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

Your first-ever appointment with a therapist is on the calendar? We've asked Dr. Naureen Whittinger, Senior Clinical Psychologist in London NHS Foundation Trust, what to expect from the first visit, how to prepare for it, and how soon you'll see the results.

woman at her first appointment with a therapist

How can I prepare for the first appointment and how might I get the most out of attending psychological therapy?

There is no need for any formal preparation before attending your first appointment.

However, it can be helpful to think 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. 

To reduce the stress of your first appointment and get the most out of the session, it is helpful to plan ahead so that you know your journey and will arrive on time. Aside from that, try to relax about your session. It is now your therapist’s job to work alongside you to better understand your difficulties and consider with you how you might work towards your goals.

Some types of therapy, such as couples and family therapy, are helpful to understand and resolve 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.

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.

Attending therapy regularly takes courage and my main advice to anyone attending therapy is to be patient with yourself, recognize that therapy might be both difficult and rewarding, and enjoy.

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.

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 would not usually be shared with anyone outside of your therapy with some notable exceptions. In the rare circumstance, your notes are requested by the police or a court of law, your therapist would usually tell you. 

What will the therapist do? What won’t he/she do?

Your psychological therapist will ask you questions about your life and what has brought you to therapy.

He should pay attention to you during sessions and be sensitive to your beliefs and culture.

Your therapist should not tell you what to do or make decisions for you. He should not judge your behavior, ridicule the solutions you have tried already or criticize important people in your life. Your therapist should neither avoid exploring your difficult feelings or push you to talk about difficult feelings or memories against your wishes. Your therapist should not frequently miss, cancel or show up late to appointments. 

If your therapist does any of these, you might want to raise your concerns with them or the therapy practice. A good therapist will be open to your feedback and he will want to rectify any 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. 

Your therapist should never touch you without your consent, try to start a romantic relationship with you, or pressurize you into paying more money than you agreed ahead of starting therapy. If this happens, you can report your therapist to their professional body.

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