Most of us have seen television shows or movies where we see characters meeting their Therapist for the first time. Sometimes these meetings are dramatic, sometimes not. Are they truly reflective of what happens in that first Therapy session? Here, Alex Amidjaya continues sharing his knowledge about Therapy and in particular, that first Therapy session.

“In the last blog post, I discussed what therapy is. I talked about how the purpose of therapy is to “help people achieve some positive level of mental wellness.” I also started to describe the answer to the next question people tend to have about therapy, which is: how do Therapists do what they do? At this point I got into some examples of what activities or conversations in therapy can look like. From here, I think it would be useful to address a question that comes up for many who are considering therapy or have made the commitment to starting already: what happens during the first therapy session?

To answer this question, let’s consider some of the examples I gave when I explained what happens in therapy as a whole. I brought up how someone experiencing depression may learn to spot self-defeating patterns of thought, how a someone suffering from a phobia of air travel might go through a series of increasingly involved exposures to their fear in order to overcome it, and how someone living with a history of trauma may unlearn reflexive anxiety that isn’t serving them anymore. As we can see, the issues that bring people to a Therapist’s office are highly varied. That’s great because it means that almost regardless of issue, you’ll be able to find a Therapist for you. It also means that the Therapist will spend some part of your first session together asking you questions that help to define that issue. Even though you’ll likely provide a history and list of issues you’re experiencing on an intake form, the Therapist will still want to hear directly from you what is bringing you in. That’s because intake forms don’t allow you to actually narrate your story and do little to facilitate developing the relationship you may have with your Therapist. You might want to think of these first questions as a bottle-neck that helps the Therapist get down to understanding what is between you and mental wellbeing. The questions may start out broad (“what brought you to my office today?”), start to narrow as a history of your issue is gathered (“when did you first notice feeling this way?”), and ultimately become pointed and insight-provoking (“do you believe you have a choice in the way you’re feeling about this issue?”).  In order to help you, your Therapist will need to understand what it  is that you’re facing.

Other questions that come up in this first conversation you have with your Therapist may seem mundane, but you can rest assured that they are about understanding what’s going on in your life and getting an appropriately complete picture of it. The Therapist may want to know about who you live with, whether or not you like your job, what your long-term plans are, and even if you’re involved in a romantic relationship. Additionally, a Therapist will need to know some basic information about your psychiatric history if you’ve got one. The kinds of medications you take, how much of them, and whether or they’re being used as prescribed are all important pieces of information to consider in helping someone on their journey to wellness. As you can imagine, the same is true for illicit substances, which brings me to another point: many are reluctant to share information with Therapists for fear of legal or social repercussion. This hesitancy is almost entirely unnecessary, as privacy law in healthcare known as HIPAA (Health Insurance Portability and Accountability Act) prevents your Therapist from sharing anything shared with them during a session unless it is necessary to protect you or someone else from immediate harm or they are compelled to by subpoena (which you would have an opportunity to dispute). As a general rule, what’s said in session stays in session.

All of this is the mechanics of a first therapy session though, and I would be remiss if I did not speak to what is likely the most important thing: building a comfortable and trusting relationship between Therapist and client. The strength of the therapeutic relationship is the single most important factor in whether or not the therapeutic process will be a success for the person engaging in it. Your Therapist will most likely cover the basics discussed here during your first session, but their most important job is initiating a successful relationship with you.”

**And… each Therapist may approach all of this differently, to meet your needs.**

To schedule a first Therapy session, contact MySpectrum at: 804-924-2236. We will be happy to set you up with a Therapist and start you on your journey.