What can I expect in my first session?

Most clients go into their First (Intake) Session with some level of nervousness or anxiety. Often this concern centers around not knowing what will be discussed in the first session, if they will mesh well with their therapist, and general discomfort with the unknown. Granted, every therapist is different so this guide cannot fully explain how everyone does intakes, but it is fairly standard. If nothing else, this is our format for intakes here at Tennessee Mental Wellness. The hope here is to provide some guidance and information regarding what to expect. It gives you a “peek behind the curtain” so to speak.  

Reviewing Policies, Confidentiality, and Important Paperwork 

Therapists usually have a number of Policies and Procedures they need to communicate in the first session. These will echo your Intake Paperwork and will often include Limits of Confidentiality which explain what reports therapists have to make and when your information might be shared outside of session. It is also common to discuss administrative procedures such as No Call No Show or Late Cancellation Policies. Contact information for the therapist or the office may also be shared here. Communication Policies and Boundaries are often a common disclosure here. Additionally, pros, cons, and limitations of Telehealth can be disclosed here. This is the section for business disclosures going over the Intake Paperwork and highlighting what is most important for clients to be aware of.

Learning About Your Therapist’s Approach and Specialties 

Another key point is Therapist Specialities and Modalities. Here your therapist will often discuss their licensing credentials, types of clients they most often work with, and how they create change and progress with their clients. At this point, your therapist will often lay out a roadmap of what working together could look like. They will likely ask if that type of work and focus sounds helpful to you. This is where you get to start providing feedback regarding what you are seeking, if you think they are well equipped to help you, if you have questions regarding what techniques or tools they will use, and you can inquire about their experience helping clients like you if you choose to.

Your Therapist Begins Learning About You 

From there, the therapist will likely shift the focus off of themselves and onto you. The above sections may cover the first 10 minutes or so of the session. The rest will be focused on getting to know you. Here, your therapist begins going through various assessments to better understand you and your background. These might be paper and pen assessments or they could be verbal. Often, you’ll be asked about your family you grew up with, your relationship history, what you were taught about emotions and coping, how you build and maintain trust and relationships, and what symptoms you are currently experiencing. You may also explore any safety concerns if applicable. All of this is your therapist “calibrating” to you and your personal needs. Most of these questions will focus on your past and progress up towards the present.

Once you have arrived in the present, your therapist will likely begin to explore what brings you in now. This is not a challenge or judgement. More than likely, you have been dealing with your personal challenges for days, weeks, months, or years. So your therapist is curious what has motivated you to seek help now. They will also likely assess how ready and motivated you are to begin working on changing the situations that contributed to you seeking help. Oftentimes, the hardest part of therapy is being honest with yourself regarding what you have been through, how you understood it, and how it impacted you. That process could begin briefly in this stage of the first session.

Setting Therapy Goals and Creating a Treatment Plan 

Likely, the time is getting close to being up at this point. So you will most likely transition from the present into the future. Here, your therapist wants to know what your goals are. They want to know what would make this a good use of your time, efforts, and resources. Therapy is a large investment in time, emotional energy, and financial commitment. Therefore, they want to identify 2-3 goals that you agree will increase your quality of life significantly to make your investment in yourself worthwhile. These goals will be crafted into your Treatment Plan which makes your road map for therapy. It becomes a way to mark progress and confirm that your time is being used well.

Billing, Scheduling, and Next Steps 

As the session is wrapping up, you will likely move into Billing and Scheduling. At most practices, your card information will be kept online so your therapist will simply confirm the card, payment, and if you want a receipt. For scheduling, it is highly recommended and beneficial to go ahead and schedule your sessions several weeks in advance. This is helpful to start building momentum through maintaining consistency in meeting, it helps to prioritize your goals and time, and it allows you to avoid playing calendar shuffle at the end of each session. If your therapist’s schedule is filling up or if you are needing a “prime time” session (afternoon or evening) then scheduling in advance is especially helpful. Usually, times at 3pm and later are in highest demand due to teens being out of school and adults leaving work around that time.

Ok, you made it! Your intake session is complete. At the end, some therapists will open the door to a time for optional feedback. They might use a survey, ask if the session was helpful to you, ask if the session met your expectations, ask if you have any questions about the process ahead or the modalities they use, or invite you to ask any other questions on your mind. This doesn’t always happen, but it is very helpful to allow you to confirm that your time and resources are being used in the most effective way. Additionally, if you have any concerns or misgivings about the therapist you are seeing, this is an excellent time to vocalize and explore those concerns. Ultimately, this is a service you are pursuing and investing in. So make sure you are getting what you need.

The Goal of Your First Therapy Session 

First sessions are not meant to be scary or overwhelming. They do contain a lot of information both from the therapist and the client. However, you continue to have full control over the pacing and how deep you choose to go in your disclosures due to not yet knowing your therapist well. At the end of the day, the first session is for policies and procedures, letting the therapist get up to speed on you and your life, setting goals, mapping out scheduling, and confirming that you are each a good fit for the other. Every therapist is a little different, so each first session is a little different. This list is by no means comprehensive, but it should give you a good idea of what to expect.

If this was helpful for you or if you’d like to learn more about Tennessee Mental Wellness, give us a call! We are located in both Hendersonville and Gallatin. We offer free 15 minute phone consultations, or you can book a first session directly from our website. We have several therapists with a variety of specialties who would love to help you on your journey.