First therapy

First Therapy Session 101: The Most Popular Questions Answered

Even when we clearly understand that we need to see a counselor, we might postpone this decision simply because we don’t know what’s going to happen during the session.

Moreover, prior to coming to the session, we need to find a therapist that would fit our requirements and desires. And that’s quite a difficult task.

But when we have answers to the questions that bother us, it becomes way easier to actually book the appointment and dive into the productive work with the therapist.

So let’s figure out all the details you should know to feel calmer and more confident during your first session with a counselor.

First of all, how to find a suitable therapist?

No counselor would be a good solution for everyone. A true professional tends to focus on certain issues because it’s impossible to excel at everything. That’s why mental health professionals specialize in addressing different issues.

For example, if you struggle with anxiety, you should look for a therapist who specializes in this issue. And if you are trying to overcome problems in your marriage — a couple’s or family counselor will be a nice fit.

Besides that, you should consider these details:

  • Do you prefer to have offline or online sessions? There are plenty of online platforms that offer access to mental health professionals. It’s a much more affordable and convenient way to get professional help.
  • If you want offline sessions, are there good therapists near you? Often, when we experience inner turmoil, it’s hard for us to leave our house, let alone commuting to another side of the city to see a counselor. So it’s better to choose a professional nearby.
  • What’s your budget? Therapy can be expensive, but it doesn’t mean it must leave you broke.

Once you find a couple of options, ask those professionals about their rules — how you’re supposed to make an appointment and what you should do if you can’t attend a session.

Also, ask about the conditions for emergencies and access to a therapist between appointments. Finally, learn about the therapy methods they’re using and see if these approaches suit you well.

Should I worry that my secrets will be disclosed?

No, a licensed counselor keeps things confidential. In fact, usually, you will sign a form that will outline the rules of confidentiality.

However, you should know that in some situations a therapist must inform authorities about their clients.

For example, if they think that you might be a danger to yourself or someone else. Or if it’s a matter of abuse of a dependent or underage person. Yet, in most cases, the therapist will talk to you first about it and try to solve the issue between you two,

Feel free to ask your counselor all the details about confidentiality. This will make you feel more secure.

Why does the first session last only 30 minutes?

The first session is always a tryout. It should let you see if you like the therapist at all, and if their approach suits you.

So you shouldn’t expect the first session to be very productive in terms of solving your psychological issues. It’s supposed to let you get a sample of what future sessions would look like.

So what happens at the first session?

You’ll meet your counselor for the first time. It’s a good opportunity to ask them all the questions you’re interested in. For instance, you can freely ask about their educational background and therapy methods, or anything that you are willing to make clear.

Don’t worry about asking too many questions — that’s what the first session is about. Your counselor also will ask you some questions to get a better understanding of your problems and needs.

What questions can I expect to hear from the counselor?

The first session allows you and your therapist to get to know each other. Clearly, you would like to learn more about the therapy process, and the counselor needs to learn more about you and your concerns.

Therefore, you can expect them to ask you:

  • Is it your first session ever or did you try some kind of therapy?
  • What made you reach out for professional help? What issues are you dealing with?
  • Are these issues recent?
  • How have you been coping with your problems before coming to therapy?
  • What do you think could cause these issues?
  • What do you expect from therapy?

Don’t be afraid to elaborate on your answers and try to be as honest as possible. Remember, your therapist won’t tell anyone about what they learn from you.

What about questions regarding my childhood years?

Most likely, your counselor will ask you about your family and the way you communicate as it could be related to the issues you’re dealing with. But despite the widely-spread belief that every therapist digs into your childhood, many of them don’t do that.

They might prefer to focus on the present time rather than trying to find connections between your problems and some very remote past experiences. Yet, if there was some traumatic event in your childhood, you might need to tell them about it.

Can I start feeling worse after therapy?

That’s another concern that keeps many people away from getting professional help. The answer to this question is, yes, you might feel worse. It happens not because therapy isn’t working but because it actually works.

Sometimes, we don’t want to face a painful truth, and if it’s necessary for you to admit something unpleasant, your therapist will lead you to that.

For example, you might have a friend you’re in a relationship with for years. But lately, you don’t feel as connected to them. When you tell your therapist about your concerns, they might point out that this friend reaches out to you only when they need something. But they are never available for you when it’s you’re the one in need.

Admitting this fact may be painful, but it’s necessary. Remember that a therapist will never tell you to just stop being friends with this person. The mental health professional will let you make your own conclusions.

Will a therapist tell me what to do?

You shouldn’t expect your counselor to give you advice. It wouldn’t be a professional thing to do. The job of a therapist is to identify the issues and help you find your own solutions to them.

They will point out some important details and provide you with effective tools to manage your mental health issues and teach you coping skills. They will never tell you what exactly you should do. Their goal is to teach you how to go about your life as a whole and confident human being.

What therapy methods might a therapist use?

It largely depends on the therapist you’ve picked and the issues you’re dealing with.

In recent years, cognitive-behavioral therapy became one of the most popular approaches. It allows counselors to detect negative behavioral patterns of their clients, figure out how to fix them, and teach a client the healthy way to deal with certain situations.

Behavioral therapy, on the other hand, offers a more complex approach that includes desensitization quite often. This method is very effective with clients that struggle with severe phobias, for example.

Many professionals use humanistic methods in their practice — for example, person-centered therapy, and often emphasizes a goal of self-actualization.

But typically, therapists would use a mix of approaches or choose the method that suits a specific client the most. Don’t hesitate to ask your counselor about the approach they’re going to use with you — it will help you gain confidence in therapy.

How many sessions will I need?

It largely depends on the issues you deal with, the approach a therapist takes, and the underlying problems they will find during sessions.

For example, a single behavioral issue, such as excessive anxiety, can be fixed within 15-20 sessions with cognitive behavioral therapy. If you show enough flexibility and adapt to changes quickly, the course will have fewer sessions. Although you should understand that this is just a generalization, and each situation is unique.

You can ask your therapist to estimate the work you’ll both need to get done. Yet, most likely, the therapist won’t give you a definite answer because they don’t know the depth of your issue yet.

So it’s better to focus on the process rather than trying to predict the future. And remember that you shouldn’t stop therapy once you feel better — you will need a couple more sessions to make sure that you won’t go back to the habitual behavior.

Kate Skurat

Kate Skurat

Licensed Mental Health | Washington, United States

Kate has a B.S. in Psychology and M.A. in Clinical Psychology from Pepperdine University and has worked in healthcare since 2017. She primarily treated depression, anxiety, eating disorders, trauma, and grief, as well as identity, relationship and adjustment issues. Her clinical experience has focused on individual and group counseling, emergency counseling and outreach. Read more