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Writer's pictureLisa Rodeheaver

What to Expect: The First Appointment

If you have ever been to therapy before, isn't the first session the most awkward? Yet often we set a lot of stakes in first impressions. As a therapist, I don't really enjoy the first session. Read on to find out why. On the flip side, never been to therapy before but thinking about starting... here's what your therapist will want you to know in advance.


The first session is often filled with paperwork. And if it isn't filled with paperwork, it usually starts off with paperwork. By law, therapists are required to get consent for your treatment (look for a document titled Informed Consent for Treatment or something similar). They will most likely also provide you with a lot of information regarding their rules and policies surrounding scheduling, phone calls, financial responsibility/fees, your rights and responsibilities as a client, and, of course, a HIPAA document detailing laws regarding keeping your information private.


It is important to review all this information even though it is a lot. It helps get you familiar with what is expected of you and also what you can expect from your therapist, services, and the agency.


The problem with all this (necessary) paperwork? It makes for an awful first impression! Trust me when I say your therapist did not get in this profession to do paperwork. They want to provide treatment, but they also want you informed so nothing that happens down the road surprises you (like what to do when your insurance changes!).


After all these consents and rules and privacy policies, etc etc... often there is still an evaluation. This is where your therapist will ask you questions ranging from what brought you to therapy, to past crisis type situations, to family history of mental health or substance use, and so on. Depending on the therapist and agency (and sometimes even dependent on your insurance), this could be a short questionnaire or a lengthy interview with your therapist.


You would think that would be the end of it, right? But one of the most important pieces to your therapist, and really to you too, is a preliminary treatment plan. This is where you and your therapist identify specifically one or two goals that YOU want accomplished with therapy. You is capitalized because you have final say - yay or nay. Your therapist works for you (within certain regulations). I say preliminary because it could change even by the second session. But it's important for your therapist to know what you want out of therapy, because that affects how they approach treatment, and if they can even help you.


So, as I said, I sometimes hate the initial session. Paperwork can feel like it's getting in the way of getting started, especially if you feel in a spot where you really need help and don't want to deal with signatures. But your therapist needs your signatures in order to even provide the treatment you are asking for.


Be prepared that this first session might not yield all the relief that you want; but also understand that this sets the foundation for you and your therapist to both be on the same page moving forward. The second session might be more what you both are looking forward to.

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