Finding The Perfect Therapist Part 3: The First Session

“Is that normal?!”

So you’ve finally admitted that you need therapy!

You’ve searched online, called or emailed, and scheduled your first appointment with a therapist that you feel meets your needs in terms of expertise, availability and cost.

And now, you’re finally at that first appointment.

You’re ready for your first therapy appointment

Great! Now what???

The first session a person goes to when starting counseling is always a jumble of thoughts and emotions.

If you are going to meet with a therapist in person, you have to find the office (preferably showing up a little early to fill out paperwork or avoid any traffic mishaps).

Then there’s the fun of sitting in a waiting room possibly filled with other people who are all there for various psychological reasons.

Sometimes the most anxiety-producing part is sitting in the waiting room

All while you wait to meet with a stranger and make yourself vulnerable by telling them possibly the worst parts of your life and most likely things that you’ve never told anybody else…ever! Fun times!

And then, during and after that first session, you have to determine if the therapist you have found is the right fit!

The most important part is finding the right fit

What you’re looking for in a therapist

This can be different for each person depending on the issues in play.  However, generally, you’re looking for someone you feel a connection with in terms of their ability to help, as well as their demeanor and style during the counseling session.

Don’t be afraid to ask questions to try and determine if they are the right person for the job.

I often describe it like a car lot.  You shouldn’t feel obligated to keep going just because you had 1 session with them.  It may mean “shopping around a bit.”  I get that the prospect of that is not pleasant; but, you really want to make sure there is a connection with the counselor you’re working with.

You don’t have to “buy” the first therapist you meet with

For those who have never been to counseling before, they can expect to go over what I call the “business side of counseling” – confidentiality, mandated reporting, cancellation/missed appointment policy, release of information forms, etc.  Some therapists will cover this right up front and others will talk with the person about what’s going on and why they are seeking counseling first.

I usually start with the business stuff because it’s not as emotionally charged, it eases us into getting to know one another, and saves me from having to go over mandated reporting after somebody has already blurted out something that I’m bound by law to report.

At some point you can expect to elaborate on what it is that’s going on.  I always stress, “I’m a therapist, not a mind-reader!” I can’t help the person if I don’t know what it is that’s really going on.  You don’t have to pour out every little detail of the issue/s in that first session; but, enough to give the counselor a good idea of what is going on.

I usually try to explain a couple of things to first-time clients throughout the session.

1. I thank them for coming and being brave enough to admit that they’re struggling with something. Let’s face it, it’s not easy to go and tell a stranger the worst parts of your life. Counseling is often counter-intuitive. Most times we would much rather keep everything to ourselves and pretend like nothing is wrong.  I make it my goal to try to be as down-to-earth as I can and make them feel as comfortable as possible in an already tough situation.

2. My job is to work myself out of a job and “get fired.” My job is to help them identify issues and make changes for positive growth, so that I’m no longer needed.  I get that most people don’t want to be in counseling and that they wish they could wave a magic wand and just erase their awful past.  Since I don’t happen to have that magic wand, my goal is to get them back on “the yellow brick road” to positive growth, fulfillment, and self-actualization as quickly as possible.

3.  Being in counseling is tough, kind of like working out muscles you’ve never used before. They will probably feel exhausted afterwards and will often have a moment of anxiety where they question telling me about their struggles. It’s important that they take care of themselves after the first session – drink water, eat a healthy meal and try to get a good nights sleep.

4. It’s not uncommon for people to have dreams or nightmares after a first session (or a really difficult session).  This doesn’t mean you are crazy or things are getting worse.  It’s your brains way of trying to process through information.

5. I typically explain my personal philosophy on counseling, which is that I think everybody needs counseling at some point in their life.  I go for counseling and think it’s important that a therapist know what it feels like to be on the “other side of the couch”.

6. I explain that my job is to provide my clients with the best care possible, and sometimes that’s NOT me.  Sometimes that means me referring to somebody else.  I will refer a client if they are struggling with something that is beyond the scope of my training, if I feel there are issues that make for a poor fit, and I ask them to do the same.

7. Sometimes, things will get worse before they get better! Often, people have struggled for months or years before coming to counseling. Nobody can fix all your problems in 1 session.  I know I’m a good counselor…but, I’m not that good! This is not an episode of Friends or Modern Family.  It takes a bit of time to see positive results, just like working out or eating healthy.

8.  No counselor can tell you exactly how many sessions it will take to see a change.  I know that’s frustrating, and particularly in America, we want to know how long it will take and what parts need to be ordered.  But, this isn’t a car or a plumbing issue.  It doesn’t work like that.

9. The biggest question everyone has is, “am I crazy?” To which I explain, that is a very sane question and concern to have.

This is the whole reason why WebMD exists!

10. This is often directly followed by, “Can you help me with this?”

We all want to make sure that what we’re struggling with is within normal limits and that the professional we are working with is equipped to handle it.

We never want to hear from any psychological or medical professional…”Wow! I have never seen anything like this” (translation, “you’re super-dee-duper crazy”) which is usually followed by, “I’m going to need you to sign a release so I can include this in the research journal I’m trying to get published in.”  That’s bad news.

11. I stress that with counseling…you get out what you put in.  Making positive changes in your life takes work! And the therapist can only point you in the right direction and help you get there.  A lot of the “heavy lifting” will have to be done by you in the end.

Ultimately, you’re trying to determine if the counselor you have chosen is able to help walk you through what you’re struggling with.  Don’t be afraid to ask any questions you might have.  You have to be the one to decide whether there is a connection there and whether you feel comfortable moving forward in therapy.  This is your mental (and sometimes physical) health we’re talking about after all.  You want to make sure you’re getting the best care that you can!