First Time Seeing a Therapist: What to Expect and What to Ask
Brooke Randolph, LMHC
Most people are a bit nervous or unsure of what to expect the first time they visit a therapist. While every client is different, here are some things that you can expect along with questions that are often asked.
If you haven’t completed the basic paperwork ahead of time, I will have a copy of the informed consent contract and intake form for you to complete. These can be printed ahead of time or the intake form can be completed online. If you have proof of income for the sliding-fee scale, it is helpful to bring that with you at the beginning.
What will we talk about in the first therapy session?
In the first session, I want to try to understand what you want to get out of our work together, what you want to get today, what is most important to you, and what brought you to my office in the first place. The first time we meet, you may not feel like you get very far as we are setting a baseline and goals. It is also important to know that you can feel worse before it starts improving. This happens for a variety of reasons, but I understand that it is not always fun to see me. On the other hand, I laugh with many clients and it is always my goal to encourage and empower even when facing difficult truths and situations.
It is likely as we talk about your primary concern, we may identify other issues that cause you distress. While some people like to address things as they come up, others find it more productive to stay focused on the primary issue and note these other things to address at a later time.
Is therapy confidential?
I try to assure all of my clients that they can expect confidentiality when working with me. The most basic way your confidentiality is protected is by not involving third party payers
; our meetings are simply between you and I, unless you choose to invite someone like a supportive friend, spouse, etc. to join us. You may choose to report our sessions to your insurance company and request reimbursement or you may choose to pay in cash and there will be no record of meeting together. Unless you complete a signed document, I cannot even acknowledge that you are a client. If I would happen to see a client in public, I would let you determine if you wanted to say hello or not. I keep minimal files and notes, which are stored in a locked file cabinet.
Is therapy right for me?
You can also expect that I will meet you where you are, customizing my approach for what works best for you. Some people want to spend most of the time talking and some want to hear more direction from me, some want homework and assignments. It is important to me that you get what you need from our time together. I am always open to your feedback. I will present options that can help you meet your goals or ease distress. Some may sound simple, but if they were simple, you wouldn’t be in my office. Some may be outside of your comfort zone and that is ok. You are the one living your life and you direct how this goes. You are welcome to reject any suggestions.
I believe that therapy is right for everyone, especially if you connect to a therapist who can work with you in a way that works well for you. We all have areas where we can make improvements. Even if life is going well, it can be helpful to talk through different life situations. Everyone has some negative thinking pattern or belief about themselves that can be limiting or holding you back. It is helpful for most people to approach counseling with an idea of what you would like to improve; however, if you are committed to the long-term analysis approach, you are welcome to stretch out on my couch. People see me for a variety of reasons. No concern is too small if it causes any level of distress in your life.
How often should I come?
Near the end of our scheduled time, we will schedule our next session. People often ask me how often they should come and what is too often. Just like everything else about counseling, it is unique to you. Some people do well with 50 minute sessions and some want 90 minute sessions. Some want to meet weekly at a specific time, some come every 2-3 weeks, some come monthly, and some come regularly and schedule 30 or 60 minute online or teleconference sessions in between. Depending on your level of distress and your schedule, it is likely that you will want to start out more frequently and stretch the time between sessions after some progress has been made. During intense periods of life, people may come to see me more than once a week or schedule an additional online or teleconference session. Many find it helpful to schedule consistently, whether it is the same time every week or the same time once a month.
How do I pay and what does it cost?
Another common questions I get in the first session is about payment. You can pay with cash, check, charge, or your Health Savings Account (HSA) debit card or checks. All sessions are billed at an hourly rate based on where you fall on the sliding fee scale. Objective and personality tests can be taken for a flat rate. The Prepare-Enrich
relationship survey and the Neurogistics
neurotransmitter test are paid for through those companies. For more information on taking any of those tests, please contact me
Counseling should be a safe space, and I strive to create a comfortable environment. I am open to questions or feedback at any time. If you are still not sure if therapy is right for you, please feel free to schedule
a free 15 minute teleconference.
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