What to expect from your first therapy session in Santa Rosa
So, you are finally ready to set up a first appointment for therapy. Your stress and anxiety has likely been building up for quite some time before getting to this point.
While you know you’re ready for help, you probably have some questions about what to expect in setting up your first therapy appointment. My goal is to make sure my clients feel comfortable during this first session by providing as much information as possible so you can make the most of your first session.
What will happen after you decide to schedule?
1. You will be sent a secure link via email to fill out some paperwork on a secured EHR (Electronic Health Record) system. You will fill out some information about what brings you into therapy, an introduction to my practice policies and services, along with some other related paperwork.
Everything can be completed and signed online before your first session so that I have time to review it and we can jump right into your session when we meet.
2. If you would like to seek health insurance reimbursement, I will walk you through your options, including the benefits and possible downsides of choosing to involve health insurance. For more information about your options, check out this blog.
3. You will provide your contact information to receive text or email reminders of your appointment day and time through my secure, online portal.
What do you need to do to prepare for the first session?
While there is no formal preparation for the first session, depending on your situation you might want to take some time to make sure you are set up logistically to do regular weekly therapy. This might include:
Decide how you want to do payments for sessions. This might include, signing up for Thrizer, looking into using a HSA/FSA card for payment, call your health insurance company to inquire what level of reimbursement (if any) you expect to receive for seeing an out-of-network psychotherapist (I can send you a script of what to ask and how to get the information you need).
Work out any scheduling arrangements you need to make with school, work, family, etc., so that you can hold your weekly reserved therapy time without interruption (this is important to keep us consistent in your therapy work). If you are meeting with me over video, make sure you have a secure place set up for the session with good internet connection.
Decide if you want to give yourself some “buffer” time before or after your sessions so that you can make full use of your 50 minutes. Sometimes therapy can bring up strong emotions, so transitioning immediately back to work or seeing your partner after therapy can be difficult for some of my clients. You don’t want to feel like you have to hold back in sessions because you are thinking about the work meeting you have right after.
Plan to give yourself the time you need to bring yourself back to your present-day life or plan to have time before the session to get in touch with what you want to focus on in the session.
Review my paperwork and write down questions or concerns you have, so we can address them fully in the first session.
What happens in the first therapy session?
The first session is sometimes referred to as an “intake session.” In my practice, the first 1-2 sessions are on a trial basis for both myself as the therapist and the client. We both need to feel like it’s a good fit before committing to a weekly consistent time.
This session is an information-gathering session where I ask questions about your life, relationships, family, work, important events within your life, history of your mental health, and most importantly--what brings you into therapy.
I will also introduce you to some basic concepts and the way I help through Acceptance and Commitment Therapy. We do goal setting that is specific to Acceptance and Commitment Therapy.
We will meet either in person in my office or over telehealth (video). If we meet in person, I will give you the directions to my office which is centrally located near downtown Santa Rosa and close to Santa Rosa Junior College. If we meet over video, I will send you a link to the secure system I use for my video sessions.
When you come into my office building, you can have a seat in a waiting area until your appointment time. I will bring you up to my office at the appointment start time, and where you can make yourself comfortable on a couch or chair in my office while we talk. You are welcome to bring water or other (non-alcoholic) beverages to the session.
Our sessions will last 50 minutes, but I keep track of the time for us (and have a clock behind me so you can have a sense of the time too).
Our sessions are completely confidential, meaning everything we discuss remains completely private (besides a few exceptions related to the law and physical safety). I sometimes take some notes as we talk so I can better remember all the important details of your life.
To get a better sense of how I work with clients as a therapist, check out my About Me page.
At the end of a first session, I often send my clients home with questionnaires/assessments specific to ACT (the type of therapy I provide). This helps us know where you are starting and gives us something to measure against when we do our reassessments every few months. It helps us know if we are making progress in your goals and are on track.
Are there any rules for therapy I need to be aware of?
I respectfully ask that you do not come to sessions intoxicated in any way (this includes alcohol, marijuana, or other legal/illegal drugs that will impact your ability to fully engage in the session). This is for your benefit- therapy is most effective when you are sober so that we can better identify your thoughts and feelings, and be able to learn, develop, and remember new skills. If this will be an issue for you, please talk to me about it beforehand.
Therapy is meant to be a safe place to talk about lots of issues. You are welcome to talk about any issues relevant to your life, including sensitive issues like physical intimacy, body-related concerns, political beliefs, religious beliefs, suicide, death/dying, existential questions, etc. There are a couple of exceptions to confidentiality (related to imminent risk to self/others, child/elder abuse, and a couple of others- we can talk about them in the first session if they are of concern).
If something comes up that I have concerns about, I am going to be upfront and honest with you about it in our session.
You can curse, get angry, cry, etc.
If you begin engaging in verbal or physical behaviors that are crossing the line, again I will tell you and ask you to stop. Threats to me or others, yelling, and any type of physical aggression to myself, or my property are not okay, and I will have to end the session. This almost never comes up with my clients, but I think it is important to clearly state where the line is.
Am I allowed to ask you personal questions?
You are, and I will tell you if I am able to answer them or not. For the most part, I don’t share too much about my own personal life and experiences because it can interfere with the work we do clinically together. This is just my style, every therapist does it differently. Occasionally I will self-disclose if I think it could be helpful to you and your goals.
Will I have homework?
ACT therapy often has exercises, reflections, activities, and experiments I will encourage you to try to utilize between sessions. I provide handouts of what we review in sessions. I sometimes make book recommendations.
The types of things I might suggest you complete in between sessions often include reflection activities to help you get a better sense of the important values in your life, communication skills, trying out a new “committed action,” or ways to settle your thoughts/mind during stressful moments.
How often do I have sessions?
After the first 1-2 trial sessions, if it feels like a good fit, we will finalize a weekly time to meet on an ongoing basis. My method of therapy requires a weekly commitment; however, you get to decide when you end therapy.
While every person’s journey is unique, my former clients who report they have fully met their therapy goals, on average, typically do so in about 21–22 sessions, or approximately five months of weekly therapy.
What if I don’t like what happened in the first session or I am not sure it is a good match?
It’s okay to not pick the first therapist you do a consultation call or session with! Therapists know that potential clients are typically trying out different clinicians to the right fit and will not be offended if you choose another person to work with (I promise I won’t be!)
I am happy to give you referrals to other therapists I think would be a good fit for you if you ask.
If you do not get a good vibe from a therapist, trust your gut. There are many therapists out there to choose from, and it’s not worth investing the time and money into working with someone you feel is not understanding or connecting with you.
Ready to schedule your first session? Get help with a Santa Rosa Therapist
I hope this helps give you a better sense of what an initial therapy session would be like for you. As you continue to research into therapy and learn more about the process, you are already taking action steps towards change. This takes major courage!
Now it’s my job to help support that motivation to change so that you can begin feeling some relief from the stress in your life. Skip the phone tag and schedule a free 15-minute phone consultation into my online calendar today. I’d be happy to hear about what is happening and if I am the right therapist to help you.
Have more questions? Check out my FAQs
Angela Sitka, LMFT is a licensed therapist with a private practice based in Santa Rosa, CA offering in-person therapy to individuals in Sonoma County and virtual therapy to individuals in California. She specializes in men’s issues, relationship anxiety, breakup recovery and divorce counseling.