Coming to therapy for the first time can be really difficult. Making a decision to get help doesn’t come easily. Many people have struggled with an issue for a long time before seeking help and even reaching out to a counselor.

If you’ve made it this far, you’re doing great! I know there can still be some anxiety about what’s going to happen in counseling, especially the first time you come in. To make it more comfortable, I’ll give you a quick overview. Knowing what to expect out of any situation helps our mind feel more comfortable, and that’s what I want you to experience in our work together.

When you come into the suite, you’ll find a very relaxing waiting room. People sometimes tell me they feel better just sitting there, and I always reply there welcome to get early or leave late if they like. Help yourself to tea or water.

I do share my suite with two other fantastic therapists. You might see some other clients in the waiting area. It’s unusual for anybody to interact while they’re waiting, sort of like at a doctor’s office. Just know that we have completely separate practices and everyone here will respect your confidentiality.

I usually leave my door open when I’m expecting a client, so I will come out to the waiting area and invite you in when I hear you enter the suite. If I’m in a session, I’ll come out and look for you as my other client is leaving.

Once you’re in for the first time, I just like to chat a little bit about arriving or make some small talk. We don’t have to launch into exploring your problems right away if you’re not ready for it. Our relationship is like any other, and it’s normal to have some warm up conversation before getting more personal subjects. On the other hand, if you’re feeling nervous, I’m happy to talk about that.

We do have some paperwork requirements from the state, and I also like to run over my individual counseling policies briefly. It’s a great chance to ask me any questions about my professional background, approach, or policies just to make sure we are on the same page before we start. I believe a clear and intentional beginning to counseling allows us to get into our work with a sense of safety and security.

I also like to have people take a paper and pencil assessment about some of the problems they been experiencing recently. I just want to make sure I don’t miss something that could be going on with you. Sometimes people don’t mention all their problems initially or even know some things could be important for me to be aware of as a therapist.

If needed, I sometimes like to give some additional assessments so we can establish a baseline of how you’re doing with a particular problem, for example with depression or anxiety. While by far the most important thing I hope you get out of counseling is your own sense that things are better for you, it’s also very nice to see some numbers to acknowledge the progress you’ve made, as well as for us to monitor whether or not we are meeting those goals.

I also like to review the personal history form you’ve hopefully received ahead of time. If you haven’t completed it or you didn’t receive it before the first session, that’s no problem. We can get to it later, or you can take it home and do it before our next session. Many of the questions I’m looking for will be answered during our first meeting as we naturally began discussing your life.

Getting these assessments and personal histories gives me a good framework to begin to understand the particular concerns that have brought you in. Think of it like your general health practitioner getting a basic health history, taking your blood pressure, weighing you, etc. before treating you for whatever conditions you are concerned about.

Speaking of doctors, you probably notice most of them taking notes of some kind of the other during your visits. I also find this helpful so I can remember what we discussed from session to session, so it’s okay with you, I usually jot a few things down while were talking on my pad.

This is all to get us ready to discuss the problems you’re experiencing that brought you in with some framework for both of us. It’s usually premature to begin to work directly on helping you with those concerns, but it is a step that can help us formulate some goals. I usually begin to see what counseling approaches are going to be helpful for you and I might even share that with you.

After our first session, most of the other sessions we do will start with whatever you’d like. Some people want to share recent events, some want to pursue specific techniques, some want to discuss their problems, some want information about what they’re going through so they can understand their experiences. Any of that is fine. You’ll usually discover my primary response is to ask more questions rather than giving advice or suggestions, although I’ve got a trove of ways to get out of struggle that I might present to you with as relevant. Counseling is really about you and your goals, and I don’t have any agenda outside of giving you the results you’re looking for.

Something you might want to know about our sessions that might be different from other therapists is that I really love to have some experiences here in the counseling office. These experiences will last longer than our discussions in your mind. These can be little playful experiments, sometimes they are observing physical, emotional, or thinking sensations that are happening right now as we are working together. For many of my clients, we will do some mindfulness practice right in the office at some point and I might provide some instruction targeted to your particular needs. None of this might be what you’re looking for, and again that’s okay. It’s most important to me that we connect and you feel that our work is helpful for you no matter what it looks like.

As always, I am happy to discuss any concerns you have about the counseling process either before our first session or during our work together. It’s always my honor to be able to help you with some difficult and vulnerable aspects of your life, and I never want you to be confused or in the dark about what’s happening in our work.