Your First Therapy Session is like the First Day of School
Hello! Happy Monday!
I hope you took care of yourself this weekend and if it wasn’t in the cards for this past weekend, we have another weekend coming up!
Last week, we talked about how therapist shopping can be pretty dang similar to the dating process. This week we are going to dive into what happens next.
We found a therapist, but now what? While we can check off “Find therapist” on our to-do lists, the unknown of what comes next can create a whole lot of big feelings.
Going into therapy for the first time is very much like the first day of school. While you don’t have to pack a lunch nor spend 8 hours in a school building, the nerves of the unknown and expectation we may have for ourselves can be very much the same.
First Session:
In the seconds (minutes/hours/days) before your first appointment some panicky questions may come to mind:
“What should I expect? How much talking do I have to do? What if there are awkward silences? Do I have to fill them? How much of my trauma should I dump on this person right away? Do I have enough stuff to talk about? Am I wasting this person’s time? What if they don’t like me? What if I don’t like them? What if I just cry the entire time? What if what I share is too much?” And so on.
And the answer to most of them is, “You are okay, you don’t need to know the answers to these questions right now, just know that there is very little way to “mess up” in a therapeutic environment. This is a new experience and it is okay to be nervous”.
Similarly to school, we have to learn that it is okay to not know everything right away and that it’s always okay to ask questions, especially if they feel like silly questions.
On the first day of school, we are rarely expected to understand what the class is or to be able to ace the final right away. We need to give ourselves the same permission to not expect anything from ourselves on the first day (weeks) of therapy.
All therapist’s have different approaches to their first session. Some call it an intake session or perhaps an initial session. First sessions are generally spent reviewing paperwork and maybe even going through some assessments. These logistics are focused on for a few reasons:
1. Legally, we need to make sure that any and all intake paperwork is understood and signed appropriately.
2. Assessments can be used to identify a baseline of where we are starting.
3. It is a great ice breaker to further get to know our clinician and for our clinician to get to know us!
Reminder: We have permission to ask any question that you have! We have permission to be curious about why we are completing paperwork and assessments!
Personally, I like starting with a Biopsychosocial Assessment. This allows for a therapist to learn and hear about all aspects of you as a person. The biological, psychological, and sociological factors that make you, you.
These assessments and paperwork could take a single session, but could also span multiple sessions. It definitely takes some of the pressure off of us, the client, to come up with what to talk about.
Creating and setting therapeutic goals:
In school, teachers have objectives for the classes that they are teaching. Objective are goals that are set to make sure that students are learning what they should be learning during the semester.
For therapy, we use goals. Unlike school where objectives are set by the teacher, goals are a collaboration between us and our therapists. We may have immediate goals that we know we want to move towards or we can engage in discussions with our therapists to identify what we want to work towards. Some examples of therapeutic goals are:
I want to work on finding effective self-care and coping skills to replace my current maladaptive behaviors.
I want to begin exploring the effects on past childhood trauma to identify my negative behaviors and work towards creating a more positive vibe in my mind.
I want to process and talk about what goes on for me day to day.
I want to understand and learn why my brain does what it does.
Our goals can be as vague or specific as we want them to be in the beginning. We will work together with our therapist to fine tune the goals that work best for us. (And then your therapist will probably translate it to fancy and therapeutic language).
Once we identify the goals we want to work towards, that's when the good (and maybe hard) stuff can start.
Utilizing the Therapeutic Relationship:
This is the part of the school year that involves “learning”. We explore, talk, reflect, and take information/education in while our therapist leads us towards accomplishing our goals.
This is also where we find out if we connect with our therapist and if you can build a therapeutic relationship with them.
What is a therapeutic relationship? Great question!
Therapeutic Relationship/Alliance/Rapport: Is the product of mutual respect, trust, and care between the clinician and client. Building this relationship allows the client to feel safe to engage in the work that it takes to move towards goals (SBT, 2023).
We all have teachers from our past that we liked and didn’t like. Think about the differences between those teachers? Did you feel safer with the one that you had a better relationship with? Probably! They likely felt safer to engage with and maybe even allowed you to learn in ways other teachers weren’t able to. This is the same thing that happens with therapists!
Feeling comfortable in the therapeutic relationship and liking how our therapist works is by far the most important part of therapy! The speed at which the therapeutic relationship builds can be different for everyone. It may be immediate or it may take a few months to really feel safe to get to vulnerable topics.
This is where school and therapy differ. At school once we are assigned a teacher we generally have to stick it out for the rest of the school year, but in therapy if we feel like the relationship is not building or we can’t see ourselves working with a therapist, we can always transition to another therapist!
You’re doing it!
At this point we are on our way to doing therapy! As I said, therapy can be compared to school. But unlike school there is no way to be graded or to fail therapy. If we are showing up every session and engaging with our therapists we are doing the work! We don’t need to set expectations to “win” or to “heal” in a certain period of time. Therapy is often a lifelong activity that evolves while you do.
I hope this has been helpful in curbing any nerves you may have had about starting therapy for the first time! Have any questions? Don’t hesitate to reach out and ask them!
Virtually yours,
Sara Barber
P.S. Remember if you are reading this (and you aren’t one of my clients) I am not your therapist and you should take what I share with that in mind. I’m here for the laughs (mostly at myself) and the education. If you’d like me to be your therapist or are interested in finding a therapist, email me!