By David Ensor, LSW
Starting therapy for the first time can be frightening if you don’t know what to expect. Will your health insurance cover therapy? What will the therapist ask? How should you prepare?
I’m here to help you understand a therapist’s perspective and give you a few tips to get ready. In this article, we’ll discuss how therapists get to know you, what to ask your therapist about, and the diagnostic process. My goal is to get you comfortable and ready to make a big step forward that can change your life for the better.
What Will Your First Therapy Session Look Like?
Typically, other than the necessary paperwork, you won’t need to prepare much before your first therapy session. Still, you may want to research the therapist, and you must be ready to share personal information. Most therapy sessions are 45 minutes to one hour. The first session is a fact-finding mission for both of you. It’s a chance to get to know each other and introduce yourselves.
What to ask a therapist on a first visit?
When starting therapy, you’re welcome to ask the therapist anything you want to know. A therapist should be open and honest, barring sharing anything too personal. From a therapist’s perspective, this is a professional relationship.
Depending on how much you know about the therapist before going in, it’s totally understandable and expected to ask questions like:
- Do they have a family?
- Have they dealt with your problem before?
- How do they put their words into action in their own life?
Personally, I don’t suggest anything to my clients that I don’t already do or am willing to do. Whether that’s meditation, sleep, or attempting to have a good diet, with that in mind, we are all human beings and have our own problems.
While a therapist is not going to get too personal, they will most likely be willing to discuss their experience with issues in a general way. These are essential pieces of information that will help you feel comfortable.
How Do Therapists Get to Know You?
A good therapist will want to know all about you, including:
- Your family
- Your living situation
- Your work situation
- How do you feel about these?
- What are your biggest issues daily?
- What are your triggers?
In the first session, most of the conversation will be surface-level, but you may get into deeper issues. Think of it like a first date to see if you mesh. There is no commitment, and you can see if the therapist can help you.
During the first session, your therapist wants to understand your problem and see how they can help you address it. A therapist will look at all your stressors.
- Do you work overnight?
- Are you living with three kids, your wife, and your mother-in-law?
- Is your dog terminally ill, and are you dealing with grief?
- Have there been previous diagnoses?
- Are you currently on ANY medications (even those not for mental health)?
All medication has the possibility of causing side effects, and these can affect your mental health. Make sure you talk to your medical doctor about it if they do.
What do therapists say in the first session?
A common misconception of therapy is going to therapy and talking about your problems will fix everything. That’s not true. While talking about, expressing or venting your emotions, and finding out where they come from can be helpful, it will not necessarily solve the problem. Most of the time, actions are required.
A therapist will help guide you in new behaviors to help change how you feel. With every one of my clients, at the end of our first session, I ask them to write a list of values. These values can be morals or priorities. Things within your life that you’re always trying to reach but can’t fully obtain or perfect. What are those things that continue to drive you?
- Love
- Hard Work
- Integrity
- Honesty
- Open-mind
I also ask new clients to research meditation practices that may fit their needs. Meditation is unique to the individual. The meditation that works for me won’t necessarily work for you. That may be walking in the woods or exercising at the gym. Meditation, for me, begins with breathing. This tool helps me and can be an excellent starting point.
Can Your Therapist Diagnose You at the First Session?
Ultimately, your therapist is trying to check two boxes to make sure you receive the proper care and ensure insurance covers your visits.
- Does your particular issue fit into a DSM-5 classification?
The Diagnostic Statistical Manual of Mental Disorders (DSM) is the diagnostic reference manual in the United States that all mental health professionals use for their patients and is regularly updated.
- Will your insurance company cover the diagnosis?
Most insurance companies do include therapy in their coverage, but not every therapist will be in your network or be covered. It’s necessary to contact your insurance company before your first appointment to ensure coverage.
Depending on their licensure, your therapist may diagnose you during the first session or afterward. Licensed Clinical Social Workers (LCSW) oversee Licensed Social Workers (LSWs) to ensure the diagnosis is valid before it is given to the client.
It is also helpful for the therapist to know whether there have been previous diagnoses before to see if they are accurate or valid. Someone who was diagnosed with depression in the past does not necessarily mean they still have it today.
Some of you may be hesitant about therapy and feel like a diagnosis could negatively impact your life. Mental health has had a stigma for years, but this is something that all medical health workers are fighting against. Just because you have a diagnosis of anxiety or depression, it does not change you as an individual. You are a unique and valued part of society, and a diagnosis does not change that.
Remember, you don’t have to share your diagnosis with anyone. Your diagnosis will help your therapist understand your needs and give you ways to deal with the issues you’re having.
It’s important to know that everything discussed in your therapy is private and protected by the Health Insurance Portability and Accountability Act (HIPAA), a federal law that protects sensitive information. You will be asked to sign a HIPAA form before your first appointment, which ensures your protection.
What’s Next?
After your first session, your therapist has to write a summary of the session. Insurance does not get these notes, but they are stored for the therapist to look at in the future. The therapist will schedule additional appointments for the client and potentially make further suggestions.
Sometimes, medication can be helpful, but only psychiatrists, medical doctors, or nurse practitioners can prescribe medication. If your therapist recommends medication, they will point you to your medical doctor or a psychiatrist to work in tandem with the therapist.
Either way, therapy is about finding the right tools and resources to help address your needs. Finding the right therapist and treatment for you is a process that starts with your first appointment. I offer a free 15-minute consultation to make sure you’re comfortable with me before you start. If you are ready to get started, call Blair Counseling and Mediation to schedule your consultation.
