What to Expect from Your First Counseling Session
Taking the initial step in scheduling an appointment with a therapist can oftentimes be the most difficult. However, it is quite common to also experience some anxiety leading up to the first session. Knowing what to expect at your first visit can help to alleviate some of that stress.
When you first arrive at your counseling session, there may or may not be a receptionist. If not, have a seat in the waiting room. Your counselor should be out to introduce themselves and show you to the office. If you're not sure where to sit, feel free to ask the counselor. You will probably be asked to fill out some paperwork with your general demographic information. You will also be asked to sign some forms. This simply gives the therapist permission to bill a third party, such as your insurance company or the employee assistance program (EAP), for services rendered. You will give your permission for the counselor to share with the third party some general information about why you are seeking help, your diagnosis (if you have one), and your goals for the sessions. Your therapist should go over this with you and also address issues of confidentiality. What you and your counselor discuss remains confidential. There are certain exceptions to confidentiality, such as if there is risk of harm to yourself or someone else, or in cases where there is any suspicion of child or elder abuse. Counselors are mandated reporters, so they are required to report these risks to the proper authorities.
The counselor will initially ask you why you are seeking treatment. Expect to discuss your presenting issue and how it is affecting you emotionally. The counselor may also ask general questions about your background in order to get a better idea of where these issues stem from. It's important to be honest about your concerns and about your history, and a good therapist will never make you feel judged or shamed.
One common misconception is that significant headway in resolving your issue will be made within the first session. The initial session is a time for information gathering and assessing your situation. Don't expect the counselor to dispense a great deal of advice or feedback during the first session. Instead, the therapist may reframe or clarify what you've said. They may jot down notes while you speak, for help in remembering key points. The counselor will also work with you to determine a goal for your sessions. Think about what it is that you specifically want to achieve from counseling. The goal you choose should be SMART:
- S—Specific
- M—Measurable
- A—Attainable
- R—Realistic
- T—Time-defined
In general, therapy sessions will last between 45 and 55 minutes. After your first session, you will probably have a good idea of whether or not you believe this counselor will be a good match for you. If you are unsure, try to give the counselor another session or two before you make a decision to seek out a different therapist. The first session can sometimes feel awkward or uncomfortable, but by the second or third session, you should know if this provider is a good fit for you.
Chambers, M. (Reviewed 2024 [Ed.]). What to expect from your first counseling session (B. Schuette, Ed.). Raleigh, NC: Workplace Options.