy task. It is full of variables that can turn people away from seeking help. With that being said, I want to speak to those who have either scheduled their first appointment or have been thinking about doing so. 

Confronting the Dread: Preparing for Your First Therapy Session

The day has arrived. You are booked and ready to go with your therapist of choice when a sense of dread begins to infiltrate your system, or maybe it has been there the entire time. This dread is attempting to communicate with you. What the dread is saying to you, I am not too sure as I am not you and would never be able to experience that for you. I do know, however, that it has a purpose, and it might be to stay home instead because you do not know what is to come. Let me help you confront that sense of dread with how my first therapy sessions are conducted. 

Arriving at the Appointment: Creating a Comfortable Environment

Firstly, you will arrive at the appointment. That will either be virtual or in-person these days. Either way, you have to arrive at the meeting. If the session is virtual, connect with things in your environment that bring you comfort. Wear your favorite clothing, light your favorite candle, hug your favorite pillow, whatever that thing is for you. If it is in-person, most of the same apply to you; be comfortable. Therapy is not a job interview, and therapy is not a formal setting. Therapy is a setting where you will hopefully be doing some hard emotional work. BE COMFORTABLE. 

The First Session: Evaluating and Understanding

Secondly, let's get to what you are more than likely to do in your first session as a client. All first sessions are evaluation sessions. If you are using your insurance, the literal billing code to your insurance is classified as 90791: Psychiatric Diagnostic Evaluation. How this will look will be different depending on your therapist. If I were your therapist, I would have already received your paperwork detailing what you were looking to accomplish in therapy, your most significant challenges, screens for anxiety, depression, early childhood trauma, and a few other questionnaires. This groundwork would allow me to ask you follow-up questions on those questionnaires and get to the bottom of what you wanted to get out of therapy. From there, therapists will want to know your background. They will ask things like, "what is family like?" Or, "have you had any previous counseling experience before, and how did that go?" All we are looking for in those moments are if we are the right person for you or not. If that answer happens to be no, that is entirely ok and is in no way a reflection of you, the client; instead, it is a therapist practicing how they are supposed to. You would not want a pilot to tell you how to drive your car. 

The Role of Diagnosis in Therapy

A diagnosis is also a part of the initial therapy session or even the first couple sessions. Insurance companies need diagnostic codes to process payments. That's the cold hard truth. Your therapist will take all the information you are giving them and then process that through their therapeutic judgment and assign you a diagnosis. Remember that 300 million number we talked about at the very beginning? Yes, they have a mental health diagnosis. You are NOT alone; hell, I have several. I would always take this diagnosis with a grain of salt (if you even see it or not). Many diagnoses match the criteria for other diagnoses, so there is tremendous overlap. 

Making the Most of Your First Session: Tips & Suggestions

Here is what I would invite you to do in your first session with your therapist. 

  1. Understand that this is YOUR time to invest in YOURSELF.

  2. Realize that the therapist is probably also nervous (I know, we all have our shit).

  3. You can leave at any point you want.

  4. You made it this far, and for that, I congratulate you.

  5. Ask the therapist questions; your questions are invaluable in therapy.

  6. Feel your body reacting to the session.

  7. See if they are the right fit for YOU.

  8. Plan self-care after your session is over.

  9. Think of the session more as an introduction.

The Journey of Self-investment and Growth

You have made it this far; keep it going. You are strong, and you are capable. If you would like to learn more about what a first therapy session could look like for you, please feel free to contact me at any time. I am more than happy to elaborate on the words above. Take care of yourself and allow yourself the kindness and bravery to continue investing in yourself. 


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How to Find a Therapist

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Empowering Communication: How to Advocate