top of page

What to Expect in Your First Therapy Session

Are you about to go to a therapist for the first time? Whatever your reason for seeking help, you will be more at ease and get better results if you know what to expect.

In your first session, the therapist typically will ask certain questions about you and your life. This information helps her make an initial assessment of your situation.

Questions she might ask include:

Why you sought therapy. A particular issue probably led you to seek counseling. The therapist has to understand your surface problem(s) before she can get to the deeper issues.

Your personal history and current situation. The therapist will ask you a series of questions about your life. For example, because family situations play an important role in who you are, she’ll ask about your family history and your current family situation.

Your current symptoms. Other than knowing the reason you sought therapy, the therapist will attempt to find out if you’re suffering from other symptoms of your problem. For example, your problem might be causing difficulty at work. The therapist will use this information to better understand your problem.

Don’t just sit there

Therapy is a team effort. If you don’t take an active part in the session, you won’t find the counseling experience valuable. Here are some things you can do to make your first session as successful as possible.

Be open. Therapists are trained to ask the right questions, but they’re not mind readers. The therapist can do her job more effectively if you answer the questions openly and honestly.

Be prepared. Before you get to the session, know how to describe “what’s wrong,” and to describe your feelings about your problem. One way to prepare is to write down the reasons you’re seeking help. Make a list and then read it out loud. Hearing yourself say it a few times will help you describe things more clearly to the therapist.

Ask questions. The more you understand the counseling experience or how counseling works, the more comfortable you’ll be. Ask questions about the therapy process, and ask the therapist to repeat anything you don’t understand.

Be open and honest about your feelings. A lot will be going through your head in this first session. Listen to your own reactions and feelings, and share them with the therapist. You’ll both learn from these insights.

Be sure to go to your first session with realistic expectations. Therapy is not a quick fix for your problem, rather it is a process. With some effort on your part and a strong relationship with your therapist, it can be a successful tool toward resolving problems.

Therapy is a process

Expectations of therapy: Each individual brings individual needs and skills to the therapy process; accordingly we will develop the style of therapy that best meets the needs, resources and goals of treatment. The therapeutic process aims to help clients to help themselves, by facilitating a deep awareness of what is actually troubling them and by helping to empower and direct them to make the appropriate changes.

Sometimes therapeutic interventions may be paradoxical. There may also be homework between sessions; reading, practice or behavioral change which can be a positive supplement to the therapeutic process.

Possible types of therapy

Individual vs Family Therapy

  • Individual therapy, which explores the root of feelings and behavior, is traditionally a safer, more secure option to working with the entire family at once. Treatment with individuals helps facilitate a thorough focus on the most important emotions beneath the individual's symptoms.

  • Family therapy is a powerful way of repairing the damaging effect of long-term problematic interactions. Over time, maladaptive communication patterns drive a wedge between family members, resulting in the members becoming disconnected from one another, or overly involved with one another in an unhealthy manner. Therapy would consider each member's role in the symptomatic interactions, versus assuming any single member is responsible for the family's issues.

Theoretical Orientations

Insight-oriented therapy, focuses on unconscious processes as they are manifested in a person’s present behavior. The goals of psychodynamic therapy are a client’s self-awareness and understanding of the influence of the past on present behavior. In its brief form, a psychodynamic approach enables the client to examine unresolved conflicts and symptoms that arise from past dysfunctional relationships and manifest themselves in the need and desire to abuse substances.

Mindfulness psychology interprets mindfulness as a state of active, open attention on the present. When you're mindful, you observe your thoughts and feelings from a distance, without judging them good or bad. Instead of letting your life pass you by, mindfulness means living in the moment and awakening to experience.

According to Object Relations psychology, human beings are always shaped in relation to the significant others surrounding them. Our struggles and goals in life focus on maintaining relations with others, while at the same time differentiating ourselves from others. The internal representations of self and others acquired in childhood are later played out in adult relations. Individuals repeat old object relationships in an effort to master them and become freed from them. The self is perceived in relation to the establishment of boundaries and the differentiations of self from others (or the lack of boundaries and differentiations).

Interpersonal therapy focuses on the interpersonal relationships of the client - symptoms are treated by improving the communication patterns and how people relate to others.

Techniques of interpersonal therapy include:

  • Identification of Emotion — Helping the person identify what their emotion is and where it is coming from.

Example — Roger is upset and fighting with his wife. Careful analysis in therapy reveals that he has begun to feel neglected and unimportant since his wife started working outside the home. Knowing that the relevant emotion is hurt and not anger, Roger can begin to address the problem.

  • Expression of Emotion — This involves helping the person express their emotions in a healthy way.

Example — When Roger feels neglected by his wife he responds with anger and sarcasm. This in turn leads his wife to react negatively. By expressing his hurt and his anxiety at no longer being important in her life in a calm manner, Roger can now make it easier for his wife to react with nurturance and reassurance.

  • Dealing With Emotional Baggage — Often, people bring unresolved issues from past relationships to their present relationships. By looking at how these past relationships affect their present mood and behavior, they are in a better position to be objective in their present relationships.

Example — Growing up, Roger’s mother was not a nurturing woman. She was very involved in community affairs and often put Roger’s needs on the back burner. When choosing a wife, Roger subconsciously chose a woman who was very attentive and nurturing. While he agreed that the family needed the increased income, he did not anticipate how his relationship with his own mother would affect his reaction to his wife working outside the home.

Family therapy views a person’s symptoms as taking place in the larger context of the family. For example, just as a particular department in a business organization may suffer because of the problems in another department, a person with depression may be responding to larger family issues. For example, a depressed adolescent’s symptoms may be related to her parents’ marital problems.

Family therapy is a style where cognitive, behavior or interpersonal therapy may be employed. However, it is most often used with interpersonal therapy. Some special techniques of family therapy include:

  • Genogram — A genogram is a family tree constructed by the therapist. It looks at past relationships and events and what impact these have on the person’s current emotional technique.

  • Systemic Interpretation — Views presenting issues as a symptom of a problem in the larger family.

Example — 16-year-old Billy’s getting into trouble in school and staying out at night are viewed as unconscious attempts to shore up his parents’ failing marriage. It is noted in the sessions that the only time his parents get along and work together as a team is when they are dealing with Billy’s problems.

  • Communication Training — Dysfunctional communication patterns within the family are identified and corrected. People are taught how to listen, ask questions and respond non-defensively.

There are many other theoretical orientations which may influence your specific needs in treatment at Oceanside Family Therapy. We offer a non-pathologizing and non-blaming approach to treatment, which focuses on empowering individuals in breaking maladaptive patterns of behavior with an individualized treatment plan.

There are no specific amounts of sessions to commit to. Sessions can be either be scheduled regularly or simply as needed. Our goal is to provide support and growth for our clients to benefit with minimum care, not to become dependent on therapy. When life stress increases, our clients know that they can always reach out to schedule with us, regardless of how long it has been since the last session.

Psychodynamic needs are often initially scheduled weekly, however, Brief Strategic Family Therapy sessions are very effective one time per month for up to 12 months.

bottom of page