You’ve done it! You’ve signed up for therapy and are awaiting the next chapter of your story to begin. You may have been to therapy before (or maybe you haven’t), but either way, it can be nerve wracking. Finding someone you fit with and (generally) it being someone you have never met can be daunting.
What should you wear? What should you say? Should you cry at the first session? How much do you really want to tell your therapist? What if you don’t like your therapist?
These questions are ones that people may ask themselves before their first session. The first session is unlike the following sessions, and therefore it can feel like a strange encounter. The first session is known in the “counseling world” as the intake session. The purpose of the intake session is for the therapist and you to create the most whole and accurate picture of you as possible. In other words, this is a time where your therapist goes over all there is to know (as if that’s possible in one session) about you to help gather a picture to help you both out. One way in which your therapist gets to know you is through the use of forms. There are probably going to be a lot of forms you must fill out. These could include informed consent, intake forms, release of information, questionnaires, and so on.
This is the most important document that you want to read with a careful eye. We aren’t trying to slide anything past you, but we really want you to know what it says. An informed consent is super important to not only the therapist, but for you as well.
Essentially, the document lays out the framework for the legal and logistical parts of therapy. The informed consent will likely be packed with information such as social media policies, mandated reporting laws, what will happen to your file if your therapist expires, payment arrangements, cancellation policies, confidentiality statements, and anything else that your therapist may think is important.
This is likely to be the form that takes you and your therapist the most time to digest. The purpose of the intake form is to get as much information as possible about you that could inform the therapeutic process. For our team, the intake is online so you can take your time thinking of the answers! Then, we go over it together.
So many different domains are associated with mental health therefore your intake form is probably going to be longer than any other form you must fill out. Most of the time the form will begin with questions to gather basic information; What’s your name? Where do you live? What is your birthday? How do you identify your gender? Race or ethnicity? Therapists know that age, gender, and ethnicity can influence certain disorders differently than persons of differing age, gender, and ethnicity. Also, in the first part of the intake, you will find questions that inquire about work, living arrangements, and education. Our mental health can negatively influence these areas of our lives and it is good to know if these areas are ones that can be positively influenced by therapy. The next sections are not necessarily in this particular order; however, they are all generally included in the intake forms.
Relationships are invaluable as social supports during times when you may feel like you are not feeling like you. Your intake form will want to know about all the types of relationships you have had since you were a child. Did you have supportive parents or siblings? If not, who were your role models? Do you have friends that you can talk to when you are feeling down? Do you have a significant other? If so, do you feel happy with that relationship? Do you have a relationship with spiritual or religious beliefs? All these various relationships can be important when discussing what supports you when you are not in the therapy office.
Being honest with your therapist is crucial. Therapists know how difficult it can be to talk about hard things you may have experienced (i.e., neglect, childhood abuse, family or parent substance abuse, couples conflict), but they also know how much of a need it is and relief it feels to get it off your chest. Although that doesn’t all (i.e. getting it out) come within the first session, we are prepping for the opportunity ahead of you!
There will be questions about previous therapy. Your therapist will want to know if you have been in therapy before. Did someone refer you to therapy? Were you ever hospitalized for psychiatric purposes? Do you take any psychotropic medications? If so, what are they? Most likely, your therapist will inquire what you liked and disliked about previous therapists and what previous goals were. Your therapist may also want to know what you expect from your new therapy. How long should it last? What do you want to see change from the beginning to the conclusion of therapy? Last, your therapist will want to know in your own words why you are coming in. What exactly is happening so that you sought out therapy? Knowing what you have accomplished in previous work and what you expect from current therapy will inform your therapists approach.
Typically, towards the end of the intake form, your therapist will want to know if there is anything else that you want them to know about you. This is a great opportunity for you to expound on any of the answers your previously provided. Also, towards the end of the form, your counselor will ask you to write your strengths. You are so strong and have come so far in life! Your therapist will want to know how you have made life work and then help you find even more strengths within yourself.
Release of information
Although release of information may not be discussed in every intake session, it is good to know about.
A release of information is a form that allows your therapist to speak with other professionals you may visit. In the therapy world when many professionals come together to help the health and well-being of an individual it is called collaborative care. Your therapist may ask you if you would like your other health-care professionals to be able to communicate with them. Collaborating with other professionals can enhance the effectiveness of therapy in many ways. Therapists often spend more time with clients than other health professionals. Because of this inequal amount of time, therapists can act as an advocate for their client if there are any concerns.
If you agree to a collaborative care approach, you will be signing a release of information. On a release of information form there should be specific information; who can the therapist speak with, when the form will expire, and what you can do if you decide to retract the form. As mentioned previously though, it might not be discussed in session because it might not be of interest to you. This is not required.
Not as if you have had enough papers to fill out, your therapist may ask you to fill out some questionnaires. These questionnaires may be completed at different time intervals such as weekly, monthly, or every three months. Questionnaires serve a purpose, but the purpose may vary.
First, to get a baseline. For therapists, they cannot know where to go if they don’t know where you are. A baseline is an understanding of where you currently are so that your therapist can help you move to where you want to be.
Second, questionnaires can potentially help identify what it is that you are experiencing. Sometimes it is hard to tell whether or not it’s anxiety, depression, obsessions, and so forth. Tentatively identifying what you are experiencing helps inform treatment.
Last, questionnaires can identify when you may need immediate help. It can be very uncomfortable to talk about thoughts of suicide or homicide, but it’s important to talk about it. Research has consistently backed up that directly questioning is the best way to help an individual who is at an extreme end of harming self or others. When you indicate that those thoughts are present, it’s important that your therapist can help you right away.
So now… Let’s talk about it!
So, you have filled out the mountains of forms. You are ready to go in and spill your guts to your therapist. Before you do, it is important to know that the first session will mostly be information gathering. This will not be a normal therapy session. I repeat: this will not be a normal therapy session. This session is to gather more information from you, really a sense of who you are (and for you to meet and get a sense of your therapist), provide you an opportunity to elaborate on any of your answers on your intake form. During this session you may often feel the need to focus on the critical aspects that drew you to therapy; but, as urgent as those feel, you probably won’t get the chance to talk about them in depth. Not that your therapist doesn’t want to hear about the things you’re coming in for! They totally do (or should if they are a good fit).
They are also tasked with getting the biggest view of you as possible, that way they can pinpoint how to move forward and help you find what works for you. If you come in and talk about your problem before your therapist can fully understand you as a person, they may not be able to provide you the most individualized help. The intake session can feel like a weird encounter. You may hear your therapist say, “That sounds really important, and I want to come back to that, but for now, I need to know…” You are also welcome to say, “I know that we have to get through all this stuff, but I want to make sure we talk about…” That way your therapist knows that a specific topic is very important to you.
In summary, there are a lot of forms. These forms give your therapist a clear understanding of who you are so that both of you can make the most informed decisions as possible. You need to carefully read through the informed consent document and decide if there are any release of information forms you would like to fill out. Also, be prepared for more questions as your therapist may want to use a questionnaire. Finally, be prepared to talk about all the forms. The intake session can be quite nerve wracking, but hopefully, you will have a positive experience and you are able to begin your journey towards health!
About The Author
Molly Lyons- Counseling Intern
Molly is currently in her final year of the Master of Science in Clinical Counseling at Central Methodist University (CMU) and is a student intern at The Counseling Hub and Boone County Mental Health Coalition, where she will assess and provide mental health interventions and resources for individuals and groups in Boone County schools. She obtained her Bachelor of Science in General Psychology with a minor in Child Development from Central Methodist University directly before enrolling in the counseling program. Prior to pursuing her counseling degree, Molly received an Associates of Science in Early Childhood Education from Moberly Area Community College.
Molly has experience in the Counseling Center at MACC's Columbia campus, providing counseling services for students around the topics of identity crises, school-related stressors, depression issues, and coping with anxiety. Molly has co-facilitated Safe Zone trainings which introduce its members to the LGBTQ+ community terminology and basic information. Molly has also completed on online course in LGBTQ+ Counseling Competencies (College and Career Readiness) through the American Counseling Association (ACA). Molly is an active member of both the ACA and the Association for Multicultural Counseling and Development (AMCD).
Molly enjoys working with diverse populations and seeks to always be open to new learning experiences. She works best with individuals who are trying to discover who they are and how they relate to their world, as well as others in their world. Molly believes that a person’s external factors can provide both barriers and resources towards growth and that one must discover these in order to thrive.