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The First Therapy Session: How to Prepare and What to Expect

Is your first-ever appointment with a therapist coming up? We’ve asked Dr. Naureen Whittinger, Senior Clinical Psychologist at the London NHS Foundation Trust, what to expect from the first visit, how to prepare for it, and how soon you’ll see results.

Interview has been edited for clarity.

How to prepare for the first therapy appointment

“There’s no need for any formal preparation before attending your first appointment,” Dr. Whittinger says.

However, she suggests thinking about what you are hoping to gain from therapy and how you might tell your therapist about this: “Make sure you are clear about what your therapist can offer you and write down any questions you might have about the therapy ahead of time.” 

Aside from that, Dr. Whittinger advises simply to relax about your session. It’s your therapist’s job to work alongside you to better understand your difficulties and to consider how you might work towards your goals.

Not all therapies are the same. Dr. Whittinger says, “Some types of therapy, such as couples and family therapy, are helpful for understanding and resolving problems in relationships. These typically involve attending with the other people in your life. This type of therapy works best when everyone involved is happy to attend and prepared to work towards the same goals.”

What to expect from the first appointment

“Your first appointment is a chance for you and your psychological therapist to learn more about each other and how therapy might be helpful for you. This appointment gives your therapist a chance to explain more about how therapy works and gather more detailed information from you about any current difficulties,” says Dr. Whittinger. 

Your therapist will let you know when the session is over and may give you some homework or formulate a plan for your next session with you at the end of the session.

Psychological therapists are bound to rules of confidentiality, meaning the things you talk about in therapy will not be shared with anyone outside of therapy, with some notable exceptions.

Dr. Whittinger also says that psychological therapists usually have a professional supervisor who they might consult on your case, but this supervisor would also be bound to keep your information confidential. “The other exception is if you have told the therapist something that gives them serious concerns about your safety or the safety of others. In this case, your therapist has a duty to act to protect you and others from harm.”

Your therapist might take notes during or after the session. These notes usually won’t be shared with anyone outside of your therapy, with a few exceptions. “In the rare circumstance that your notes are requested by the police or a court of law, your therapist would usually tell you,” Dr. Whittinger explains. 

What will the therapist do? What won’t they do?

Your psychological therapist will ask you questions about your life and what has brought you to therapy. “They should pay attention to you during sessions and be sensitive to your beliefs and culture,” says Dr. Whittinger.

And Dr. Whittinger also shares some things that a therapist shouldn’t do:

  • Tell you what to do or make decisions for you
  • Judge your behavior, ridicule the solutions you have tried already, or criticize important people in your life
  • Neither avoid exploring your difficult feelings nor push you to talk about difficult feelings or memories against your wishes
  • Frequently miss, cancel, or show up late to appointments 
  • Touch you without your consent, try to start a romantic relationship with you, or pressure you into paying more money than you agreed to before starting therapy. If this happens, you can report your therapist to their professional body.

“If your therapist does any of these, you might want to raise your concerns with them or their therapy practice,” Dr. Whittinger suggests. 

“A good therapist will be open to your feedback and will want to rectify their mistakes. If you are still not satisfied with the service offered by your therapist, you are within your rights to stop attending therapy, even if you have committed to a number of sessions.”