Starting therapy with a new person can feel daunting. Whether you’ve been in therapy before or it’s your first time, every therapeutic relationship and experience is different. Let’s take a look at what to expect when getting started with therapy. We’ll break down the typical steps, experiences, and expectations along the way.
Step 1 – Deciding to Start
People enter therapy for many different reasons. You might be experiencing a temporary life event that is shaking things up, or maybe you feel like it’s time to explore thoughts and feelings that have been causing you suffering for a long time. Even if you have previous experience with therapy it takes courage to decide to reach out to a stranger for support and connection. Therapy involves sharing your life and who you are with another person, and that isn’t something to be taken lightly.
At this stage it can be helpful to do some journaling or other types of reflection. You could make a list of why you’ve decided it’s time to start therapy. You can write down symptoms you’re experiencing, problems you’ve been having at work or in relationships, or goals you’re having difficulty reaching in life. If you’ve gone to counseling in the past, consider what worked for you and what didn’t so you can get an idea of what you’re looking for from a new therapist.
Step 2 – Finding a Therapist and Reaching Out
There are many ways to find a therapist. Referrals may come from your existing support team or friends. You might also search through your insurance company’s provider list or by using the Psychology Today website. It can be hard to tell a lot about someone from a photo and short bio! You can look for therapists who share common values or identities and who list the issues you want to work on as areas of interest or speciality.
You can keep it simple and basic when reaching out for the first time. Most therapists have an intake form on Psychology Today or their website. You can leave your contact information and a brief message about your interest in therapy. This is a good time to ask if the therapist is taking on new clients and if they accept your insurance.
Step 3 – Introductory Call
Many therapists offer a brief call, usually around 15 minutes long, to connect and see if it would be a good fit. Many things go into determining whether a therapist is the right fit for you to start working with! Some of it is a general “vibe check.” Ask yourself if this person feels like someone you can talk to openly about what’s going on in your life. Other issues related to fit are practical like scheduling times, office location, and desire for in-person or virtual sessions.
The introduction call is also your chance to go into more detail about what brings you to therapy and ask any questions you might have for the therapist. You don’t need to “tell your whole life story,” but you can share about broader themes such as experiences of depression and anxiety, situations you’re struggling with, and things in your life you’re wanting to change. Questions for the therapist might include wanting to know if they’ve worked with people experiencing issues similar to yours, and what types of treatment might be helpful.
Step 4 – Intake Paperwork
You’ve found a therapist, had a good intro call, and feel ready to start. That’s great! The final step before your first session typically involves completing intake paperwork. At ARCH Counseling Center, we have a client portal for intake documents and other paperwork. You’ll receive an email with a link to set up a portal profile. From there you’ll be able to access a series of documents to complete and sign.
The number of documents can feel like a lot, so it’s okay to take your time and come back to it. Many of the forms have to do with privacy of confidential medical information and providing consent for your therapist to meet with you. There’s information detailing therapist and client boundaries, cancellation and rescheduling policies, and payment structure.
There’s also an intake document where you have an opportunity to provide more details about what brings you to therapy, including your history and how symptoms are impacting your life. If you’ve been through trauma or have a complex background it can sometimes feel triggering and overwhelming to be faced with so many personal questions. Please know it’s okay to provide incomplete answers or skip parts of the intake document. This document is meant to help your therapist begin working with you in a way that is customized to your needs, and sometimes those needs require taking a slower start to disclosing traumatic events and history.
Step 5 – First Session
Now it’s time for your first session. Every therapist does first sessions a little differently. I like to use the time to get to know the new person sitting across from me and learn about their life and what kind of changes they’re looking for. Sometimes this includes going into detail about family history and background and sometimes not. Typically, some type of family history and background information does need to come up within the first few sessions, but no one is expected to share everything about themself in an hour!
During the first session you can get a feel for how the therapist works and what your dynamic with them might be like. Some therapists like to use structured interventions such as worksheets and specific practices to do at home. Others are more open-ended, and sessions explore what the client is feeling and experiencing in the present moment.
Step 6 – Is it a Good Fit?
In therapy we often talk about whether or not a client and therapist are a “good fit.” A good fit happens when there is a comfortable rapport, or interpersonal dynamic, between the two. Did you feel comfortable spending time with your therapist? Do you like the way they asked questions and explored your reasons for coming to therapy? Are you interested in the types of interventions and practices they use? Sometimes it can take more than one session to decide if it’s a good fit, and that’s fine.
It’s okay and normal to have a bad fit in therapy sometimes. It might be hard to put your finger on why you don’t want to work with a certain therapist. There’s no reason to feel bad or guilty about this. Having a good and strong relationship between therapist and client is one of the strongest indicators for positive outcomes in therapy so it’s worth the time to find someone you feel comfortable working with. It’s always your right to stop working with a specific therapist and decide to find another. You can follow these same steps and try again!
Written by: Andrea Norstad
