What to Expect in the First Session
Do you know the most frequently occurring number of sessions attended by people who start counseling? One. People most frequently attend one session of counseling.
I don’t have a crystal ball, but as a counselor I have some guesses about why this is the case.
Starting counseling can provoke a lot of feelings: anxiety, fear, and excitement, to name a few. You’re entering a new kind of relationship that (let’s be honest) is a little contrived - but not in a bad way. Counselors try to be kind, warm, and friendly, but you’re seeing them to work through something you couldn’t address through your own self-reflection or conversations with friends and family. It isn’t a friendship, but it should feel friendly. It is intimate, but not bi-directional. There are a lot of paradoxes in counseling relationships.
With so many types of counselors (we call them modalities or theories), you never quite know what to expect on the first encounter. Sometimes the personality or approach just isn’t a match. Some counselors are pretty structured and directive, others are free-flowing and open-ended. Finding one who feels like a good fit may take trial and error.
Here’s my hot take reason. Usually what occurs during the first session isn’t even counseling! Sometimes called an intake session or consultation, it’s a time for the counselor to get a sense of why you’re wanting to start therapy and how you’re hoping it can help. To do this well, a counselor needs to understand a lot of personal things: substance use, family history/background of mental health or physical health issues, your general life story - you know, what you’ve been up to since birth.
So those are my main theories, and I am partial to #3. I know it can feel strange to find a counselor, pick a time to meet, and then have to answer a lot of personal questions. But could you imagine starting deep and serious work on anything without getting some history and context? No way!
In initial sessions my goal is to learn:
Why you’re wanting to start therapy now and how you’re hoping it can help.
Any past experience in therapy.
Your background, life history, and important things about you as a person (sexuality, identity, relationships, etc.).
How it feels to be in the room with me, and whether you have any questions to help you feel more comfortable about working with me.
If I understand these things well, we will usually finish our first 1-2 sessions with each other with a shared sense of focus in our work, an agreed-upon approach, and the beginnings of a trusting relationship. These are the seeds of effective counseling. We don’t have to understand everything fully, but we’ve got to at least agree on how we’re going to enter the woods together.
When these things are in place, the therapy is ready to get started. Your goals and focus will probably change a bit over the course of the work, and that’s to be expected. Counseling is a non-linear, open-ended process. But if we have a strong, trusting relationship and a sense of what we’re doing together, we’ll be off to a solid start.
References
https://www.singlesessiontherapies.com/blog-post/the-most-frequent-number-of-sessions-in-psychotherapy-is-1/
https://pmc.ncbi.nlm.nih.gov/articles/PMC9355426/