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So you have found your therapist and you have a date set for your intake appointment, now what? Adding to an already overwhelming process, not knowing what to expect from therapy can create fear. I want to share some thoughts about what to expect from therapy. Before I start, I would like to tell you some of what I share ALL therapists should do and others are individualized to my style of therapy. I will do my best to make those distinctions throughout the post.  

The Paperwork

First things first, the paperwork. Like going to a new doctor, you will need to fill out paperwork before your first appointment. The paperwork will include some combination of demographic info, emergency contact, HIPAA/confidentiality, consent to treat, health insurance, client’s rights, and maybe some brief questions asking about your history. Helpful hint, take special note of a therapist/agency’s policies and procedures. This will be where more individualized information will be provided, including cancellation policies, payment methods, how to communicate, etc. 

Initial Meeting

The first therapy session will most likely be different than the others that proceed. The first session is the “get to know you” appointment. There will be a lot of questions asked in the initial meeting. The specific questions asked are highly individualized by the therapist. Here are some of the questions that I ask in my intake:

• What prompted you to reach out for counseling?
• Have you experienced significant trauma or grief throughout your life?
• Who would you identify as your support system?
• How did you learn to manage emotions growing up in your household?
• How does your mood impact appetite and sleep?

The initial appointment is also your opportunity to ask questions as well. In the past, I have had clients ask me about my professional background, if they will get homework in between sessions, and what we will talk about in each session.

HIPAA and Confidentiality

HIPAA and Confidentiality are a MUST for every single therapist. First of all, what does this mean? HIPAA (Health Insurance Portability Accountability Act) is a federal law that protects your health information as the client. Meaning, by law, your therapist cannot share ANY of your personal information without your permission. However, there are a few circumstances in the mental health world that confidentiality does not apply. Those cases are if you have thoughts to harm yourself, thoughts to harm another person, or any mention of child or elder abuse.  

Before entering into therapy, you MUST read and sign the HIPAA form. Don’t be surprised if your therapist also brings this up in your first initial meeting. It is good practice to also talk about it with clients in the first meeting if there are any questions.

Length of Therapy

The length of treatment and how often a client is seen varies. Every single therapist has a different opinion and viewpoint on this. First, it depends on the type of therapy you are doing in session and your presenting concern that contributes to the length of treatment. Someone who is going to counseling to cope with the death of a spouse would be very different than someone going to therapy to help work through a struggle with a boss. There is no “right way” or “wrong way” to do this. I would encourage you to have a conversation with your clinician and agree on a plan together.  

My style is different than a lot of other therapists. I have found the best success with seeing my clients every week at the start of therapy to help build the therapeutic relationship and gain momentum in achieving treatment plan goals. As an individual begins to make progress, I bump sessions out to every other week, then every three weeks, then to once a month, etc. I have found this gradual pace of spacing session out is the most effective. 

Goals

Identifying goals in therapy is extremely important because you have to identify where you are going if you want to make progress. I believe that goals should be collaborative between the client and therapist. I start by asking the client what they would like to work on, then together, we identify the specific goals. Goals need to be clearly identified and reviewed frequently to assess for progress. 

It is not necessary to do before an intake, but if you feel you would like to be more prepared, here are some questions to consider. You can use these questions as a guide to get a better understanding of what kind of progress you would like to make. 

• What feels most overwhelming right now? Often that is a good place to start.
• How would you know you have made progress in therapy? What would be different about your life?
• What feels like the next right step for you?
• What feels most in your control?