It’s understandable you might feel anxious or nervous about your first meeting in a psychotherapist’s consulting room. However, remember that you are doing the hiring! The psychotherapist will greet you at the door, possibly with a handshake (just for the first session), and they will show you to a private consulting room and shut the door. Everything is held in a special atmosphere of openness, respect and confidentiality.
The initial meeting is an opportunity for both parties to get a sense of what it might be like to work together. At the beginning, neither of you know how the meeting will turn out, and whether you will decide to stay. Most psychotherapists are not actively seeking new work and will encourage you to make a decision that feels right for you. There’s also the possibility they may decide they are unable to work with you, the most likely reason being boundary issues or a perceived incompatibility between your needs and the psychotherapy services that are on offer.
The psychotherapist will be interested to find out about you. Many people entering this situation for the first time are unfamiliar with being listened to in this way, and are surprised to find themselves talking more than usual, with feelings coming to the surface. The therapist will gently guide the conversation to the topic of what help you really need and how you might be able to make use of it. He or she will be attentive to how you relate and how you respond, in the present moment, and will assess your capacity to cope with the slight pressure and stress of being here.
Psychotherapists are trained to conduct a thorough assessment, but at the beginning they will let the conversation flow and unfold in a natural way. He or she will want to know the reasons that have brought you here, and how you are coping at the moment. A therapist needs to know if you will take an equal partnership in working towards your desired results – if for example you can see your part in creating your problems, how curious you are about your own inner life, and if you have the impulse to understand yourself more. The therapist will attempt to show you that being in therapy is work that you do alongside the therapist’s guidance and support, and it does not offer a quick fix. They will want to see that your expectations of change are realistic in relation to the investment of your time, money, attention and effort that you are able to make. They may make a few trial “therapeutic” statements and see how you respond to these. They will also gently explore the type of working relationship you are expecting or hoping for.
You may quickly find out that some psychotherapists tend not to answer a direct question immediately, but may respond with another question, for example “and how does that make you feel?” or they will enquire into the reason behind your question. The intention is not to be evasive or deflect attention away from themselves, but to focus more deeply on the question. However, it is not likely that they will answer very personal questions, unless they are directly relevant to the issue that has brought you here. The therapist wants to create an ambience that is focused mainly on you, where you are as free as possible to reveal and explore every aspect of yourself, and where you do not need to hold back or feel responsible for what the therapist is feeling. Many therapists also work with what is termed the “transference relationship”, where the actual personality of the therapist takes a back seat, in order to allow space for any feelings that you may develop towards them that may be based on your own life history.
For psychotherapists, the beginning sessions with a new client are particularly interesting, as they offer an opportunity to experience you with a completely fresh and open mind. Beginnings are important, as they can evoke your own earliest beginnings in life, and how you have experienced significant beginnings ever since, such as starting school or a new job. The therapist will be interested in how you are experiencing and relating to this potential new beginning, and what might be colouring this experience for you – for example your experience of your early attachment relationships.
You may find that the therapist is fairly quiet and not very talkative, and may even allow respectful silences in the conversation. You are not expected to fill these silences, and they are not intended to make you feel self-conscious or put you on the spot. You are not here to provide entertainment for the therapist or to make the conversation flow smoothly! The therapist is your host, but this is not a social conversation that you are having, but an invitation to explore and share what you really think and feel.
Some therapists like to take a little time to explore their thoughts and responses so they can put them into the right words. There is a balance between sharing some thinking space together, but also feeling you are receiving some feedback on what you have shared, that gives you a new perspective.
At the end of the session you should feel that you have been heard and understood, that you felt respected, and that you were valued and treated seriously. You should leave feeling more positive and relaxed than when you arrived, and with a sense that there is a constructive way forward.
Things you might want to find out
Do you feel comfortable enough with this person and feel that you could potentially trust him or her? Do you feel you could open up your deeper feelings, in time? Do you feel he or she really understands what you need help with, and do you feel confident about what he or she says in response to this? How do feel while you are in the consulting room with them? If you are feeling a little bit anxious, how do you feel this is responded to?
Do you feel satisfied that they have sufficient training and accreditation for your needs, and that they are experienced in the areas that matter to you?
Do you feel you are able to reach a joint agreement about what outcomes you will be working towards together?
Are they happy to explain things you are not sure about, and do you feel ok about asking? Do you feel you understand something about the way they work, and the type or model of psychotherapy that they offer?
You also need to feel clear about the arrangements for appointments, fees, missed sessions, holiday breaks, any necessary contact between sessions, and so forth. You need to feel confident that you can manage the consistency of regular sessions, as it is difficult to establish an effective therapeutic partnership if you are not able to meet once a week, at least for the first phase of the work.
Most of all you ned to feel encouraged, with some confidence and optimism that now you can begin to move forwards in your life!