The first session is an hour intake where your right to confidentiality and my personal policies are reviewed. Additionally, the hour will be devoted to understanding the reason why you are seeking out therapy and to gain an understanding of a your history. That history will include questions about who is your family of origin and your current family context, what symptoms you are experiencing, stressors that might be related to finances, relationships, work, legal problems, using drugs or alcohol etc. Clients struggle with a variety of problems such as depression, marital conflict, anxiety, issues related to a trauma or anything else that interferes with their daily living.
After gathering a history, I will ask you what your specific goals are. Usually, everyone’s goal is to “feel better.” I ask people to concretely identify what “feeling better” might look like. For example: “I will no longer avoid walking into a store for fear of having a panic attack.” “I will take better care of myself such as: exercising and getting together with friends.” “I will sleep better and have fewer nightmares.” Once the goals are clearly identified, then I will often offer some homework for the client to work on between sessions. Homework takes a variety of forms. Sometimes the task is to increase your awareness of your thoughts. Sometimes, clients will identify a concrete plan of action: i.e. walk for ten minutes three times per week. Or a particular task might be identified: i.e. sit down with your spouse and ask him/her what they think will improve the relationship. When working with couples, I usually spend the first session understanding the immediate issue of what brings the couple into treatment. A developmental history may be gathered later in the therapy. However, goals are still identified in the same way as above. At the end of the session, I usually ask people if they have any questions of me and how the session felt to them in general. I do not make the assumption that people are scheduling another appointment. Some people know right away that they want to continue, some may want to think about it and some may be in the process of interviewing other therapists before they make a final decision.