Congratulations, you've found your therapist! Now what?

It's the 1st session. You're nervous, asking yourself questions like "What will she be like? Will he think we're crazy? What have I gotten myself into?" If you've never been to a therapist before, it's like walking into a small room with a stranger who has agreed to take your money to provide you with a product you know little about. It can be weird and feel awkward. You're taking a big risk entrusting someone else with your problems, with your life. And kudos to you for your courage! I want to try to make it all a little less daunting, so here's a brief guide of what to expect when you walk into a therapist's office for the first time:

When you get there, you will be greeted with the usual pleasantries and a bit of small talk, but eventually you'll have to get serious. Your therapist will soon ask "what brings you here today?" You may have talked about it on the phone prior to your appointment, but some version of this question will be posed to bring the focus to exactly why you're paying to be there. Attempt to be as honest as you comfortably can be. It's natural to feel strange about telling someone you've never met your most hurtful problems. You don't have to say everything, just try to be truthful. This can be extremely difficult when you've come to therapy with a spouse and it's the therapist's responsibility to help you feel as safe as possible in his or her space. This is YOUR time. Use it wisely.

When you come to therapy for the first time, at some point in the session you will be asked to sign confidentiality agreements and other documents. Your therapist should verbally describe the important points of the documents to you. If you do not understand certain parts of the document, be sure to ask. Again, this is for you, not the therapist. Good questions to ask include:

  • Does anyone else have access to your files?
  • What do I do in an emergency?
  • Who will take over for you when you go on vacation or if something were to happen to you?
  • Will I/we have a diagnosis?
  • Can I/we give feedback?
  • What theories do you use? - I, for example, am quite interested in emotionally-focused therapy. Common approaches are cognitive-behavioral, solution-focused, and systems theory (for couples or families).
  • What sort of education or experience do you have with my/our specific problem(s)?

The therapist may also administer certain assessments or tests, depending on what your complaint is.

If you're going with your spouse or partner, it is also important to ask who the client is. Is it the person who called or is it the couple as a whole? You might also want to ask about confidentiality if you have individual sessions. Will the therapist keep secrets or is everything out the open, no matter what? My advice here, don't put your therapist in the position of keeping secrets from your spouse. You're in therapy - be honest. This is probably the one place in your life where you won't be judged for what you do, within reason.

NOTE: a therapist MUST report to the authorities if a person presents a reasonable threat to him/herself or others or if child or elder abuse is evident. There is also no statute of limitations on sexual abuse, so a therapist must report a living offender even if the abuse occurred many years ago. This should be discussed in your first session, as well. The therapist does not have a duty to report domestic abuse and may or may not be willing to work with abusive couples. This should be established before you get to your first session, though.

A really good therapist will have you feeling safe and heard within the first one to two sessions. If after the second session, you are not feeling this way, speak up! I hear stories all the time about people sticking with a therapist who they feel "did me no good" for long periods of time or who "liked my partner better than me". My first response is always: "Did you say anything?" or "Why did you keep going??" Again, it's weird - you're telling this person so much about your life. It's SO personal. Keep this in mind, though: your therapist is not your friend. You are paying this person to provide you with a service. You have the right to complain or seek help elsewhere (you can even ask your therapist for a referral) if you don't feel like your needs are being met. Do this, and you will get the most you can out of the therapeutic process.

Have any other great advice for therapy newbies? Let it loose in the comments section!

Next week: More on getting your money's worth in therapy