Whether you've never been to therapy or are getting to know a new therapist, the first therapy appointment can feel pretty daunting. It is especially intimidating for people who consider themselves shy, introverted, guarded, or are just not used to opening up and sharing their innermost thoughts and feelings with other people. According to Miami-based therapist Maria Sosa, MFT, feeling apprehensive is normal and totally okay. To further help put your mind at ease, Sosa notes that therapists are trained to deal with all kinds of people, including ones who aren’t initially comfortable in their presence. "It's their job to work with your anxiety, apprehension, discomfort—you name it," she says. "Therapy is a place where you get to just be as you are."
One helpful technique for easing some of that anxiety during an initial session is to have a script to guide you on what to say your first time talking with a therapist. Before you even begin the conversation, though, Sosa encourages taking some deep breaths. "Practicing taking shorter inhales and deeper exhales signals our nervous system to relax, which slowly works to deactivate our stress response," she says. "From this less stressed state, we can move forward." After you’ve calmed your system, you can start going through the six topics below to get the most out of your first time talking to a therapist (or any medical professional for that matter).
1. Let them know how you're feeling
Sosa says that it's perfectly okay to let the therapist know what's coming up for you at the beginning or any point during the session. You can say something like:
"This is my first time in therapy, and I'm feeling anxious. I just wanted to share that and unload some of what I've been carrying."
Sosa reminds us that therapy is confidential (with a few exceptions, which the therapist will discuss with you). "Let that liberate you and allow you to speak freely," she says.
2. Share your expectations
The first therapy appointment is also the best time to share your expectations about what you'll cover and take away from therapy. "We all create stories in our heads about what our first session will look like," Sosa says. "Sometimes these expectations are realistic, sometimes they're not. Instead of waiting and possibly being disappointed at the end, discuss with your therapist."
So what exactly do you say here? Sosa recommends something like:
"This is what I imagined therapy looking like..." or "In my first session, I thought this would happen..." You can also say, "These are some of the results I expected...Is this realistic?"
3. Focus on what's concrete and tangible
Often, diving straight into sharing your deep feelings is difficult, Sosa says, but you don't have to do so during the first session. You can move at your own pace if you feel uncomfortable sharing everything right away. "Be patient with yourself and your process," she adds.
Instead, Sosa suggests starting with sharing your goals and observations, and says this is one way to start that conversation:
“I've been noticing that this is currently happening, and this is how I would like for this to look differently.”
According to Sosa, “letting your therapist know concretely what you're experiencing and how you would like things to change provides a great foundation and starting point for further exploration."
4. Correct your therapist if needed
If the therapist doesn't understand something, Sosa advises letting them know as they will likely be happy to receive your feedback and redirect the conversation. "It might feel intimidating, yet this is a great place to practice being assertive,” she says.
Sosa says this could look like saying: “Actually, that's not exactly it, it's more like this.…”
5. Ask for clarification
Also, if, at any point during your first session (or any therapy session, really), the therapist shares some insights or asks questions that don't quite make sense to you, Sosa recommends asking for clarification. You can respond with:
"What do you mean?" or "Can you ask that question differently?"
6. Advocate for yourself
Lastly, we are our biggest advocate regarding mental health, so don't be afraid to do so, even during your first therapy appointment. "While it's the therapist's role to lead and guide, you're also in charge of the session," Sosa says. If something feels like it's too much or too soon, Sosa says, feel free to hit the brakes and say:
“I'm not quite ready to talk about that yet. I want to discuss it eventually. Can we come back to that?”
Advocating for yourself also means ending the therapy relationship, even after the first session, if you don't feel a connection with that particular therapist. "Therapy is kind of like dating, sometimes the client/therapist match isn't a good fit," Sosa says. "Don't be discouraged; keep looking; there's plenty of therapists in the sea."
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