Your First Therapy Session – What to Expect

Learning to Thrive: A How-To Guide for Therapy

by Gavin Hannegan, Cal Poly, San Luis Obispo undergraduate intern, supervised by Dr. Hannah Roberts

Hello Thrivers! Welcome to the second installment of a three-part series called, “Learning to Thrive: A How-To Guide for Therapy.” This series will help you understand what to expect from the beginning and end of your therapy journey. Over the past few months, we’ve explored how therapy can be an effective self-care tool no matter what your needs are. Now, let’s put those discussions into context as we explore your first therapy session.

Your initial meeting with your therapist will help you feel more prepared for your subsequent therapy sessions. You’ll gain experience with the ~50 minute timeframe, begin building the therapeutic relationship, and start adjusting to your chosen setting. This can be exciting, but may feel a little intimidating too. You might not know what to say or you may even feel pressured to present yourself a certain way. Know that it is okay to not feel fully comfortable. On the flip side, don’t expect to be fully healed the moment you leave this first session. Remember, this is only the beginning of your journey. You have so much time to grow!

Overall, your first therapy session is:

A Chance for Your Therapist to Get to Know You

There’s no better place to talk about yourself than in therapy. Of course, your therapist wants to understand why you’re seeking out therapy. But more importantly, your therapist wants to establish a connection with you. Therapist-client bonding serves a few different purposes: 

• It demonstrates the therapist’s investment in the client and that they care about what the client has to say. 
• It helps build trust between both the therapist and the client.
• It allows the therapist to be more attentive to the needs of that client, and the client to respond more positively to therapy (Vandenberghe et al., 2018).

Over time, the more open you are with your therapist, the better you and your therapist can tailor your self-care strategies to fit your individual needs. But at this stage of therapy, share what you feel comfortable sharing. You may not feel ready to fully disclose everything about an area of concern. And with only 50 minutes in this first session, you simply may not have enough time. Think of this session as the “getting to know you” stage of the relationship. The goal is to make sure that both you and your therapist would be comfortable working together. 

An Opportunity to Learn More About Your Therapist

The field of therapy has moved past the idea that therapists are “unknowable,” or that there should be rigid boundaries between the therapist and the client. While the focus of the session should not be on the therapist, you are more than welcome to ask your therapist questions about themselves. This can make your therapist feel more relatable and approachable. For example, therapists that disclose their mental health status, to a moderate extent, are perceived more favorably by their clients compared to therapists who do not practice self-disclosure (McCormic et al., 2019). Believe it or not, your therapist is human, too, and they may have personal experience with the topics you bring up in your first therapy session, in addition to their clinical experience. If you’re curious about your therapist, and you believe the information will help you feel more comfortable, then ask! 

A Safe Space to Express Your Emotions

Being open with your emotions is a skill. Some of you may have grown up in an environment where you felt like you had to hide your true emotions, or otherwise didn’t get the necessary practice to hone this skill. This may be new territory, but your first therapy session will help you navigate it. When discussing your area of concern, pay attention to the emotions that come up for you. Such sensations can range from a feeling of tension and restraint to feeling like you’ve released a floodgate of tears. It is okay for your emotions to feel messy. You and your therapist will work together to identify your emotions and understand where they are coming from. Once you can name these emotions, you can tame them. No matter which emotions arise, know that your feelings are valid. Learning to accept your emotions and thoughts can improve your psychological well-being. By asserting more control over your negative emotions specifically, you can better adapt to and overcome daily stressors (Ford et al., 2018). You’ll be provided with the tools to channel your emotions in healthy, productive ways. Having these vulnerable conversations may be the toughest part of your first therapy session, but they will also be the most rewarding. 

A Place to Establish Your Goals for Therapy

Moving forward, what do you hope to achieve through therapy? You and your therapist can develop a personalized action plan to make your next sessions feel intentional and productive. Setting goals encourages you to stay committed to the therapeutic relationship; those who do not set goals are more at risk of ending the therapeutic relationship prematurely (Cairns et al., 2019). Goals make your progress in therapy tangible. They illustrate how far you’ve come, and how much farther you want to go. A lot of the work that goes into reaching these goals will be done on your own outside of therapy, but your first therapy session will prepare you for that work. When working with your therapist to develop goals, remember the acronym SMART: Specific, Measurable, Achievable, Realistic, and Timed (Cairns et al., 2019). Examples of effective SMART goals include:

• “I will power down my phone at 9pm before I go to bed at 10pm each night.”
• “This Saturday, I will sit down with my roommate after they get home from work and have an open dialogue about our responsibilities in the apartment.”
• “When I feel stressed, I will take a minute to practice the box breathing technique.”

The types of goals you set will depend on your individual needs. And sometimes, there may be new topics you want to discuss with your therapist, so some goals may need to be delayed in favor of more pressing ones. There is no timeline for personal growth or healing. Work towards your self-care at your own pace. You have a whole therapy journey ahead of you.

Next week, we will discuss how to bring your therapeutic relationship to a close, and how to adjust to your day-to-day life after therapy. Enjoy your first therapy session!

Have more questions or feel ready to start therapy in California today? Schedule a session with one of our therapists! You can schedule online here!

We hope you enjoyed this blog post! Have more topics you’d like us to blog about? Contact us and we’ll be sure to include your topic in a future post.

References

Cairns, A. J., Kavanagh, D. J., Dark, F., & McPhail, S. M. (2019). Goal setting improves retention in youth mental health: a cross-sectional analysis. Child and Adolescent Psychiatry and Mental Health, 13(31), 1-8. https://doi.org/10.1186/s13034-019-0288-x

Ford, B. Q., Lam, P., John, O. P., & Mauss, I. B. (2018). The psychological health benefits of accepting negative emotions and thoughts: Laboratory, diary, and longitudinal evidence. Journal of Personality and Social Psychology, 115(6), 1075-1092. http://dx.doi.org/10.1037/pspp0000157

McCormic, R. W., Pomerantz, A. M., Ro, E., & Segrist, D. J. (2019). The “me too” decision: An analog study of therapist self-disclosure of psychological problems. Journal of Clinical Psychology, 75(4), 794-800. https://doi.org/10.1002/jclp.22736

Vandenberghe, L., Coppede, A. M., & Bittencourt, M. V. (2018). Building and handling therapeutic closeness in the therapist-client relationship in behavioral and cognitive psychotherapy. Journal of Contemporary Psychotherapy, 48, 215-223. https://doi.org/10.1007/s10879-018-9388-9