You’ve decided to try psychotherapy! This is a huge step that is worthy of celebration. After making this decision, you might find yourself wondering, “Ok, now what?” This article is meant to be a general guide to build knowledge and awareness. In providing clarity around beginning psychotherapy, I hope to lessen any feelings of anxiety that often show up when we start something new and unfamiliar. Please note that every therapist and every mental health practice might have slightly different ways of navigating these early stages of the psychotherapy process.
Finding the Right Fit
The first step after deciding to embark on the psychotherapy journey is to identify some potential therapists who might be a good fit for you. I encourage you to tune into your intuition as you learn about potential therapists. Some possible avenues for finding a therapist might be to ask friends or family members for referrals or recommendations, or to talk to your primary care doctor or OBGYN. If none of the referrals seem like a good fit, the next step might be to search on the Internet. It will help if you can reflect on any characteristics and qualities of the therapist that are important to you. These may include the therapist’s theoretical orientation, age, gender, spiritual beliefs. When reading the therapist’s website materials, pay close attention to whether the content resonates and you feel drawn in and reassured. That is a good sign! Once you’ve identified one or two people, now is the time to make your first contact.
The First Contact
The initial contact via Internet or phone might feel overwhelming, but rest assured that the experience is oftentimes much less anxiety-provoking than you might initially think. The first contact is not the first psychotherapy session. Think of it as an introduction to the therapist and the process of psychotherapy. In this first contact you will likely answer a few questions about what is bringing you in, figure out scheduling options, discuss insurance coverage, paperwork components, and get answers to any questions you might have.
While administrative details like new client paperwork and insurance are most likely not anyone’s favorite thing to focus on, they are very important components. Similarly to medical doctors, psychotherapists are bound by rules and regulation in regards to HIPAA, informed consent for treatment, client rights, etc. It is very important that you read through, understand, and sign off on these items prior to meeting with your therapist for the first session.
Before the First Session
It may be helpful to plan to take some time prior to your first appointment with your therapist to reflect on where you are at with your mental health and wellness, and where you would like to be. While your therapist will certainly guide you through the experience of the initial session, creating some space for reflection can help you make the most use of the space and time that you will have. If you have previously been in therapy, reflect on what was helpful and what wasn’t in those previous experiences. Sharing this feedback will help your new therapist really tailor psychotherapy to your needs.
The First Session
During the initial session with your therapist you will be able to share what brings you in, discuss any current and recent symptoms you may be experiencing, set goals of what you would like to work towards in psychotherapy, and ask questions. This first session can feel a bit overwhelming. You may be talking about things you have not shared before or thought about in a while. Disclosing these things to your therapist may bring up feelings of discomfort. Know that this is all a part of the process. Your therapist is in it with you! Share any concerns or apprehensions you might have with them. Know that this is just the first step. You will continue to meet with your therapist weekly to dive into what brings you into therapy, develop new coping skills, and identify together valued goals to work towards.
This first session can also be a time to assess goodness of fit with your therapist. While meeting anyone for the first time can be uncomfortable, trust your intuition, and give yourself and your therapist the opportunity to explore what might be bringing you in. Dive in. Try to not minimize or avoid discussing your most important reasons for deciding to engage in psychotherapy. Your therapist can only truly assist you in your journey if they know what brings you in, and what you would like to work on.
Importantly, keep in mind you can always ask questions if anything is confusing or troubling you! You and your therapist will spend time setting treatment goals, and your therapist will share thoughts and recommendations that they might have for your time together. If you have any feelings of hesitancy or reticence around these goals or recommendations, make sure to share them with your therapist.
For additional ideas, it might be helpful to check out our previous article about how to get the most out of psychotherapy.
The Second Session and Beyond
During your second session, you might find yourself continuing to talk about treatment goals and recommendations, diving into what brought you into therapy, and starting to develop new insights and a larger coping skill toolbox. Most importantly, know that the therapy space is for you — you get to set the agenda! Also, keep in mind that the more you are able to reflect and utilize the skills learned in therapy in your life between sessions, the more you will get out of the psychotherapy space.
If you ever find yourself in a therapy plateau, or feel frustrated with your progress, discuss these concerns with your therapist, so that together you may figure out the most effective path forward. It may feel uncomfortable to directly address any concerns or worries that you may have — keep in mind though that this is exactly what the therapy space is for! We are here for you to help guide you on your journey. If there is one thing you take from this article, we hope that it is knowing that it is okay to voice any questions, comments, or concerns you might have, and that your therapist will meet you with nonjudgmental openness and receptivity.