What To Expect Before and During Your First Session

Congratulations. You have already done the hardest part!  You decided to reach out and get help and support. Yeah, it might sound cheesy.  But I promise you, it’s true.  For most of us, recognizing we need help and then reaching out for help are extremely difficult. So what now? You are about to embark on a path that may be completely new to you.  There will likely be twists and turns that you can’t see from the starting point.  This can be scary for people. It is also important that you realize that to achieve your goals in counseling, you will need to embrace change.  Change is hard. Take it slowly.  This is a marathon, not a sprint. Your therapist is not the expert on your life; you are.  Don’t get me wrong.  Your therapist is a pretty smart cookie who has a great deal of education and experience that can help you.  But if your therapist suggests something you can try and it doesn’t work for you, let them know so you can try something else.

Before the First Session

Things to do

• • Decide if you will self-pay or use insurance
  • If using insurance, double-check to make sure you are in-network and if you still owe a deductible so you don’t get “surprise” bills.
  • Set up your client portal through Simple Practice. You should have received an email invitation, so check your spam folder just in case it missed your inbox.
  • Ensure you complete all of the intake paperwork sent through the client portal before your first session.  Otherwise, the therapist will have to reschedule your first appointment.
  • Set up your client portal for billing through Headway.  Keep this information up to date so you don’t have billing issues.

Things to think about

• • What are the top three things that, if it changed, your life would be a little easier?
  • What do you want to change about yourself?  Sorry, you can’t change others, so what are you willing to change?
  • What things set you off (i.e., what are your emotional triggers?)
  • What would you like from the therapist?
  • Do you have questions for the therapist about therapy or their experience or training?

During the First Session

The therapist might ask

• • If you have ever been in counseling/therapy before and what you did not like about that experience
  • Questions about your history with the problem that brought you to counseling
  • Questions about your family of origin (the people you lived with as a child)
  • About your mental health history of diagnoses or hospitalizations
  • If you have a history of self-harm, suicidal ideation/attempts, homicidal ideation

The therapist will 

• • Explain the limits of confidentiality and the circumstances under which the therapist is required by law to break confidentiality.
  • Explain the process of counseling sessions and what you might expect.
  • Answer any questions you might have
  • Evaluate whether this will be a good fit for the therapist’s area of competency.

What you can do

• • Evaluate if you feel that the therapist’s personality and style fit with what you want and need from a therapist.  If it isn’t a good fit, that is ok.  They would be happy to give you referrals to other therapists.  They won’t take it personally.
  • If you know some of your emotional or physical trauma triggers, please share those at the beginning of the session.
  • Ask for what you need.  The therapist will tell you if that is something they cannot do.
  • Be honest.  Therapists know you are not likely to spill your guts about your deepest, darkest secrets before the therapeutic relationship is solid.  But you will only get out of therapy what you are willing to put in.  The therapist cannot help you with things that they don’t know are happening because you chose to keep it to yourself.
  • Share if you are nervous or worried about something.  
  • Share what emotions are coming up for you or if you are feeling something in your body.

Your first session will feel like it speeds by.  Things will not necessarily improve after the first session, though some clients say they notice that they feel lighter after their first session. Realize that your therapist does not have a magic wand and they cannot read your thoughts.  Be prepared that you will have work to do.  Give yourself grace if things don’t change as quickly as you wish.  And don’t forget to celebrate your successes, even if they seem small to you.  Remember, you already did the hardest part by reaching out for help.

Kelly Sheridan

Kelly Sheridan, owner of Sacred Circle Counseling, is a licensed Marriage and Family Therapist who specializes in helping people heal from trauma, become better parents, and live more genuine lives. She graduated with her Masters of Science degree from Capella University in early fall 2021. She completed her internship and began her residency at a residential treatment facility for children ages 6-21 with co-morbid mental health diagnoses. She then completed her residency at a Children’s Advocacy Center, helping children and families who have disclosed physical abuse, sexual abuse, or neglect in a forensic interview, not only providing treatment to help them heal from the traumatic events they experienced but helping them navigate the confusing path of criminal trials and testifying. “I love working with families and individuals who want to heal from the things haunting them from their past.”