Before Your First Therapy Appointment


So, you’ve never been in therapy before and you’ve scheduled your first therapy appointment. Like many others in this situation, you may feel anxious because you don’t know what is supposed to happen and what is expected of you.

Generally speaking, your task on the first meeting with the therapist isbasically to describe your problem. Many people have trouble explaining what motivated them to seek psychological help and they expect the therapist to help them talk. While it is generally part of the therapist’s job to establish a rapport with you on the first meeting, which is supposed to make you more comfortable to talk and to set a foundation for a collaborative work, it is not the therapist’s responsibility to pull information out of you and to figure out what you need. You need to know what you need help with before therapy starts and it is your job to communicate it to the therapist.

Some people say that they are seeking therapy simply because they don’t feel good and just want to feel better, and beyond that they don’t know what they need. This is like going shopping and not knowing what you need to buy. I am sure that when you go to a department store to buy new clothes you wouldn’t expect their personnel to help you find what you need if you don’t give them specifics on what type of clothes you are looking for, the size, the color, the style and such. The same goes for any kind of product or service. The provider or the vendor can’t decide for you what you need. You know that if you want them to help you it is incumbent upon you to explain what you need in as much detail as possible, it is not incumbent upon them to play the guessing game trying to figure out what you need. I don’t know why people think that the mental health service would be any different, and I find it amusing that people are more aware of what they need when it comes to clothes or car selection than when it comes to their emotional needs.

The best way to understand what you need therapy for is to think about how you want your life to change as a result of therapy. In other words, you have to set up some clear goals for yourself and to communicate those to your therapist so you both know what you are working towards.

The therapist, on the other hand, should discuss your goals with you and make sure he or she understands them on the first session or within the first few sessions. It is very important to clarify the therapy objectives at the beginning because failure to do so may result in some serious problems later.

If you and the therapist aren’t clear what you are working on, at some point down the road you might become unpleasantly surprised to find out that you both were not on the same page to begin with. After you have invested a considerable time, money and emotional resources into the work, such surprise comes as a shock, even as a betrayal sometimes.

But, even if that’s not the case, not having clear goals for therapy and not making sure that you and the therapist are on the same page will result in ineffective therapy that is unfocused and unnecessarily prolonged.

In the worst case scenario, unfocused therapy with undeclared objectives may feel like a paid emotional support or a paid friendship or worse, a paid platonic love relationship rather than a professional service. This a precarious situation because it contains a potential for blurring or crossing professional boundaries, and, even if that doesn’t happen, it creates the confusion about the nature of your relationship with the therapist, which can be very harmful in and of itself.

The importance of setting clear goals for therapy cannot be underestimated. Let your therapist know on the first session what you want to work towards, and, if they don’t seem to be interested in discussing it, I strongly recommend not to waste your time with them and to find another therapist.

An important notice: your goals can, and, most likely, will change over time. This is absolutely normal because, as therapy proceeds and you feel its effect on you, your emotional and mental states change and your needs start changing accordingly. The change of needs, desires and goals is a sign of progress and growth and is a sign that therapy is working. But no matter how much change you undergo, you always know what your needs are right now at the present moment.










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