– By Shweta Chhabra, Clinical Psychologist

There is still a lot of stigma around mental health issues and their treatment, either it is medications or therapy. People often question about the evidences to prove mental health conditions and even question about the effectiveness of the treatment. And if by any chance they are convinced to take therapy sessions, the speculations start to increase and feel that they will decide after 1st session whether “therapy” is for them or not. But is it the right approach? Do medicines cure the very first day and do we take medicine the 1st day and then decide whether or not continuing it from next day? If not then let’s find out- what to expect from first therapy session.

First Therapy Session

Before we agree to take therapy, we speculate a lot towards the topic. Like- Is therapy a real treatment?; Am I that weak that I need another person to help out with my life?; I’m a “Man”, I don’t need therapy.; It’s just talking, how can someone help me just by talking?; It’s just another way of looting people. etc.

Did you also have any such questions?

Then somehow, either by pressure or just for testing, we agree to take the session. Now it’s all or none, either the first session will convince to take further sessions or it’s just over. The expectation bar is really high.

Exploration

We may have high expectations but in reality the first therapy session is all about exploring. The therapist would most likely be exploring the symptoms, history, current situations, perception, coping, etc. It is known as the foundation of further sessions and therefore, expecting to get healed in the very first session is something very impractical.

Again questions may arise that why do therapists have to ruin the whole session in this, and why can’t they know all this prior the session. So the answer to this question would be a question- Do doctors know what a patient is going through or the symptoms before meeting the patient?

Rapport Building

As we have established the fact that the first therapy session is the foundation of further sessions, rapport building is something that is very crucial. Without a good rapport we can’t even think of opening up and let go of our life scenarios to a stranger. Therefore, what therapists do is they try and build a healthy rapport with the client so that the client is not left confused or vulnerable. A therapist needs to build a basic trust so that the client at least is able to vent out his emotions even if not yet ready to open all his wounds.

Safe Space

In order to have better results, a space where the clients can freely discuss without any fear of judgment is required. The therapist try and make the client as comfortable as possible so that the barrier of mistrust can be broken, and the first therapy session is the foundation of that trust. Yes, it takes the whole session and sometimes more sessions are required to break this barrier.

Further, the confidentiality and privacy of the client is also discussed in the very first therapy session. This again helps in building the trust and resolves the mental conflict of “whether or not” open up in front of the therapist.

Mode of Therapy

After setting up the foundation and through the exploration, a therapist would be able to discuss on what areas client might need help in and what therapeutic mode would be helpful for them. Apart from that, what a client can expect from throughout the therapeutic process is also being discussed in the first therapy session.

Yes, the mode of therapy is usually decided on the first therapy session, as no one therapeutic mode will be helpful for all, as we know every individual is unique and so is their coping.

Need for Testing

The first therapy session helps the therapist in understanding the basic perception of the client and the severity of their problems, however, sometimes it’s not the case. When clients find difficult to maintain a basic trust and are unable to discuss about their problems in detail, a therapist might ask for some certain tests to be done (which are done by the therapist or a psychologist only).

The tests may vary from paper pencil test to more intense projective tests, based on what the therapist might want to explore on.

Treatment Duration

This is a much trickier question than it seems, as not every individual will require same amount of therapy sessions. Based on an individual’s severity of symptoms to their amount of trust, further their engagement in the whole therapeutic process decides the treatment duration.

A therapist might give the client a tentative amount of sessions that they may require but again it would depend on the engagement of the client as well. We need to understand that therapy is a two way process and both the parties are equally important to enjoy the success of it.

Conclusion

First therapy session includes the exploration of the symptoms, history, current situations, perception, etc. by the therapist and building a healthy rapport with the client. Apart from this, a therapist tries to provide a safe space for their clients to involve and evolve, and discuss privacy and confidentiality policy with them. Then with enough exploration, therapist may discuss further about the need for testing and if not then the mode of therapy that might be beneficial for the client will be discussed. Furthermore, a therapist may give a tentative number of sessions which may require but it is dependent on the client as well. Both the therapist and the client make a commitment towards a process and together they achieve desired results.