It takes a lot of strength to make that first therapy appointment, but now that you have, you might be wondering what it will involve.
Scheduling your first therapy session requires resolve — to admit you may need some help or that you have a condition, symptoms, or challenges to work through — and self-awareness to recognize you need a little help.
So if you’ve made your first counseling session already, you should know just how much strength you truly have.
And if you haven’t picked up the phone quite yet, there’s nothing to fear in doing so — and everything to gain.
But if you’re new to therapy, you might be wondering exactly what to expect when meeting with a therapist or counselor for the first time.
Despite some misconceptions, a therapist’s job isn’t to solve your problems for you.
They aren’t there to tell you what to do, or to tell the people who’ve hurt you just how wrong they were.
In fact, most therapists won’t bother touching on the rights and wrongs of people in your life. Instead, they’ll focus on helping you turn your focus to what you can and can’t change — ultimately: you, your choices, and your responses to events.
Depending on your reason for starting therapy, most therapists will spend time encouraging you to look inward.
This might mean talking through past trauma and developing strategies to help you cope.
Looking inward might require you to explore any phobias you have, and then work with your therapist to overcome them.
Or you may dive deep into your interpersonal relationships — not to examine the faults of others, but to help you better understand your role in making relationships better or setting boundaries in order to protect yourself.
Whatever your case may be, you’ll find that therapists can be great sounding boards and provide excellent resources when needed. But their main goal is to help you learn how to better help yourself.
Your first session will probably involve your therapist asking you a lot of questions about you, how you cope, and your symptoms (it’s basically an interview). You may also chat about goals for therapy, expectations, and more.
Your first therapy session can be emotionally draining, even if you don’t initially expect it to be.
Therapy can involve unearthing many things your brain has worked hard to bury — the painful memories and feelings you may not have been up to exploring on your own. And as you sit down for first-time therapy, you may find the floodgates opening… whether you mean them to or not.
This is pretty much to be expected. Still, it can feel surprising, especially if you find yourself opening up to a stranger in ways you haven’t been able to open up to others in your life.
Don’t let it scare you. Being open and candid with your therapist is one of the best things you can do for yourself.
And, you should know that not every session will be so intense. It often happens that initially starting therapy can take a lot out of you. That’s OK.
While we may all just call it therapy, there are several types of therapy intended to suit different needs.
According to the American Psychological Association (APA), the five main categories of therapy include:
- Psychoanalysis and psychodynamic therapies. Based on the teachings of Sigmund Freud, this type of therapy aims to explore unconscious meanings and motivations in order to change negative behaviors, thoughts, and feelings.
- Behavior therapy: This approach aims to help a patient change certain behaviors by using a variety of tools, including desensitization.
- Cognitive therapy: This therapy is focused on helping patients modify actions and reactions by first changing one’s thoughts.
- Humanistic therapy. These therapies typically center around the patient and avoid framing therapists as authorities, instead presenting them as empathetic and concerned listeners.
- Integrative or holistic therapy. An integrative approach means that therapists don’t embrace any one discipline, and instead blend various approaches together in order to meet the needs of individuals. Integrative therapy follows the principle of acceptance.
Among these five disciplines, there’s a long list of therapies that you could benefit from:
| Therapy | Basics |
|---|---|
| Art therapy | Uses creative mediums to express and explore feelings and emotions. |
| Acceptance and commitment therapy (ACT) | Focuses on infusing value-guided actions instead of reducing symptoms of a condition. |
| Cognitive behavioral therapy (CBT) | Generally has a set, short-term timeline with a specific goal in mind. For instance, CBT might be used to help a patient overcome a fear of public speaking. |
| Dialectical behavioral therapy (DBT) | Aims to help patients process and cope with difficult emotions. |
| Equine-assisted psychotherapy | Forges a bond between patient and horse as part of the healing process. |
| Existential therapy | Aims to help patients consider the responsibility they have for their own choices. |
| Exposure and response prevention (ERP) | Exposes a patient to their source of anxiety or fear, but guides them into resisting compulsions that are triggered. |
| Gestalt therapy | Aims to help patients work through unresolved issues and examine how those issues impact their daily lives and choices. |
| Interpersonal psychotherapy (IPT) | Focuses on providing patients with self-service tools to better manage their interpersonal relationships. |
| Rational emotive therapy | Encourages a patient to challenge irrational thoughts and beliefs, and replace them with rational ones. |
Most therapists and counselors will use some combination of therapy types and tools, though some might mainly use common therapies like CBT or DBT.
Though therapy isn’t like a menu where you can make specific requests, you can ask about ones you’re interested in as you call around and vet a potential therapist.
Now that you’re aware of what to expect from your therapist and yourself, we’ve put together a few quick pointers to help you maximize your time in therapy.
Do
- Be kind to yourself. Therapy can be emotional; you’re allowed to have big feelings.
- Tell your therapist why you’re there. There’s no reason to be vague.
- Be willing to reflect on your own thoughts and behaviors. A good therapist will challenge you to look inward.
- Close your session with a plan. Do you have homework before your next session? Some new behavior to try? When will that session be? You may want to write it down or throw a reminder on your phone so you don’t forget.
- Give therapy at least a few tries. It does get easier, and the first session is often just about providing background info, which means it may not be as helpful as you would have hoped.
Don’t
- Put up a wall. Therapy only works if you commit to leaning in with your therapist.
- Ask personal questions about your therapist. Healthy professional boundaries mean your sessions should be focused on you.
- Lie. Therapy won’t do you any good if you aren’t willing to tell the truth. And it’s a waste of a good copay!
- Drop a bomb on your way out the door. While some sessions may be packed with things to talk about, try to prioritize the big things at the beginning. When you reveal big topics as your session is ending, you’re doing both yourself and your therapist a disservice. Share while there’s still plenty of time to discuss! Bookmark the bombshells if you don’t get to them before you touch that doorknob.
- Stick with a therapist you don’t feel a connection with. Just as in life, you won’t always mesh with everyone you meet. You’re allowed to search for a new therapist you feel comfortable with, rather than sticking with one you don’t.
Therapy can be extremely beneficial — but it won’t heal you overnight.
The American Psychological Association says that half of folks with mental health symptoms need between 15 and 20 sessions. So if you’re being treated for a mental health condition, you’ll need to be prepared to commit to several months of treatment if you hope to see the improvement you deserve.
But don’t let that overwhelm you. Take your sessions one at a time, and assess how you feel about the value of therapy after each one.
There are a wide variety of therapeutic options available — and countless therapists who work with different approaches.
If you find you aren’t getting much from therapy, you may just need to try a different therapist or approach.
But you don’t need to figure all that out in the immediate aftermath of your first session. Instead, give yourself some space and time to process.
Don’t be surprised if you’re especially tired following that first session. You’ve started some important work, but it’s still definitely work — it’s normal to feel the weight of that initially.
So go home, try to relax, and consider the fact that your emotions might need time to recover in the same way your muscles do after a strenuous workout. You’ve earned the breather, and by allowing yourself that opportunity, you’ll be better prepared to dive even deeper at your next session.