What to Expect in your Initial Therapy Appointment

(Today’s blog is the final installment in a 3-Part series regarding starting therapy. Part 1 focused on questions to ask yourself or situations that might make you want to consider therapy.  Part 2 addressed ways to find a therapist to work with, and Part 3 will focus on what to expect in your initial therapy appointment. If you missed either earlier post, click here to catch up!) 

Now that you’ve decided you want to start therapy, and you have selected a therapist to work with, what comes next? 

The therapist should give you a heads up as far as what the next step is after you schedule your first appointment.  Each therapist might do things slightly differently, so don’t be afraid to ask if you are not quite sure what to expect.  Some might have you come in 30-60 minutes prior to your first appointment to fill out paperwork. Some, like our practice, use electronic health records, and would ask you for an email address to send you access to a secure client portal.  In this case, you can view and fill out the paperwork at home, and electronically sign it.  Either way you complete the paperwork, expect to read about the practice’s policies and procedures, how they handle your confidential information, consent to treatment, and fill out some background information as far was why you are looking to start therapy.  This paperwork would outline things like if the practice allows interns or non-licensed therapist, if they accept insurances or their self-pay rates, if they use encrypted email and phone systems, and what their cancellation policies are.  It might seem boring, but we would suggest reading through all of this information, since at the end of the documents, you are going to sign your understanding and agreement with it.   

Each practice might handle insurance differently too.  Some practices do not accept insurance at all, and allow you to submit your self-payment to your insurance for possible out of network reimbursement.  Some expect you to verify your coverage with your insurance provider. Others, like our practice, will ask for your insurance information and will verify your benefits prior to the initial appointment.  Either way, you can follow up with your insurance provider to clarify your coverage or talk with your therapist about what your coverage might mean.  Feel free to ask questions about your benefits, as insurance is often confusing!

The initial appointment is called an intake.  In this session, the focus will be a little more administrative than future sessions.  You will probably review the documents you signed and ask any questions about them that might have come up.  Your therapist may have you complete more specific assessments (regarding anxiety or depression symptoms, for example) to gather more information.  Then, you will probably start to talk about what is bringing you into therapy, what your goals are for your sessions, and how you will know when you’ve reached those goals.  If you are using insurance, please realize that your therapist will need to make a mental health diagnosis in order for your insurance to cover your sessions.  An example of a diagnosis is anything from ADHD to Unspecified Depressive Disorder.  The background information will give your therapist information in order to make an accurate diagnosis.  Beyond a code to bill to your insurance, the diagnosis can mean very little, so don’t get too hung up on it.  Focus on your goals for therapy and what benefit you want to see rather than what your diagnosis is.  Or, talk to your therapist if the diagnosis bothers you or you have questions about it. 

Your therapist will most likely ask you, probably very pointedly, about drug and alcohol use, as well as self-harm behaviors and suicidal thoughts.  Part of our job involves your safety, and so we need to ask about these things.  Please speak honestly, so that we have all the information possible to best help you if you are struggling in these areas. 

If you didn’t have a consult prior to a first session, see the intake as your chance to ask questions and determine if this therapist is a good fit for you.  Our hope at The Counseling Collective is that you leave an initial appointment feeling (somewhat) more hopeful.  If you feel much worse, this could be a sign that the therapist, or his/her style, is not for you.  Either way, communicate openly with your therapist what your needs and expectations are. 

Hopefully, if you go through the steps we’ve suggested in this series, you will be in therapy with someone you feel comfortable with, getting help to address your problem or concern. We’d love to hear from you if you have any feedback or questions about this series, or therapy in general.  Our hope is that by sharing these topics over the past few weeks, you have a better understanding now of the beginning of the therapeutic process.  Here’s to better mental wellness!