Prepare for a Session With a Therapist

Everyone needs help dealing with life's problems sometimes. Therapists are trained to help clients with a range of issues and to act as guides on the path to emotional well-being. Still, starting to see a therapist can feel intimidating. What should you expect from the process? Will you have to explore parts of yourself that have spent long stretches of time in hiding? What do you say to a therapist, anyway? There are many things you can do to manage these concerns and be prepared to make the most of your session. Therapy is a highly enriching process that requires significant effort from both the therapist and the client.

Steps

Taking Care of Session Logistics

1. Understand the financial arrangement. Knowing what sort of coverage your insurance plan offers for psychotherapy or how you plan to pay for therapy is very important. Check your description of plan benefits for information on behavioral health services or coverage for mental health. When in doubt, ask the human resources representative of your insurance company directly. And, ask the therapist if they accept your insurance before making your first appointment. Otherwise you may have to pay out of pocket when you could be seeing a therapist in your insurer's network.
   • When you meet, remember to take care of payment, scheduling, and insurance questions at the start of the session. This way you will be able to end the session sharing, without the disturbance of logistical issues like calendar checking and payment.
   • Know that if you see a therapist in a private practice, they may provide you with a receipt that you will submit to your insurance company for reimbursement. You might be responsible for the entire cost of the visit up front, and then be reimbursed through your insurance company.
2. Check the therapist’s qualifications. Therapists come from many different backgrounds, and have different forms of education, specialization, certification, and licensing. "Psychotherapist" is a general term, rather than a specific job title or indication of education, training or licensure. The following are red flags, indicating that the therapist may not be properly qualified:
   • No information provided about your rights as a client, confidentiality, office policies, and fees (all of which would allow you to fairly consent to your therapy)
   • No license issued by the state or jurisdiction in which they practice.
   • A degree from a non-accredited institution.
   • Unresolved complaints filed with their licensing board.
3. Prepare any relevant documents. The more information your therapist has about you, the better they will be able to do their job. Helpful documents might include reports from previous psychological tests or recent hospital discharge summaries. If you are a student, you may also want to bring recent grades or other recent markers of progress.
   • This will be helpful during your intake interview, when the therapist may ask you to fill out forms about your current and past physical and emotional health. By streamlining this part of your visit, you and your therapist will have more opportunity to get to know each other on a person-to-person level.
4. Gather a list of medications you are taking or have taken recently. If you are already taking any medications for mental or physical health, or if you have recently stopped a medication, you will want to come prepared with the following information:
   • Name of the drug(s)
   • Your dosage
   • Side effects you are experiencing
   • Contact information of the providing doctor(s)
5. Write reminder notes. When meeting for the first time, you may have lots of different questions and concerns. In order to address everything you want to know, write some notes reminding you to gather all the information you need. Bringing these to your first session will help you feel less confused and more at ease.
   • Notes might include the following questions for your therapist:
     • What therapeutic approach do you use?
     • How will we define our goals?
     • Will you expect me to complete assignments to do between sessions?
     • How frequently will we meet?
     • Will our work together be short-term or long-term?
     • Are you willing to collaborate with my other health care providers to treat me more effectively?
6. Keep track of your appointment schedule. Because therapy is meant to provide you with a safe space to work on yourself, time must be managed wisely. Once you are in the session it’s the therapist’s job to keep track of time, allowing you to focus on answering questions and adjusting to the feel of therapy. But, it’s up to you to get yourself to that point. Be aware that some private therapists charge for missed appointments, and these fees are not covered by insurance.

Preparing to Open Up

1. Journal about your recent feelings and experiences. Before arriving, spend time really thinking about the things you want to talk about and your reasons for wanting to begin therapy in the first place. Write down specific things you want someone helping you to know about you, like what makes you feel upset or threatened. Your therapist will be prepared to ask you questions to stimulate discussion, but it's more useful for both of you to spend time thinking beforehand. If you're stuck and don't know what to do, ask yourself the following questions before the session:
   • Why am I here?
   • Am I angry, unhappy, distressed, afraid....?
   • How do other people in my life impact the situation I'm in now?
   • How do I normally feel on a typical day of my life? Sad, frustrated, afraid, trapped....?
   • What changes do I want see in my future?
2. Rehearse expressing your uncensored thoughts and feelings. As a client, the best way to ensure effective therapy is to break your own rules about what is appropriate to say and what should be kept secret In privacy, speak out loud to yourself the strange thoughts that you would not normally allow yourself to voice. The freedom to explore your impulses, your thoughts and feelings as they arise, is one of the key sources of change in psychotherapy. Just getting used to voicing these thoughts will make it much easier to access this part of yourself in a session.
   • Your uncensored thoughts can also include questions. You may be interested in the therapist's professional opinion about your situation or about how your therapy will operate. Your therapist will be responsible for providing this information, to the extent possible.
3. Tap into your inner curiosity. You can practice the expressing your deepest thoughts, feelings, and concerns by asking "why" questions. As you move through daily life leading up to your session, try asking yourself why you are feeling a certain way or thinking certain thoughts.
   • For example, if a friend or co-worker asks a favor of you that you feel resistant toward, ask yourself why you are resisting helping them. Even if the answer is a straightforward "I don't have time", go further, asking yourself why you feel you can't or shouldn't make time. The goal is not to come to a conclusion about the situation, but to practice pausing and trying to understand yourself more deeply.
4. Remind yourself that this therapist is not the only therapist. A good personal match between client and therapist is crucial to the success of the therapy. If you put too much stock into your first meeting without this consideration, you may feel compelled to carry on with a therapist who is not completely well-suited to help you.
   • Did you leave the first session feeling misunderstood? Does your therapist's personality make you a little uncomfortable? Maybe your therapist reminds you of someone you have negative feelings toward? If the answer is "yes" to any of these questions, you may want to consider finding a new therapist.
   • Know that it is normal to feel nervous during your first session; you will become more comfortable with the process.

Tips

• Remember that there will be another session the next day or week. Don't panic if you feel you haven't expressed everything. Like all real change, the process takes time.
• Trust that everything you tell your therapist is confidential. Unless they believe you are endangering yourself or someone else, they are professionally required to hold everything that goes on in a session in complete confidence.

Warnings

• While preparation is very important, there is no need to plan exactly what you will say. Having clear goals and some practice accessing your deeper feelings will help sessions unfold organically.

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