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Embrace | Overcome | Create Your Life 

  • Writer's pictureTerri K. Lankford, LPCS

Your First Therapy Session

In our last blog post, we talked about the starting point of your therapy journey - which begins before you actually make it into the office (or virtual office). Just to review, your starting point of therapy may look like:

  • Recognizing you’d like to see a therapist: whether you’re experiencing symptoms of a potential mental health concern or you’d just like to improve your mental illness, the first step is deciding you’d like to talk with a mental health counselor.

  • Finding a therapist: you can find a therapist through directories like Psychology Today, Inclusive Therapist, Therapy for Black Girls, Therapy Den, and more.

  • Conducting a consultation call: you may want to ask about your potential therapist’s background with your concern, training in the area of your concern, approach, and whatever else feels relevant to you.

  • Scheduling and intake paperwork: after you find the right match and pick a day and time, your therapist should send you some intake paperwork, which likely includes answering questions about yourself and signing some consent forms.

Now that you’ve followed the steps above … what’s next?

If you’re wondering what the first session looks like, don’t worry - the holistic counselors at Rise and Thrive are here to help! Here’s what the first therapy session may look and feel like for you:

Practice Policies or “Housekeeping”

Of course, we expect the first session looks like getting to the office or virtual space as designated by your clinician. We also expect your clinician to introduce themselves. After these two steps are done, there’s likely to be an introduction to the clinician’s practice policies - some housekeeping, if you will!

In this part of the session, the clinician will likely cover:

  • How scheduling works for them: some therapists like clients to schedule independently on a client portal. Other therapists like to have weekly days and times that stay consistent for a client, so they just block it out on their calendar each week. Still, other therapists may just schedule a single session for you at the end of your current session. Regardless of how your therapist does it, they’ll likely talk about how you can see them again.

  • How to communicate between sessions: communication between sessions should be in a secure manner - so not FaceBook messenger, Instagram, Snapchat … you get the idea. Your therapist likely has a phone system, secure email, or client portal they’d like to communicate with. Be sure to download any apps if necessary!

An important note here: many private practice therapists do not have 24/7 crisis

services. This means if you find yourself in danger of hurting yourself or others

between sessions, they should tell you an alternative plan, like calling 911 or your

local mobile crisis number.

  • Any late cancellation or no-show policies: many therapists have a late-cancellation or no-show policy, which is just an office procedure regarding canceling or rescheduling sessions. For example, at Rise and Thrive, we ask clients to give us at least 48 hours’ notice if they need to miss a session. Many therapists in all 50 states will charge a fee if they don’t receive the appropriate amount of notice.

Confidentiality Spiel

If you’ve had therapy before, you know the confidentiality spiel. This is one of the most important elements of your first session because it helps you make an informed choice about therapy. The confidentiality spiel goes like this: what is said in here stays in here, UNLESS:

  • You PLAN on hurting yourself or others. Note the word “plan” here - if you are FEELING like hurting yourself or others, this is not reportable. If you PLAN on hurting yourself or others, you and your therapist should come up with a solution, like calling a mobile crisis team or going to a crisis center. Whether you’re just “feeling” or you’ve moved to “planning”, please let your clinician know.

  • There is child abuse or elder abuse. This applies if the perpetrator still has access to children or the elderly - for example, if they’re a teacher, parent of little ones, daycare worker, caregiver, nurse, etc. In this case, child abuse or elder abuse must be reported to keep others safe.

  • A judge subpoenas your records. This is a relatively rare occurrence, especially if you’re not actively involved in a legal battle. The most common reasons for your records to be subpoenaed are in the case of divorce or custody hearings.

So … Tell Me About Yourself.

After some housekeeping and the confidentiality spiel, you jump into the fun part: the questions! Therapists all have their own style of intakes - some therapists focus solely on your presenting concern, and others collect a lot of information that may not seem as relevant to you at the moment. Some questions you may be asked in an intake session include:

  • What brought you into therapy today?

  • How long has this been going on?

  • Tell me about your family growing up.

  • Do you use drugs or alcohol? How often?

  • Is there a history of mental illness in your family?

  • What do you do for fun?

  • Who do you turn to in times of need?

  • What are some of your strengths?

  • Have you been to therapy before? What did you like? Didn’t like?

All of these questions (plus others) help clinicians get a picture of who you are. It also helps them to diagnose what may be going on for you, if diagnosis is part of their practice.

We hope the second part of this series on trying therapy for the first time helps you visualize what the process looks like the first time you step in the door! If you want to try it yourself, we’d be happy to help you along the way. At Rise and Thrive, getting started with us is easy. Reach out today to see if we’d be a fit! We look forward to hearing from you.




Welcome to Embrace | Overcome | Create Your Life.


I’m Terri Kiser Lankford, owner of the Rise & Thrive Counseling Practice, a Licensed Professional Counselor Supervisor (in NC), and the host here at Rise & Thrive Counseling, PLLC and the Embrace| Overcome|CreateYourLife Blog.


I’m also an entrepreneur, Syltherin, foodie on a fitness journey, complete book nerd, photography novice who happens to think music is life. 


Warning! This site is about motivation, health & wellness, and self love.  but its also about various mental health issues and may talk about subjects such as suicide, self-harm and other touchy subjects at some point. This site is not intended for youth and may be “too much” to some.


Nothing on this site should be considered a medical recommendation. I am not a doctor. Anything of interest should be discussed with your doctor or therapist, or me (in person) if you are my current client.  No guarantee of accuracy is expressed or implied. (Sorry, I have to say that.)


All writing and mental health information here are accurate to the best of my knowledge at the time of publication. However, keep in mind my opinion, and available information, changes over time.

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