If you have never met with a therapist or counselor, or have been in therapy before and want to know how I work, here is what you can expect in the first session.
Before we begin, I will ask you to carefully read and sign a consent form that explains potential risks and benefits, rules regarding confidentiality, and other matters including session length, fees, and cancellation policies. As a Registered Psychologist, my Code of Conduct requires that I go over these points with you to make sure you understand what you have read, and to allow you to ask questions. It also reassures you that psychotherapy occurs within a framework that is confidential, respectful, and mindful of your rights.
The First Few Minutes
I will start by asking you a simple question: what brings you to see me? You can expect that this part of the session will be unstructured so as to give you a chance to describe your concerns, and to allow me to ask questions.
As we talk, you will get a sense of how I work as a therapist, and whether my approach is a good match for you. Research consistently shows that the client-therapist relationship is a crucial factor in psychotherapy outcome. So if you experience me as attentive, compassionate, and knowledgeable as to how to help you get to where you want to go (i.e., feeling better), then that’s a good indication that we will work well together.
What’s the Focus?
How the session proceeds depends on what is troubling you. If, for example, you are struggling with depression or anxiety, I may have you fill out a brief form to get a baseline reading of your mood, and ask you about life factors, coping strategies, and personal beliefs that may be contributing to your difficulties. If trauma is a factor, we may talk about the precipitating event (to the extent that you are comfortable discussing it), and review options for trauma therapy. Whereas grief counselling tends to be unstructured, therapy for stress management is more directive, and I will teach you relaxation techniques, problem-solving strategies, and suggest readings. What this means is that my approach will vary, depending on your needs.
How I Work: The Curious Therapist
One of my main goals in the first session is to begin to get to know you as a person, which is to say that I will not view as the embodiment of a label or diagnosis. It also means that I am interested in who you are apart from what it is that brought you to therapy. It is only natural that you will want to discuss whatever is causing you pain (and that will be our main focus), but chances are I will also wonder aloud about your strengths, goals, hopes and dreams, as well as the things that make you happy.
An Underlying Assumption
I will also ask about your relationships. Our lives are inevitably intertwined with, sustained by – and sometimes hurt by – our interactions with others. We all exist within multiple relationships and systems; maybe you are someone’s partner, parent, child, sibling, employee, co-worker, boss, etc. As I get to know you, I will want to know how you interact with those people and how those relationships affect and define you. I will also ask you about your family history, but rather than have it be a dry interview, I tend to sketch out a brief family tree and fill in the details as they emerge.
The End of the First Session
What now? By the end of the first session, both you and I will have a clearer sense of:
- What’s bothering you.
- How you want therapy to help.
- Blind spots we can address.
- How I can help.
One Last Thought
It is only natural to want to expect a therapist to give advice. Many first-time clients ask me to tell them what to do – and I will of course share my knowledge and expertise and suggest tools for positive change. However, unless you engage in behavior that harms yourself or others, what I will not do is tell you how to live your life.
It is also very common for new clients to want to be “fixed” by the end of the first session. Psychotherapy is many things. It can be profound, funny, deeply moving, silly, poignant, sad, meditative and soothing, or surprising. What it is not is a quick fix – and I urge you to be suspicious of those who promise just that. Turn on the television or radio, and you will find no shortage of experts who “fix” the client by telling them what to do. In the real world, therapy is a highly interactive, egalitarian, and collaborative process. Working with a psychotherapist is not like taking a pill that makes a headache go away. In order for you to feel better, both you and I must assume an active role, and much depends on what you do between sessions.
Last of all, it bears saying that taking part in therapy can be one of the more worthwhile things a person can do, and as a therapist I find it personally rewarding to be involved in a meaningful and beneficial profession.