What to Expect Your First Therapy Session

You’re finally ready to start counseling.

Congratulations! The hardest part is over. After scouring the Internet and looking for your perfect fit, you made the decision to finally start therapy.

For many this can be nerve-racking, scary or even embarrassing. While everyone understands a trip to the dentist’s or a doctor’s appointment, counseling, unfortunately sometimes carries a negative stigma and isn’t usually a topic of mainstream conversation. Consequently there is little accurate information or a frame of reference for what to expect.

Here, we want to ease the tension associated with your decision to enter therapy. Part of the fear of attending your first session is just the unknown.

Read below and let’s clear some things up!

Why is there so much paperwork?

We know. It seems like a lot, but we promise, it’s all to your benefit.

Talk therapy falls under the same category as any other healthcare. Because of this, there are necessary intake questions to understand and complete before you have your first session.

Intake Questionnaire

It’s important to know your demographics and reasons for seeking help. Your therapist wants to know a little bit about you so he or she can better prepare for your first session.

Informed Consent

Counseling falls under HIPAA protocol meaning there are necessary consent waivers all clients must complete in order to ensure confidentiality. Legally, these are required before you can even be allowed to start sessions with your therapist.

Financial Agreement

Since this is a fee-for-service industry, cancellation policies for no shows and missed appointments and any other fee notices are all issues clients need to be aware of.

Even if a client is unable to make their session, that time is blocked off on a therapist’s calendar and can not very easily get made up. Simply, this means, no session, no paycheck. Thus, most therapists require financial consent forms and credit card information to ensure payment.

Is everything confidential?

Good question. The answer is sometimes.

As previously stated counseling is covered under HIPAA to ensure privacy and security. While the majority of the time all your information is secret, there are a few times in which your therapist will lawfully break confidentiality.

1) If you’re a danger to yourself or others.
Therapists are required to provide adequate care and in the cases of suicidal ideation or self harm, they may be need to get other professionals involved to keep you safe. Therapists also have a duty to warn. This means if a client has plans for homicide, they are required to notify any and all intended victims.

2) Mandated reporters of child abuse, elder abuse or any other dependent
In most states it is required that therapists report any information about situations involving dependent abuse or neglect. A therapist must also report if someone who previously abused is in a position of care with another dependent.

This includes reports of possession or use of child pornography, and reports of children witnessing domestic violence.

3) If a therapist is subpoenaed to testify in a court of law.
While this is a rare phenomenon, occasionally a therapist will be subpoenaed. This presents a particularly tricky situation as legally they are required to report, however, ethically this can come in conflict with duties of confidentiality and privileged communication.

In the event of a subpoena your therapist will be consulting legal help to ensure they are disclosing as little personal information as possible. This is a case-by-case basis.

What kinds of questions will my therapist ask?

Your therapy session is your time. Therapists will be curious about what you would like to discuss and accomplish in your time together.

A first session will be pretty basic. It’s a space to get to know each other and devise some goals for your work.

Think of it like you’re going on a road trip. You’re in the driver’s seat, but your therapist is there to point out sights, suggest alternate routes and even advise you on the speed limit as you explore your emotions.

Will my therapist give me advice?

You’ve all seen the media depictions of therapists as all knowing, and wise. In every show, they have just the answer to solve your problems.

However, in modern therapy most therapists try to do the opposite. Advice giving is very personal and even inappropriate. It can create a dependency on your counselor and will not help you build self-confidence.

Even with all the training in the world, a therapist won’t always know the right answer for you. Remember you are unique. It’d be almost insulting that in just 50 minutes they’d know exactly how you should run your life.

If you’re really stuck, a therapist will help you to organize your experience and make more sense of it. Frequently, understanding and expressing your emotional reactions can clarify the proper decision to follow through with.

Remember, therapists are essentially constantly talking themselves out of a job. Their goal is to empower you to the point that you no longer require their services.

How do I pay?

At Patrick Tully Therapy, we accept check, cash or card. Many offices even have an automated billing service that can manage your account.

While some practices take insurance, Cycles Couples Counseling does not. When you bill through insurance you are only allotted a set amount of sessions based on your diagnosis, regardless of your unique emotional needs.

For example this may look like, Depression you get 5 sessions. Anxiety you get 4 sessions.

We believe this does not take into account your needs or any stressors that can change along treatment. Rather than rush to cram, we’d rather give you the time you need to heal.

When do I need to come back to therapy?

Truly? Whenever you want.

Therapy is not mandated. However, it would be wise to consider your therapist’s recommendation on scheduling. Too much time between sessions can make it hard to consolidate your progress, but more than twice weekly can mean you need a higher level of care than talk therapy.

You can work with your therapist to schedule at regular intervals that work for your needs.

But, I’m still nervous for my first session!

That’s okay. That makes a lot of sense. You’ve never done this before.

Patrick Tully Therapy offers free consults for you to get to talk to your therapist and get more comfortable with the situation.

Call us today or fill out the form below and let’s do something different!