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What to Expect in Your First Therapy Session

A person with long brown hair sitting on a sofa talking to a therapist in a room with natural light from large windows, brick walls, and plants.

What to expect the first session:

While counselors are all different in their approaches, I am going to discuss a few elements to be expected from an initial therapy session, which is usually called an “intake.”

Introductions- Your counselor should introduce themselves to you and guide you step by step through the whole intake process. Finding the right counselor may take time and it’s very normal to have questions for your counselor. It’s encouraged for you to ask any and all question you might have about your counselor or about the counseling process. Counselors are used to answering questions about the work that they do and it’s helpful to start the relationship as honestly and openly as possible. Feel free to ask about their education, experience, or their thoughts on a particular subject. =

Paperwork- You will have some paperwork to fill out and review with your provider. Sometimes this paperwork can be done ahead of time but it will always be reviewed early in the intake session. Counselors typically dislike this part of the process as much (if not more!) than clients, but it is absolutely necessary to collect this information. Topics paperwork will cover often include (but aren’t limited to)
basic demographic and contact information, insurance information (if insurance is being billed for services), payment agreements, provider information, confidentiality agreement, policy and procedure information, medical history, and current symptoms and concerns. Reporting and discussing this information can be monotonous but it’s a critical time to ask any questions about any of these topics. This is a great time to ask questions like, “what happens if I’m late or need to cancel a session?” or “How do I reschedule an appointment?” Going over this information in the beginning, can avoid frustrations later for both client and counselor.

Goals setting – Your counselor will most likely ask about what brings in you in for counseling and what you hope to get out of it. It’s helpful to establish some goals and a sense of the direction you would like to head from the very first session. It’s very normal for these to be broad or feel difficult to define. Often clients may just say they want to “feel better.” That’s ok! I would encourage you just to be as honest as you can. Your counselor will help you work toward identifying what positive change might look like for you.

History Taking- Your counselor will also ask you questions about what you are currently experiencing and questions about what you may have experienced in the past including family history, trauma history, and medical history. This is called “history taking.” History taking is important for your counselor to get to know you better and understand more about what you have been through and possibly better understand contributing factors to what you are currently going through. This process may feel invasive and it’s fine to let your counselor know how you are feeling about sharing this information or what you’re not ready to talk about.

Scheduling – Another topic often discussed in an intake is scheduling. You will work with your counselor to figure out when and how often you will meet. It can be helpful to remember to bring your schedule to your intake appointment to make this part easier. Feel free to ask what your counselor’s schedule is; sometimes counselors can work evenings or weekends to accommodate busy schedules.

So far I’ve discussed introductions, paperwork, goal setting, and history taking, and scheduling. Intakes are different that normal counseling sessions simply because there is so much ground to cover! However, the most important part of an intake is getting to know your counselor and allowing them to start to get to know you.