You’ve made an appointment, now what?

Starting counseling for the first time can feel daunting. Every counselor handles the intake process a little differently, but here’s my take based on both my experience as a client and as a counselor myself.

Step 1: Paperwork

Part of our ethical code (and Texas state law) is ensuring you understand your rights as a client. Mental health records are considered Personal Health Information and are protected under HIPAA. Because of this, your therapist will ask you to sign forms that outline confidentiality and its limits.

You'll also review important details about fees, services, therapeutic training, and other helpful information. Be sure to read the informed consent carefully! While I personally review this information during the first session, it's crucial that you understand what you are agreeing to.

Many clinicians, myself included, prefer that you complete your paperwork before the first session. This allows for more valuable face-to-face time with your therapist instead of spending time filling out forms.

Step 2: In the Room

Now you're face to face (or screen to screen) with your therapist. Feeling nervous is normal. After all, this is a stranger you're expected to share your struggles with and trust with your emotional well-being.

In my experience, many clients "word vomit" for several sessions before we get to the core issues—and that's completely okay. Surprisingly, it can be easier to share your story with a stranger than you might think.

Personally, I enjoy those initial sessions because they provide valuable insight into your world. This context helps me distinguish between healthy, adaptive behaviors and those that may be maladaptive or harmful.

Different therapists may structure their first session in various ways. Some may explore your childhood, current struggles, and self-care habits (like I do), while others may prefer assessments, worksheets, or homework assignments. There's no one-size-fits-all approach—each therapist has their own method for helping you unravel the puzzle that is you.

Step 3: After the Session

Some therapists won’t schedule a follow-up appointment at the end of the first session to avoid making you feel pressured. Others (like me) prefer to schedule immediately to save time and streamline the process.

After your session, it's important to increase your self-care. Therapy often involves being vulnerable, and this can leave you feeling a little drained or triggered. Be kind to yourself. Take time to process what came up, drink water, play a video game, or engage in any other activity that feels comforting and calming to you.

Final Thoughts

Starting therapy is a brave and important step. Understanding what to expect in your first session can ease anxiety and help you feel prepared. Remember, counseling is a collaborative process, and finding the right therapist is key to making meaningful progress.

If you have any questions or concerns before your first appointment, don’t hesitate to reach out to your therapist for clarification. Your mental health journey starts with that first courageous step!