First visit with therapist, how do I go about it? What should I say or ask? What should I expect?

January 11, 2010 8:07 AM

I have an initial consultation with a therapist tomorrow. What should I talk about? Do I jump straight into my problems or are there questions I should ask?

I am dealing with some extreme and confusing emotions because of a relationship. Through some advice here on AskMefi, I asked a coworker for a therapist recommendation. But I've always been a little doubtful of therapists. I'm afraid that some just try to manipulate you into believing you need therapy forever. Needless to say, I'm nervous about this meeting.

I'm not sure if I should go straight into my problems (i.e. what I'm feeling, my thoughts, etc) or I should ask some questions first (the logistics?). I don't know. Maybe I'm approaching this like it's a procedure, like steps I should follow that would get the most out of therapy?

I'm also a little desperate - meaning I really want to get out of this rut, it's been 6 months. And I don't know if it's a good idea to display this "desperation" right off the bat by revealing all thoughts/emotions?

Anyway, I'd like some feedback/help on how to go about therapy? I want to get the most out of it, so what should I do? Is it a good idea to just reveal everything or take my time?

posted by frozenyogurt to Human Relations (8 answers total)

In my experience, the therapist will take the lead by talking to you about logistics, what you hope to get out of it, etc - he or she won't just sit you down and stare at you.
posted by Pax at 8:15 AM on January 11, 2010 [1 favorite]

I think the most important thing is to relax and keep an open mind. You don't have to plan out what you'll say to the therapist - he/she is a professional, and will know what to do.

I think that the more open and honest you can be with your therapist (and yourself), the more you will get out of therapy. Try not to think about "revealing" or "concealing" information - this shouldn't be an adversarial sort of relationship. Your therapist is a very unique person for you, because you're paying them to listen to you - you don't have to worry about them judging you at all. I think the best strategy is to Just relax and let the therapist do their job.
posted by Salvor Hardin at 8:16 AM on January 11, 2010

I"m excited for your first foray into therapy. With the right therapist, the process can be really beneficial.

But it takes exactly that: the right therapist. So this first meeting is kind of a screening process to see if you're going to feel comfortable talking with this person. It took me four tries before I found the one I have now.

THe therapist will probably guide the discussion a little, especially if talking about logistics, but an initial question will probably be 'why are you here?'. At this point feel free to spill your guts if you feel like it, or if not, you can say something along the lines of "there's a few things that are bothering me but I'd like to take my time delving into them". I recommend becoming at least a little vulnerable so that you can see how you feel being open and honest with this person.

And if you've got fears about being manipulated into staying in therpay forever, or anything else, you can voice those. Part of therapy is about learning how to communicate your needs and feelings even if you think they might upset another person. "I feel nervous about starting therapy because I've got this idea that some therapists might try to manipulate people into staying in therapy forever". Talking it out can work wonders on your worries.

good luck!
posted by whalebreath at 8:16 AM on January 11, 2010

Generally, the therapist will introduce him/herself, explain a bit about who they are, and then ask why you decided to see someone. This is the part where you say, "i've never seen a therapist before, I'm having some problems, I'm a but dubious of the process but I think I could use some help."

Then just let things progress from there. Relax. The therapist works for you.
posted by misha at 8:29 AM on January 11, 2010

When you first go in to see a therapist, they have an intake that they need to completed about your background and why you are coming in to see them. So, there will be a good amount of questions coming from the therapist's end. If you have questions, that would be fine to ask them, and it's a good sign that you are engaged. You'll probably be able to get a good idea of whether or not the therapist is a good fit for you based on the feel of it rather than the answers to whatever questions you might have.
posted by No New Diamonds Please at 8:34 AM on January 11, 2010 [1 favorite]

Don't expect magic during the first session, like others are saying, there's a lot of standard background questions and the time passes quickly. You should be aware that estimates of the effective "dosage unit" of psychotherapy are roughly in the 90 day range. So you should relax and let the process work before concluding that it's not working.

However, if you are attempting to direct a therapist to address an acute need and they are not responsive to that over time, I personally would consider it time to look for a better fit. I went to someone earlier this year with a similar set of problems and found her continually directing the attention of the session to other life-domains that I really wasn't struggling with. When I explained to her that I was experiencing acute depression and anxiety in the relationship domain of my life and really wanted to focus on that, she became combative. After a few combative sessions I explained to her that I was in pain and she was not helping me, in fact, the frustration she was creating was intensifying the problem. She was shocked when I called to discontinue. The bottom line is that there are shitty therapists out there, but you're not likely going to know that until you've spent a few sessions working with them.
posted by The Straightener at 9:27 AM on January 11, 2010

Agree that the intake process will take up most of the session. But there should be time for you to talk and ask questions. Consider it a bit of an "interview" in which you can decide whether you want to "hire" this therapist to get started on therapy. As The Straightener said, it might take you a little while to figure out whether the approach or the person is working for you or not. You might ask things like:

Have you treated other people like me/with my kinds of problems before?
What kinds of improvements/solutions did they find?
How long do you think I might need to make improvements in this area? (A good therapist will not give you a specific deadline by which you'll be all better - but at the same time, they should be thinking about how to reach an endpoint - not envisioning eternal therapy for you. Most likely they'll give you a range, like "three months to a year", depending on the problem and any complicating factors that might arise).
posted by Miko at 10:47 AM on January 11, 2010 [1 favorite]

Make sure to ask the therapist the things that you want to know the answers to, whether those be operational things like "what happens if I need to cancel an appointment" or more complicated things such as "how will you know if therapy is helping me". The most important thing at the beginning is to get a feel for whether you can work with this person. It's good to find out how they respond to you and whether their style is going to suit you. On the other hand you might just end up immediately feeling comfortable talking about your stuff and if that works then that's fine.
posted by y6t5r4e3w2q1 at 12:45 PM on January 11, 2010