What is it Like to See a Counselor for the First Time?

I think this counselor is a little too close to her client. Respecting client’s personal space is important!

Coming to counseling for the first time can be a bit unnerving. You may feel discomfort at the thought of talking to someone new about things that are personal to you. That’s normal. Most clients who are coming to counseling for the first time will tell me they don’t know what to expect. So, if you’re nervous about coming to counseling for a first session and don’t have a clue what it will be like, you’re not alone. Allow me to attempt to debunk some mystery about the first session or as we refer to it in the counseling realm, the intake. 

Of course, what the first session of counseling will be like will depend on who you are going to see. Some agencies have standard intake questions they have to ask in the first session such as whether or not you are experiencing suicidal or homicidal thoughts. Intake questions can be lengthy, and as a result, the counselor may have to cut you off at certain points to get through it all with you. Understand, they are not trying to be rude, but trying to get a complete, yet condensed picture of what is happening. Counselors who take insurance are also fulfilling insurance requirements that require a diagnosis and in order to diagnose someone, the counselor needs a complete picture of symptoms. Personally, I prefer to use my intake paperwork that people fill out prior to the first session to ask these types of things and use it as a springboard to conversation. Your therapist may have you fill out paperwork ahead of time or ask you to fill out the paperwork when you get to the office. Either way, It behooves you to be honest on the intake questions because your therapist can’t help you in full if they only have partial truths to work with. However, there may be things you don’t feel comfortable sharing just yet, and that’s alright.  

I will now share how I approach a first session. The purpose of the first session is to start building a healthy working relationship, gather important information, and collaborate on next steps. Let’s break each one of these down individually.  

Building a healthy relationship is foundational to any good therapy process. If you came to see me, I would start out the session by talking about some basic get to know you information such as the kind of work you do, who you live with, and what you like to do for fun. If you’re in college, I want to know what you’re studying. The goal is to get to know you as a whole person instead of just focusing on your symptoms. My goal is to help you feel heard and understood. This time may seem like chit chat to you, but I’m learning some valuable information about your strengths and support system. You may be so focused on the negative things that are bringing you to counseling that you often miss the positive things you have going for you. The strengths help support and guide the counseling process.    

Of course, I would allow you time to talk more specifically about the situations or symptoms that you are coming in for. I would encourage you not to pressure yourself into feeling like you have to tell your counselor the whole story right away. This is not how anyone in your life has gotten to know you. It takes time for information to unfold. You can always come back to topics in future sessions. As a counselor who is curious by nature, I will ask questions about things I think it would be helpful for me to know about. If your counselor asks a question, and you aren’t ready to go there yet, let them know. You can politely say, “I’m not ready to talk about that yet.” Even though it can be hard talking about emotional and stressful things, there is a sense of relief that comes from getting it out in the open. Having someone hear your story and respond in a compassionate way can be healing. 

You don’t just want to be heard though. You are also interested in finding a solution. This is why at the end of an intake session, I like to provide a summary of feedback about what I’m noticing, as well as my approach to targeting the symptoms or issue. Some therapists may have you set goals for what you would like to get out of therapy in the initial appointment. It’s important to think about what you really want. I feel bad and want to feel better is vague. What would you be able to do if you were feeling better that you are not able to do now? How would you like to approach challenging situations? Whatever you’re needing, it’s important for you to feel good  about the direction you’re heading in with your therapist.     

And sometimes you won’t. If the therapist does something that makes you feel really uncomfortable, don’t go back. Several years ago, I went to see a therapist as the client and he answered his cell phone in session. On the other line was one of his clients. This was a dealbreaker for me. Another time, I was annoyed in the first session because the counselor kept saying, “what else?” to get more information out of me. He seemed nice, but I was looking for more feedback than I was getting. I decided to give him another chance and see how things went the next session. Our second session was much better. I decided to keep seeing him, and we were able to accomplish great therapeutic work together. Other times, something just doesn’t feel right like you and the counselor are not on the same page. I’ve had that experience as the client and as the therapist. As we like to say in the counseling world, sometimes, it’s just not a “good fit.” Don’t give up on counseling if you have a negative experience with a counselor or two. You wouldn’t avoid getting your teeth cleaned if you had a negative experience with a dentist. Try someone different. You may want to talk to them over the phone to get a feel for what working with them might be like or do more extensive internet research.        

Counselors have different ways of wrapping up their sessions. I admit that I used to end abruptly, and found it wasn’t the most helpful. Now, I like to get feedback from my clients at the end of every session. This helps me know if I am on track with what they are wanting or if there was something I did in the session that didn’t jive.  

Taking care of yourself after your first counseling session is important. You may need a little time to decompress after talking about emotional things. You may want to go on a day you will have off work or don’t have any pressing projects. You don’t know how you’re going to feel afterwards. If you decide to attend regularly, you may not need time to decompress after every session, but give yourself that gift after the first session. I hope this article was helpful and reduced some anxiety about your initial counseling appointment.  

For more help on founding a counselor who is right for you, click here.  

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