What to Expect in an Initial Therapy Session

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It is very natural to fear the unknown. Our media represents counseling and other forms of therapy in all sorts of different ways. Most often these representations could not be further from the truth. This blog post serves to provide an outline of what to expect from a counselor during your first session.
You can expect to do paperwork. I know, BORING. But this is very important for getting to know who you are and what your provider can do to help you. This should be a collaborative process so if there are parts of the paperwork you don’t understand or seems strange, be sure to ask for clarification. In this paperwork, there will be intake questions about your medical and psychiatric history so the provider may get a snapshot of your previous engagement in any services. This helps during case conceptualization to provide the most relevant care for you at this time in your life, but also to get a glimpse of your treatment team’s cohesion and/or if there are other concerns your counselor should look out for (e.g., medication side effects, etc.).
Also, during this paperwork, your counselor will go over informed consent and limitations to confidentiality. Counselors and other mental health and medical professionals are mandated reporters. This means that if abuse, neglect, or suspicion of either of a minor, older adult, otherwise at-risk adult, or place must be reported to authorities. This is not just during the initial intake session either – it is at ANY time during counseling. While this might sound like an authoritative “power move,” it was truly put into place to reduce the incidences of abuse and neglect. When people are in a situation like this, it may be difficult to get help or find their way out of it which is also why this limitation to confidentiality exists. By reporting abuse/neglect, the victim may get support, resources, and more they may not have otherwise.
After the initial intake paperwork has been completed, a counselor might employ other intake forms or assessments. One that I like to use is the R.E.S.P.E.C.T.F.U.L. intake form which explores many aspects of a client’s culture. This might feel very revealing and vulnerable, but this can inform your counselor of your preferences such as pronouns or other cultural identifiers that would be unfair to assume such as ethnicity, race, sexual orientation, religion, and more!
Some examples of the assessments a counselor may ask you to fill out is the OQ-30.2 which assesses self-danger, particularly self-harm and suicide. This is not to imply that anyone is suicidal, but it can be a different way of opening the conversation of self-worth, self-esteem, and self-perception. There are virtually infinite numbers of assessments out there which will differ depending on age, presenting problem, and more. There are assessments for couples coming in for couple’s therapy. Family assessments exist and more.
After all of this, the counselor will be collaborating with you on a plan for future sessions. I recently heard of a therapist who creates goals and objective with clients then each week uses the last 10 minutes of a session to discuss, with the client, what they think their progress has been. While this may not be the case for every counselor’s style or every setting, there should certainly be a conversation about your goals within counseling and re-evaluation as the sessions continue.

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Brightside Counseling Services, LLC
edmonds@brightsidecounseling.net  |  303.353.9226
5650 Greenwood Plaza Blvd. Greenwood Village, CO 80111