What do the first few therapy sessions look like?

There are so many questions I’ve heard over the years that come up and often give pause to people who are thinking about starting therapy. “What should I bring up first?” “Should I talk about that?” “What does my therapist want me to talk about?” I think the heaviest lift can often be the thought of having to ‘start from the beginning’ or ‘explain all of it’ to someone. I totally get how draining and demotivating that sounds- so I encourage you to have a different idea when coming in.

For intake sessions

I usually guide the structure of intake sessions more than I do in sequential. I start off giving time for informed consent discussion, start to establish some rapport and answer common questions. I then start to go through my intake questions. Theses touch on current stressors and more general history questions as well. More times than not, one or two of these questions are tied to why you’ve come. So we spend time discussing your reasons for starting therapy and I then usually weave my history and intake questions into the conversation from there. There usually is only so much that we get into on that first session so we will continue on in the next. There is no rush and as the process goes on until we get to what we need to.

Please please please try to decrease the pressure on yourself:

You do not need to put an expectation on yourself (not only in intakes but throughout the duration of your time in therapy) that you have to spend the first few sessions telling every huge event of your history. I find there may be people who really want to ‘get it all out’ and if that’s what you need in the intake- great we can do that. But I also try to find a balance to focus on what is happening in the present that brings you to session. I like to make sure that you and I have an understanding of each other before diving into really heavy content so you feel safe enough to explore. Having more time together before exploring difficult things also helps me know how to best support you.

Do you (the therapist) want me to disclose specific things?

There are no rules or expectations I have of you to talk about something particular in your intake. A big part of my job is to listen to what you say and start to touch and explore what I notice, or put words to an experience you’re recalling upon. In order for that to happen, I cannot have an rigid agenda. In fact, I often rely on you to be yourself so we can really get to know what is happening without any filter.  I have open and ongoing conversations about your goals and direction we want the work to take to ensure we’re on the same page. I also will ask you what I feel like im missing to help releive you of any pressure that you may have put on yourself.

Taking up space in sessions from the start

Another huge part of the process is that you can ask questions in our session. If you feel uncertain, want a temp check or some reassurance- please ask! If you’re feeling unsure of something you’re brining up, the structure of session or anything in between you should ask. I want you to! Ideally our cadence starts to feel known, relied upon and helps build insights and growth.