What to Expect From Your First Therapy Session

Many couples enter the first session of couple’s therapy with a hesitant mindset, not knowing what to expect or having unrealistic expectations, questions about the process, doubts, and uncertainty. I’m hoping by the end of this article, you have a much clearer idea of what to expect in the first session of couple’s therapy and how to make the most of it. The information I provide is the same for online therapy as it is with in-person therapy. So, let’s get right into it!

After you have chosen your therapist and booked the first appointment, these are the three things you can expect from your first couple’s therapy session:

  1. Informed consent: If you are doing online therapy, expect to receive a therapy contract in your e-mail. If you are doing in-person therapy, you will be receiving this contract the first thing when you walk into your therapist’s office. The contract between therapist and client mainly includes informed consent, i.e., your consent to receiving therapeutic services under a contractual agreement whereby you agree to the therapist’s policies on: confidentiality, payment, rescheduling & cancelling appointments, and expectations of therapy. Make sure to read the contract and ask any questions you may have related to the process of therapy before you sign it (both partners are required to give consent and sign the contract). If you didn’t already ask these questions in the phone consultation, then this is a good time to discuss your expectations of therapy, ask questions about the therapist’s style or approach, any concerns you may have about affording the sessions, any concerns about confidentiality, etc.
  2. Assessment: After you give your consent for receiving services from the therapist, he or she will ask both of you about what the presenting issue is, i.e., what brings the two of you into therapy. This is the part where you both share the struggles or issues in your relationship that led you to decide to come into therapy. As you present the issues, the therapist will also be asking questions to assess your relationship such as your relationship history, family history, addictions, mental health issues, domestic violence, etc. Depending on what therapeutic framework your therapist is working from (e.g., emotionally focused therapy), or the nature of the presenting issue (e.g., affair, abuse, addiction), he or she may ask to meet each of you individually the following two sessions before reconvening for couples therapy. This allows you and your therapist a chance to discuss things more openly in a private session.
  3. Goals: Your therapist will ask you both about what you hope to achieve from therapy. This is the goal setting phase of therapy and a crucial one. Your therapist will assist you in identifying and developing specific goals for therapy – the more specific your goals are, the more effective therapy will be. Specific and definitive goals present a clear direction for both you and your therapist. For example, if you say your goal for therapy is “better communication”, your therapist might ask questions like, “how will you know your communication has improved?”, “how will your communication look different if therapy is helping?”, and “how will you know you no longer need therapy?” Such questions are asked to help you and your therapist identify what exactly to work on to increase the effectiveness of therapy. If you answer, “We will know therapy is helping when we both feel heard and understood by each other,” then your therapist will assist you in working through barriers that are coming in the way of “feeling heard” and “feeling understood”. If you answer, “We want to be able to communicate in a way where one of us is not angry and the other is not walking away,” then your therapist knows to address anger with one of you and shut down response with the other.

Some couples might walk away disappointed from the first session of couple’s therapy if they were hoping to get a quick solution to a problem that needed to be “fixed”. This is an unrealistic expectation to have because for any therapist to be offering solutions to “fix” your problems when they have just met you for the first time can have serious – even dangerous – implications for you or your relationship. It can take anywhere from one session to three sessions to set a clear roadmap and a solid foundation for successful therapy. The clearer the map, the more effective and fast paced therapy will be. Be patient and have faith in the process. Walk into the first session with realistic expectations and walk out of it with clear goals in mind on what you will focus on achieving in therapy. If by the end of the first session you have identified and developed clear goals for couples therapy, you are already one step closer to achieving those goals and improving your relationship.

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