Therapy Note: The First Session

Too often, myths and misconceptions about mental health services prevent people from seeking support. My goal is to provide a space where these myths and misconceptions may be examined. The blogs titled “Therapy Note” dispel or provide clarification to some of the more common myths for the population/topic listed in the title of the note.

Myth 1: Treatment starts at the first session.

Reality: The first session is also referred to as the initial or intake session. It is generally structured differently from a treatment session and does not involve interventions. The time is utilized to gather information and may involve forms, questionnaires and tests in addition to the verbal interview. This may feel frustrating that you did not “start” working on the issue right away. However, you want the therapist to get to know what your goals are prior to giving you ways to address them.

Myth 2: If I attend a first session, I have to continue with this therapist.

Reality: One session does not obligate you to ongoing sessions. It is okay if you do not “click” during the first session. This may feel like a difficult conversation to have. However, therapists know how important the right fit is for treatment. Some may welcome this as part of the process and allow space for this by asking if you would like to continue at the end of the first session. If the therapist does not ask if you would like to continue, you can bring it up. It is a great exercise of setting your own boundaries to be able to say this is not a good fit for you. You may also simply say that you are going to continue your search.

Myth 3: The therapist will disclose personal information during the first session to make me feel “at home.”

Reality: A therapist does not typically disclose personal information unless it is relevant to treatment. This is to provide a boundary for the therapeutic space to be solely about the client. It is fine to ask your therapist questions. It is up to them to navigate if and how to share personal information.

If you are seeking faith based counseling or feel as though a certain race, gender or sexual orientation is important to you, let the therapist know.

In addition, some couples may want someone who is married or has been married. Some parents may want a therapist who is a parent. In any of these cases, when you want to know personal information, you have to ask yourself (1) why this is important to you (2) how will this information impact treatment?

Myth 4: The intake forms include questions about suicide. The therapist thinks I’m suicidal.

Reality: Therapists have to assess all clients for suicidal ideation as part of our ethical obligations.

Myth 5: The first session did not go well so therapy is not for me.

Reality: Even if you do not find the right fit with the first therapist, continue the process. Every therapist is different. Therefore, your experience with one, does not set the tone for all.