What should I expect in therapy?

A brown brick apartment building with the words "How are you, really?" pained on the side in black letters. — Photo by Finn on Unsplash

In our last article, we left off with booking an initial consultation with a therapist – but what should you expect when you actually go to your initial consultation?

What about your first real therapy appointment? What will that be like, and how can you best prepare for it?

Let us walk you through both!

What should I talk about at my Initial Consultation?

An initial consultation is a short meeting (generally no more than 30 minutes) where you and your potential new therapist get to know one another and get a sense of whether or not you’d be a good fit for one another.

Initial consultations are generally open-ended and free-flowing conversations. This means there’s not a whole lot of structure to them; each could be quite different.

That being said, if you prepare a bit ahead of time, you can ensure you ask the questions that matter to you!

Here’s what you might want to do in an initial consultation:

Start by introducing yourself.
You may want to share a bit about yourself — what does life look like for you? Perhaps you share more about what you want to accomplish in therapy or what encouraged you to seek support.
Ask the therapist about themselves, too.
Perhaps you want to know what inspired the therapist to pursue therapy as a career or learn a bit about their background or other interests. Regardless of the questions you ask, their replies will likely reveal more about their personality.
Ask questions about the way this therapist practices.
In our last blog post, we listed some things that vary between therapists, like the type of therapy they do (group, couples, individual), their areas of specialty (e.g. anxiety, attachment, etc.), their therapeutic approach, their values, the times they work, etc. They may or may not list these things on their website or profile, so you’ll want to ensure you ask about anything you’ve determined is important for you. Exploring some of these questions may also help the therapist understand if their approach matches your goals well.
Thank them for their time.
You don’t have to commit to booking an appointment with that therapist at the end of the initial consultation. You can simply say, “thank you for your time. I will contact you if I decide to book an appointment with you”. You might also want to clarify their booking process since sometimes it’s different for first-time clients.

Remember that they might not accept you as a client if they also determine you wouldn’t be a good fit. This might be due to various practical reasons — like you’re looking for a modality that isn’t their primary one, or you’re looking for a therapist who specializes in an area they do not specialize in, and so on. Therapists are humans with their own traumas too, so sometimes therapists don’t work with clients who have specific traumas that hit too close to home for them.

After the initial consult, you may want to ask yourself:

Did they meet important criteria on my list of things I’m looking for in a therapist? If they met some criteria but not others, am I okay with it?
Do I sense potential here? Could I see myself continuing to build a relationship with this therapist? Why or why not?
Do I want to book an appointment with them? If not, what’s holding me back? Is whatever’s holding me back connected to the idea of going to therapy more broadly, or is it something about them specifically?

If you determine that you don’t think they’re a great fit for you, that’s okay! You can continue searching for a different therapist.

If you’ve determined you want to move forward and book an appointment with this new therapist, go ahead and do it!

How do I Book and Prepare for my First Therapy Appointment?

Now that you’ve determined you want to begin regular therapy sessions, you’ll need to start with booking your first therapy appointment.

People generally feel less anxious if tasks are broken down into smaller steps and they have enough information about what to expect to feel well-prepared.

So, in that spirit, here’s a suggested list of how you can book, prepare, and show up to your first therapy appointment.

# 1 Book the Appointment

Book your appointment via their online booking system, through their admin, by emailing, or calling – they will likely have instructions on their website for how to book your first appointment.
Don’t let yourself forget about it! Create a calendar event for yourself that includes all the details about your appointment (e.g. location, time, etc.)
Why does this matter? Beyond not wanting to waste anyone’s time, many psychologists will charge fees for missed appointments!

#2 Complete the Paperwork

Before the first appointment, your therapist might send you some paperwork to complete and bring to your first appointment. This includes very basic things like collecting your contact information, but importantly, the therapist should provide written information about their rates, work hours, codes of ethics to which they are bound (including information about confidentiality and the limits of confidentiality), which professional body they are registered with, and more. This information is important to read and understand, so if you have questions about it, ask the therapist!

#3 Prepare for your First Appointment
- You might want to prepare for your first appointment. But wait, you might be thinking, “therapy isn’t like a play where I need to memorize my lines, right?” Correct. You don’t need to memorize what you want to say. Not at all.
  However, you may want an idea of where you’d like to begin!
  
  How can you do this? You may want to start brainstorming all the things you want to work on in therapy.
  
  Here are some prompts that can help:

Am I grieving something? For instance, the loss of a person, relationship, job, dream, or ability. How is this impacting me? How is it impacting the people around me?
What do I think is stressing me out in my life right now? How do I tend to cope with stress? What do I like or dislike about my current coping strategies? How is it impacting the people around me?
What are my goals? Why are they important to me? Who else would benefit from me achieving my goals? What do I think might be slowing or hindering me from achieving my goals?
What do I appreciate about myself? What are my strengths? How have I historically built on those strengths? How do I want to continue to build on my strengths?
What do I most want to change about myself? Why do I want to change it? How do I think that making this change will benefit my life and/or the lives of those around me?
What am I struggling to accept about myself or my life? What do I want to make peace with? What do I want to let go of that’s weighing me down?

Don’t be overwhelmed by this list. You don’t have to work on all of these things at once. But if, through considering these questions, something stands out to you as very urgent, or perhaps the most longstanding, or maybe as the easiest entry point – pay attention to that. That may be where you decide to begin.

#4 Show up!

Plan to show up a bit early if your appointment is in person. This will involve thinking ahead about things like how you’ll get there, where you’ll park, what traffic will be like, and so on.
If your appointment is online, ensure you have the equipment you need, like a working camera and microphone, as well as a good internet connection. You’ll also want to ensure that you have a private space for your appointment where there’s little likelihood of being interrupted.

What Should I Expect at my First Therapy Appointment?

Your first therapy appointment may look different based on your therapist, the kind of therapy you’re doing, and the primary modality the therapist uses, but first-time therapy appointments are generally a conversation like this:

Your Therapist Will Ask You Questions

Your therapist will likely have some questions for you to get to know you better. They might want to ask about your life currently (like are you employed, who do you live with, and so on) to get a sense of potential stressors and stabilizers in your life.
You don’t need to share more than you want to, and can always say “can we come back to that another session” if it’s not something you really want to discuss in your first appointment.
You might want to share some of your goals for therapy and decide what takes priority. Your therapist may have questions for you about your goals and why they matter to you. You may want to brainstorm with your therapist about how you might be able to measure success (i.e. how will you know if you’re making progress on your goals?). They may have some ideas for you to think about!

You Can Ask Your Therapist Questions

While the questions will focus on you and your life, you may still want to take some time to get to know your therapist better. While therapists generally work hard to leave their judgments at the door, they’re still human and have various beliefs, biases, frameworks, and worldviews that influence their practice.
Perhaps you still have more questions about therapy (and their specific modalities or areas of focus) that you didn’t get to ask them in your initial consultation. You can ask them now!
If you had questions about anything in the paperwork they provided for you, you can also ask!

A Note on Time: your therapist likely charges for 50-minute sessions, and may be booked back to back. They’ll let you know when the time is up, but just be mindful of not going over time.

That’s pretty much it! At the end of your session, your therapist will let you know how you can book subsequent appointments and how you can pay for your session.

Wait… I Have More Questions!

Great, we’ll do our best to answer!

Can I take notes during my session?

Yes! If notes are helpful for you to process or remember what you discussed in your session, then go for it.

Will the therapist take notes during my session?

They might! It depends on the therapist. If you feel uncomfortable about notes, feel free to start a discussion with them about note-taking!

What if I’m nervous or don’t know what to say?

Totally fair; you can be upfront about it too! Sometimes even saying it aloud makes it easier.
Take time to get to know them, too. Take it slow.
Preparing a little ahead of time can help with this. Think about what you want to focus on? Why is it important to you?

What if I try therapy and I’m super uncomfortable the whole time?

That’s fair, talking to a stranger, especially when sharing personal information, can be super uncomfortable.

Remember that you don’t need to share more than you’re comfortable with. It’s perfectly acceptable to say, “I actually don’t want to go there,” or “I might share more about this in the future”.
In order to help you, your therapist doesn’t need to know the details of every bad thing you’ve ever experienced or done. Healing doesn’t always require that kind of disclosure.

What can you do in the moment to feel more comfortable?

What do you normally do to help yourself through discomfort? Breathing exercises? Asking for a moment to collect yourself? Do what you gotta do!
You could share with your therapist that you’re uncomfortable. They might ask what they can do to help you be more comfortable.

What could you do ahead of time to help with the discomfort?

Would talking to friends about their experiences of therapy help? Maybe you can ask them if they initially felt uncomfortable and how they dealt with that.

Rember that most things are tough the first time you do them, simply because it’s new. Remember that first day on the new job? The first day starting a new grade? First date with a new person? Firsts come with nerves, but that doesn’t last forever. You’ve got this!
And lastly, remember that growth is often uncomfortable, but that doesn’t mean it’s a bad thing! Discomfort might just be a signal that you’re growing.

If you made it this far, thanks for sticking with us! Whether you decide to go to therapy or not, we want you to know that we’re rooting for you.

We hope you find the healing, growth, and peace that you’re searching for.

That concludes our four-part series on therapy! If you have questions or ideas for us about future blogs we could write about therapy, let us know! Get in touch at info@nextgenmen.ca