What do I need to know before my first psychologist appointment ever?

March 27, 2006 11:50 AM

I'm going to see a psychologist for the first time ever. What kind of questions do I need to ask? What should I expect in general?

So, here's my story: 30, female, single, semi-overweight. Lacking motivation or understanding of what I want to do with my life. Have all sorts of issues with my parents and not meeting their expectations (I am successful, just not their definition of successful). Every once in a while, I get very sad and depressed, but never suicidal. I was on prozac once, for 2 years. I don't think it helped much, and I'd like to work out some of my issues in a more natural manner, and for me, at this point in my life, therapy sounds like a good approach.

I have an appointment with a doctor recommended psychologist. I know she is a phD and uses psychotherapy. I don't really know what this means. What types of questions should I be asking my psychologist during my first session to get to know her and to get an idea of how she may be able to help me, or to find out if she is going to be able to help me at all?

Also, what should I expect my first meeting with her to be like? What are "sessions" usually like?

Thank you!

posted by anonymous to health (9 comments total)

You might ask what sort of tradition she practices. Psychoanalytic (Freudian, Jungian, or other), cognitive, cognitive-behavioral, and interpersonal are some of the different approaches and techniques that are out there.

You might ask her what her "sessions" are usually like. She's going to have a better idea than nearly anyone else, since she's present for more of them than anyone else is.

You might ask what kind of an endpoint therapy can have. This is puzzling and troubling to a lot of people and it can be good to hear a therapist's views on the matter.

You might ask her whether she thinks she can help, after she has heard your story. That assumes that you would be interested in the answer to that question.
posted by ikkyu2 at 12:59 PM on March 27, 2006

Ask her whatever you want to know - she'll say no if she doesn't want to discuss it. I'd ask about price, policy on session cancellation, availability for scheduling and reschedulings. How frequently she usually sees clients, if there's a price attached to that (I've known therapists that charge more if you see them once a week than if you schedule twice/week sessions).

I'd ask about her background, why she went into her job, how she feels about it. What kind of cases she's worked with. Ask her for recommendations if you want. Tell her you're new to therapy and what to know what to expect from it, and what you can expect from her.

You will get a "feel" for her and decide if you're compatible once you've been in person. It's kind of a personal thing. Sometimes you can rule candidates out after one session if you don't like him/her. There's no shame in shopping around for therapists if you don't seem compatible. There's also no shame in discussing your feelings about how the therapy is going and what you need/want from your therapist with your therapist.
posted by Marnie at 1:01 PM on March 27, 2006

I've seen a few mental health pros in the past, but I'm no expert. Since no one else has answered you yet, I wanted to suggest that these are perfectly ordinary questions about the experience you're posing, but you should just ask your doctor during your first session. You and your doctor will get to know each other, and she'll have questions for you about what you expect/hope the process to be. She'll mention any important ground rules, and get a sense of your comfort levels. Don't hesitate to ask your own questions, and he honest with your answers to hers.

The most important advice I can give is to open up to your doctor. Leave any preconceived notions you have about communication in the waiting room and talk freely about your hopes, fears and wants.
posted by chudmonkey at 1:03 PM on March 27, 2006

A lot depends on the personal style of the therapist. Some are rather assertive, challenging the things you say almost aggressively. Others are much more laid back to the point of seeming almost passive, offering little obvious direction to the session. So perhaps a good first question is, "how do you conduct a session?"

The session format is pretty standard: you go into the room, you take a seat, the therapist takes a seat, and you start talking. The therapist may say something like, "So, what's on your mind?" or she may refer to some specific issue or event from the previous session ("How did the job interview go?") Depending on the therapist's style, she may ask you questions, make observations, or may simply listen. In some forms of therapy, the psychologist may offer "homework" in the form of an assignment to put into practice the stuff you talked about this week. (For example, if you are concerned with your procrastination in looking for a new job, the therapist may ask you to set a concrete goal to achieve in the following week, say, updating your resume and contacting your references. Or the assignment may be something more general, such as taking note of the circumstances in which you become angry during the following week.) Or, again, the particular therapist's method may be less structured.

There are several main types of therapy within the general framework of "talk therapy," specifically Dynamic, Cognitive and Behavioral. As a starting point for understanding how your therapist works, you might ask her which of these types of therapy she does, and then you might ask her to explain just how this method works.

Sometimes a therapist and patient make a sort of "contract" specifying what outcomes the patient desires and a length of time or number of sessions set as a goal for reaching those outcomes. If you are very concerned about expense or time commitment, you might ask about this sort of plan. Or the therapist may suggest it herself.
posted by La Cieca at 1:07 PM on March 27, 2006

I just started seeing a therapist and what I found really useful is that before I went I spent some time with some flowchart software and mapped out exactly what problems I had and what impacts they had in my life, and essentially what I wanted to get out of the sessions. This was really useful for me, and I gave it to the therapist and she said she found it really useful too.

What you find in therapy is that it's really easy to go off on tangents, lose focus, so I think having clear goals is important. Also, there's a terrible tendency to think that because you're seeing a professional they can see with some clarity all the family issues, rejections etc etc which you carry around with you, and of course they can't. The more you go out of your way to inform them, the more productive your sessions will be - remember, 50 minutes ain't long, so you need to utilize that time as best you can.

I know I'm not directly answering the question, but I think if you go well prepared, you'll be in a better position to gauge if this person can help you.
posted by forallmankind at 1:10 PM on March 27, 2006

I don't think you need to ask questions so much as pay attention to how you feel while you are there. Do you feel comfortable with her? Do you feel comfortable in the physical space of her office? Does she seem like the kind of person you feel ok sharing your deepest darkest secrets with, or does she seem judgmental? (Even if she's a perfect therapist, it's your reaction to her that is important.)

The first session, she's going to ask you most of the questions. Answer honestly, or you're wasting both your and her time. Your second paragraph "So, here's my story: ..." is perfect for that first introductory "Why are you here?" question. She'll ask about the Prozac, and why you took it and why you stopped. She'll ask about your general health and your sleeping and eating patterns.

In my experience, sessions are usually about an hour, give or take. You basically carry on a conversation, except the topic is YOU. But, it's ok not to talk or volunteer much either. The therapist should be able to ask the right questions to get you talking comfortably, or at least to get the info she needs.

Be cautious of: someone who feels they can diagnose you definitively after a short conversation; someone who talks about themselves and their qualifications endlessly; someone who insists on sitting behind a desk (throws off that comfy dynamic, imo); someone who insists that it will take X number of sessions (costing X number of dollars) to cure you; someone who talks about "cures" at all.

The best thing is to relax and be honest.
posted by SuperSquirrel at 1:16 PM on March 27, 2006

I'd ask her, toward the end of the session, how long she sees therapy lasting. Think for yourself about whether that seems like a good amount of time. Therapy does not have to take forever.
posted by OmieWise at 1:30 PM on March 27, 2006

ask what will decide when you are finished. what are they (you?) expecting from this? how will you know when it is complete? and, if things don't work out, how will you know if it has failed? you (or someone) are paying for something - find out what.
posted by andrew cooke at 1:43 PM on March 27, 2006

Anonymous, I can only offer one experience of therapy which was when I moved to the UK. GP refrerred me to the NHS service. My therapist was a PhD and I was a bit hyper about therapy. My images were more Woddy Allen. I was uncomfortable in the first session that she didn't want a "label" attached to the type of therapy she used. She was extremely pleasant and pointed out that while she uses elements of CBT she would have to see how our sessions developed. I went on to form an excellent theraputic relationship with her and understood that I was trying to tie things down as I needed to control this relationship, pigeon-hole it if you will.
I don't know if this will help but when I started letting the therapist do her thing and guide me everything improved.
The approach was to deal with issues that are more contemporary and only delve into past problems where they ahve a direct impact of the present.
In the first session she clearly laid out a kind of plan or contract, I was aware that treatment was usually in groups of 8 sessions and continuing them was optional as long as I felt I needed to continue them. In all, I had 2 periods of 16 weeks and 8 weeks.

All of the advice above, plus make sure you are comfortable with your therapist. Once you have that sense do open up and be as honest as you can be. It really works and I wish you all the best with the experience
posted by Wilder at 5:23 AM on March 29, 2006