Here’s what to expect.
The process of therapy is different for every individual, and every counselor brings different skills and perspectives to the table as well. But in general, when first entering therapy there are some physical and emotional tasks that are underway that you should expect to happen.
The physical tasks of the first stage of therapy are doing intake paperwork, filling out any relevant assessments, discussing your presenting problem, and discussing your goals for therapy. Administrative tasks are important here as well, such as figuring out billing and communication processes. The information you have provided during these first sessions gives the counselor information to conceptualize your issue- considering factors such as your personality, your upbringing, your culture, your religious preferences and more. Through conceptualization and discussion, you and your counselor should come up with goals that are realistic for you.
The emotional task of the first stage of therapy is for the therapist and client to start forming a relationship. This may sound simple but it is quite complex. Just in the first session you are giving a LOT of information to a stranger for them to be able to assess your issue and you rightfully should be picking up on cues to try to figure out if they’re reliable. This is a vulnerable process and there is nothing wrong with feeling uncomfortable here. A good therapist should expect uneasiness in their clients at this stage, and try to anticipate and provide a safe environment. Your counselor should demonstrate support, respect, deep listening, unconditional positive regard, empathy, and consistency. They should not be distracted, judgmental, unpredictable, or unavailable in any way.
All of these things are going on underneath the surface and the administrative and physical tasks can interfere here if they are not laid out clearly. Imagine if you thought you would be doing virtual therapy because your first session was virtual and then the counselor states that they only virtual for the intake session and do in person for continued sessions. Or say that your counselor said that your session fees would be $40 with your copay and it ended up being $75. That would be a lot to adjust to when first starting therapy! These kinds of details are important to clear up so that trust, safety, and a professional level of intimacy can be formed so the client knows they can rely on the therapist.
Katheryn Kiker 