What to Expect at Your First Counseling Appointment

If you’ve never been to a counseling appointment before, your mind can fill in information that you don’t know with all kinds of anxiety-producing stories. You may have been thinking you need to go to counseling, but the stories in your head keep you away. “What if they think I’m an idiot? Or worse, what if they say my problems are my own fault, and I end up feeling worse than I already do.” You have a fear of being judged harshly by others, but the truth is no one probably judges you harsher than you judge yourself.

When thinking about coming to counseling or therapy, the first step is to reach out through a contact form on a website or with a phone number. You may have to wait up to a couple of days to get a response because therapists are usually in session all day except for a lunch break. If you call, you will most likely have to leave a message. It’s not likely to help if you keep calling expecting the therapist to pick up. However, if you leave a message, most therapists or someone from their team, will usually respond within 48 hours to set up a consultation appointment that lasts about 15 minutes. These are usually free, but not always, so be sure to check with your particular therapist. During these calls, the therapist will ask you what you are seeking help with along with some standard questions about yourself. These calls help the therapist to get a sense if they will be the right fit for you. Do they have the special training that is needed to help you with your situation?

Go into the call with a generous assumption knowing that the therapist most likely has your best interest at heart. If they say they are not the right fit, ask for some referrals of other therapists they may know who might have the right skills to help. This is not a sign that you are too much or not enough. It is simply trying to assess if the two of you will be a good match to help you meet your goals. There is so much research that suggests the therapeutic relationship is a major contributor to therapy outcomes. This relationship is central for the counseling process and making sure you get a therapist who has the skills you need, combined with the personhood of the counselor, are salient.

Once you find someone who may be a good fit, you will complete consent forms and practice forms that set the boundaries around the therapy. You will then setup an appointment if you didn’t do so on the consultation call. Usually, once all the consent forms are signed, you will be able to begin therapy as long as you are in the state of the therapist’s licensure at the time of therapy. Unfortunately, if you are travelling to a state where your practitioner is not licensed, it can become an ethical and legal problem. It’s usually best practice for both the client and the counselor to be in the state of licensure when therapy is occurring.

When you attend your first appointment, your therapist may review all of the consent and practice forms that you signed to make sure you fully understand the documents. This first appointment is called an intake appointment and its usually a little longer with a different structure than ongoing therapy. The therapist will ask you what may feel like 50,000 questions about your personal life including what your childhood was like and what your life is like currently. You will get an opportunity to tell your story about what is bothering you and how you hope therapy can help. At some point during this intake session, your therapist will schedule your next appointment(s) if you haven’t already done so.

Your therapist will work with you to collaborate on a treatment plan about how you might be able to go about meeting your goals. Unfortunately, there is no magic pill to cure mental health challenges or mental injury because there are so many factors that influence it, but there are things you can do! Mental health change includes your active involvement, as well as efforts to change your thoughts, feelings, and behaviors.  You will have to work both inside and outside of the counseling sessions.  There are no instant, painless, or passive cures. Most likely, you will have to work on relationships and make long-term efforts.  Sometimes change will be easy and swift, but more often it will be slow and deliberate, and your efforts may need to be repeated. This is because you aren’t only changing your outside behavior, you are also changing your brain structure! You are creating new neural pathways in your brain, and that simply takes time. Don’t put a timeline on your change; instead, focus on slow and steady effort with consistent, intentional, small changes because that is what usually makes the biggest difference! Some will go to therapy for a few months, and some will go for a year or more. It’s different for everyone so comparing your journey to someone else’s isn’t usually helpful. Just keep your eyes focused on your next right step. You don’t have to have it all figured out when you show up!

It’s important to understand you are making an investment in yourself. Many people have said it is one of the best investments they have made. Just like others are worth the time, sacrifice, and effort, you are worth every bit of the same!

Keep in mind, these are generalities on what a first therapy session may look like. One of the biggest surprises I’ve heard is how relieved people feel when they leave. Just having someone who will listen without judgment and get into the well with you saying things like, “Yeah, I get it.” “That sounds really hard.” – and you know they mean it – seems to help ease the load one is carrying. You can see they truly care and genuinely want to be of service to you. I would encourage you to watch this video about Why You Should Try Therapy Yesterday. It’s a great video that gives you some insight on how counseling can help you learn more about yourself, ultimately changing your life in some way.

So, take a moment and ask yourself what is holding you back from trying therapy. Get curious about it. What good might you gain by committing to a few months of therapy? You can always decide to stop if you want. You have some choices in front of you: stay stuck in your patterns by doing nothing or try something new that might be helpful. You’ve got the rest of your life ahead of you. The choice is yours. What will you do?