Your First Therapy Visit

Yay! You Made An Appointment With A Therapist!

You went through online advertisements or accepted the endorsement of a friend or signed up at a public mental health facility. Now you are going to meet your therapist. If all goes well, your therapist may become someone who knows you better than nearly anyone. Now it’s time for your first therapy visit. 

your first therapy visitBefore Your First Therapy Visit

  • Gather together your ID, your insurance card and/or a method of payment that is accepted by your therapist.
  • If you have any questions you want to ask at the intake, write them down.
  • Also, before you go, enter the address into your GPS or phone and have it ready to navigate if you don’t already know where the office is.
  • If you were relying on public transportation or Lyft or Uber, it is also helpful to trace your route beforehand.
  • If you have mobility issues, you might want to make sure that the therapy space or an alternative space is wheelchair accessible. 
  • Make sure you know your deductible and copay information. Therapy works best if it is consistent over time, so be sure you know and can manage your out-of-pocket expenses. 

Your First Therapy Visit

Regardless of any other paperwork a therapist may have you sign, in the United States they must provide you (or give you access to reading) a privacy policy and an informed consent document. The privacy policy outlines your rights under HIPAA and is likely to also include any rules your therapist or their agency has on top of Federal and possibly state rules.

The informed consent is going to outline both the potential benefits and risks of therapy and should give you information on how to file a complaint against your therapist or their agency. Sometimes these are combined into one document, sometimes you sign the document online before your first visit, and sometimes you sign at the first visit. In any case, it is important that you read the document(s) carefully and understand your rights. 

Questions For Your Therapist in Your First Visit

  • What are your credentials? “Credentials” are the license information under which your therapist is allowed to practice therapy in your state. 
  • Are you familiar with (people from my background)? Does the therapist have experience with people of your sexual orientation or gender identity? Your race or national origin? What about your religion? Your set of mental health issues? 
  • What is your training on (issue)? Does the therapist have special knowledge of a particular mental health issue or type of therapy? 
  • What is your policy on cancellations? Some therapists charge you if you cancel or “no-show” with less than 24 hours notice unless there is a specific type of emergency. 

 

Questions to Ask Yourself in Your First Therapy Visit

  • Is the space comfortable, both emotionally and physically? 
  • Does the therapist seem familiar and comfortable with the issues I’m bringing? 
  • Do I feel like I could eventually like and trust this therapist?
  • Does the therapist appear to have respect for and knowledge of people in my situation of life?
  • Is this therapist listening to my concerns? 
  • Does the therapist appear to be organized and prepared for the meeting? 

Questions You’ll Answer in Your First Therapy Visit

There is a lot of material to cover in your first therapy visit, and knowing the sorts of questions the therapist will ask will help you get through them quickly. For instance:

  • Demographic information including name, address, phone number, email address, race and ethnicity, gender, sexual orientation, and religion or spiritual affiliation
  • “Why are you here”? The therapist will likely ask you an open-ended question asking you to describe why you want therapy. 
  • A safety issues question about current suicidal or homicidal thoughts and sometimes psychotic symptoms that are dangerous to you or others. 
  • A list of the symptoms that brought you to therapy
  • A history of times you’ve seen a therapist and/or psychiatrist in the past. (It’s helpful to have a list of names with you). If you have any previous diagnoses, these will be helpful as well. your first therapy visit
  • A brief history of trauma in your life. This includes physical, emotional, and sexual abuse at any age, accidents or injuries, combat (in war or community), crime victimhood,  and other situations that made you fearful for your life or well-being. Some therapists will administer the ACE survey to capture childhood trauma quickly.
  • Family psychiatric history. It doesn’t matter whether or not family members have formal diagnoses. If you’re “pretty sure” your family members, especially genetic relatives, have issues with mental health, it can be very important information.
  • Medical condition information and a complete list of medications, including supplements. Physical health issues and medications can affect mental health, and vice versa, so this information can be vital to an accurate diagnosis. (It’s a good idea to take pictures of your prescription bottles to bring with you). 

And Even More Questions … 

  • Substance use, past and present. It is important to be honest on this question. Again, substance use can contribute to and otherwise affect mental health issues, and your therapist will need to be aware if there are complicating substance use issues to your mental health.
  • Family history: This will include the family you were born to and raised by as well as your current family. Family in this context will include anyone (blood or not) that is close enough that you consider them a relative. 
  • Social history: This will include important friendships and romantic and/or sexual relationships, as well as a general social pattern, including questions of whether you’re an introvert or extrovert. 
  • Developmental history: This will discuss any developmental issues during childhood that affect you now and a general history of your childhood “milestones”. 
  • Educational history: Where did you go to school? What kinds of things contributed to the grades you got? Did you have accommodations or take special classes for learning disabilities? Did you take advanced placement or “gifted” classes? How far did you go to school? Are you interested in pursuing further schooling? 
  • Occupational history: Are you currently working (volunteer, part-time, full time)? What kind of work do you usually do? Do you enjoy your work? Is your work largely helping your life or contributing to your issues? Are you currently unable to work? Do you want to return to work, if so? 
  • Legal history: Do you currently have any criminal or civil issues affecting your life and mental health? Do you have a legal history that complicates your mental health? 
  • Strengths and limitations: What things are you good at? What kinds of support do you have? What sorts of things are a struggle in your life? Where could you use more support and assistance? 

… And Throughout Therapy

As you can see, there’s a lot to go over on your first therapy visit with your therapist, so you are likely to feel a bit rushed. This is normal in the set of expectations therapist work under, whether they are in private practice or work for an agency. Don’t worry if you don’t get to everything, because it can take time to fill out the details of any person’s life. 

However, if you find yourself strongly disliking or distrusting your therapist at first meeting, you should, if possible, seriously consider finding a different therapist. Fully a third (or more) of your success in therapy depends on the “therapeutic relationship” between you and your therapist. If you don’t trust your therapist, you will not get as much out of therapy. Of course, sometimes that trust takes time to build, so judge for yourself whether you’re going to give the trust a bit more time to build. 

If things get bad between you and your therapist, it may be time to talk to someone else. At an agency, it’s important to report any unethical or illegal behavior to their direct supervisor and/or the patient advocate. In private practice, you will want to report them to the state licensing board for their profession, and possibly to their professional organization. If it is simply a bad fit, it is not necessary to report, but letting the therapist know helps them to learn and improve for the next person.

A Note On Point of View

It is not necessary for your therapist to share your religious or political views, but it is important that they treat your views with respect. This is one area where it is completely legitimate to choose a different therapist if it is a bad fit because your politics and religion (or lack thereof) are core parts of your moral and ethical view of the world. Many therapists will redirect you and not answer direct questions about their own religion and political beliefs, and some will not. In either case, if you find that your therapist’s views are taking precedence over yours, it may be time to switch therapists. 

 

About My Practice

Some of my answers to the questions above before your first therapy visit:  

  • I am a licensed clinical social worker licensed in the state of Missouri since 2008. 
  • Graduated from New Mexico State with a degree in History in 1995, and the University of Missouri – Kansas City with an MSW in 2005. 
  • My office is down a flight of 10 steps. I can use the building’s conference room, with notice, if you have mobility issues. The conference room is on a floor with wheelchair accessible bathrooms. 
  • I have experience working with people of many faiths, ethnic and racial backgrounds, sexual orientations and gender identities, and work with folks aged 5 and up, with a preference for participants aged 10 and up. 
  • Incorporate dialectical behavior therapy (DBT), motivational interviewing, cognitive behavioral therapy (CBT), mindfulness, and other therapies in an eclectic style that focuses on the goals a person brings to me. 
  • your first therapy visitMy personal perspective is progressive and accepting of differences. I believe that compassion and kindness, sometimes leavened with hard truths, are a powerful prescription for mental health.
  • You are not required to be a progressive or of any particular spiritual or philosophical perspective to be a participant in my practice. 
  • The issues I work with most are post-traumatic stress disorder (PTSD), mood disorders and anxiety disorders, borderline personality disorder, and issues facing LGBTQ folks. 

More Information About My Practice

  • I do individual and occasional family therapy. I do not do couples counseling. Responsive Mental Health Services LLC does not currently have any groups running, including DBT groups. 
  • In the links below, you will find the resources I provide online for people I can’t see in therapy because of distance or other issues. These include videos, articles, and audio files available in several places. Feel free to take advantage of them and to subscribe to benefit from them regularly. 
  • I clearly label all content I produce that discusses community and societal level issues as “political” so that if you don’t share my beliefs and are uncomfortable with them, you can skip them. 
  • On a regular basis, I work with a very large dog named Lady Day, who is half black lab and half Great Dane. If you are not a dog person I will schedule your sessions accordingly. See the Animal Assisted Therapy tab for more details. 

Acknowledgments and Links

Thanks for dropping by.

Thank you to my family, friends, Patrons, and followers. A special shoutout (as always) to those who struggle every day and get up and keep going, every day.

Please support my work by signing up to be a Patron for a dollar or more a month or through dropping a tip at PayPal. Some of the other places you can find my work are on YouTube, SoundCloud, and the Out Of My Mind website.

If you want to see my rants and ramblings about process and politics, you can find them at my personal Facebook, my Twitter, and my political Facebook page, Am I The Only One Dancing?.

You can go to its web page or Facebook page to find out more about my therapy practice, Responsive Mental Health Services, LLC.

Finally, as always, half of every dollar I make from videos, podcasts, and writing (through PayPal or Patreon) is donated to my best friend, Katherine Malone.  She has a deadly heart condition and needs a heart transplant, but must raise $20,000 for anti-rejection drugs before she can be placed on the transplant list. You can find out more here and here, and go here to donate directly to her GoFundMe. This will continue until Kathy’s heart is fully funded.After that, half up to $500 a month will continue to be donated to assist her in paying for her anti-rejection meds.

A final reminder:  You are each important and have both much to teach, and much to learn. I look forward to learning from and teaching you all.

 

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