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17 Things Therapists Want You To Know Before Your First Session

Just in case you're imagining yourself sprawled on a chaise lounge as your therapist asks, "And how does that make you feel?"

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Taking that first step to start therapy is an exciting and brave thing.

But even once you've decided on a therapist (find out how to do that here), not knowing what to expect can be intimidating.

So to help you feel as mentally prepared as possible, BuzzFeed Health talked to Stephanie Smith, Ph.D., clinical psychologist in Colorado, and Ryan Howes, Ph.D., clinical psychologist and professor at Fuller Graduate School of Psychology. Here's what they want you to know about starting therapy:

1. If you want to feel things out before committing to a session, some therapists will chat on the phone first.

Or even if you're just nervous and don't want your first time talking to this stranger to be in a session where you're spilling your guts. Not all therapists will offer that, says Howes, but it doesn't hurt to ask. "Even if the quality of a phone call is different than sitting face-to-face in terms of getting the vibe of the other person, it's a great way to get a feeling for how comfortable you feel talking to them," says Howes.

If possible, ask if you could chat for 10 minutes or so. You might even find out in those 10 minutes that it's absolutely not going to work or that it's worth moving onto the next step.

2. Schedule your first appointment at the end of your work/school day.

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If you've never gone before, you don't know what effect therapy will have on you — you might feel completely fine to go back to work after your first session or you might need a few hours by yourself to debrief and unwind. Until you know, Smith suggests scheduling your first session on a day off or at the end of the day.

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3. Remember that one session isn't a lifelong commitment.

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So don't put a ton of pressure on it to go perfectly — or to stick with it if it wasn't a good fit. "A lot of people think, 'If I invested this time and this money, I have to stick with it' and that's not true," says Howes. "One session is really a drop in the bucket. If you know from that first session that things aren't going to work out, then it's OK to pull the cord. In fact, therapists would prefer that."

And if you're worried about leading your therapist on (which you wouldn't be, btw — this kind of thing happens all the time), then you can let them know from the get-go that you're shopping around for a good match and that this might be your only session, says Howes.

5. Think about what your goals are for therapy ahead of time, but don't worry if you don't know for sure.

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There's no right reason to go to therapy, so everyone's goals are going to be different, says Howes. It could be to get relief from symptoms from a mental illness like depression or anxiety, to help illuminate relationship problems, to deal with your past, or even to help find direction, motivation, and purpose in your life.

And if you're not sure, a good therapist will help you figure it out. "I ask people who have trouble figuring out their goals, 'If you rub the magic lamp and have three wishes, what are they?'" says Howes. "Let's go with the big goals and the big dreams of what you want your life to look like and scale it back from there."

6. It might help to write down what you want to talk about ahead of time and bring that with you.

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When you're already feeling nervous about a session and your therapist starts asking about you and your background, you might feel like you're on the spot and draw a blank. For that reason, Howes says you might feel more comfortable coming prepared with an outline or some notes jotted down. Most therapists won't tell you to do that, but won't mind if you do.

7. But either way, you should expect to talk about your history.

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Think about things like your family and important relationships, academic and work history, your relationship with drugs and alcohol, and how your current situation developed, suggests Howes. "Don't think that you have to give the full account of your life, though. You're going to miss things and that's OK," says Howes. "But come ready with the highlights."

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8. You can talk about as much or as little during the first session as you're comfortable with.

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"Some people are just ready to spill everything and talk about the big stuff, and some people it takes much longer for them to feel comfortable sharing," says Smith. "What's important to me as a psychologist is to meet people where they are."

You can also always ask to go slower, to move gradually into the deeper material if it feels like too much, says Howes. If you want, it can be super helpful to say something like, "Hey, there's something I eventually want to talk about, but I'm not ready yet."

9. You can expect the office to look pretty much like a living room.

Just in case you were imagining yourself sprawled on a chaise lounge as your therapist asks, "And how does that make you feel?" More realistically, you're typically going to have your therapist's chair across from a couch or a love seat, and whatever personal touches your therapist brings.

Also, the room might even give you clues as to whether you two will be a good fit: "The therapist's personality is probably reflected in their environment," says Howes. "So if you've got someone who's in a place that's very clinical and there's not a lot in there, then you might expect a more formal, distant relationship."

10. If you're nervous, remember: it's not your job to keep the conversation moving or to be able to perfectly articulate exactly what you’re feeling.

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That's what your therapist is there for. "The hope is with a good therapist, they'll be able to help you find the words to talk about what's going on and help you make sense of things," says Smith.

11. Ask your therapist lots of questions, too.

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Obviously, it's going to be up to them whether they answer and they might turn it back around on you, but here are a few that Howes and Smith say might help you decide if it's a good match:

* Have you worked with this issue before and what was the outcome there?

* Do you have experience with going to therapy yourself? (Most good therapists will also have their own therapists or at least will have in the past, says Howes)

* What does your treatment plan for me look like at this point?

"You're also welcome to just talk about things like why they became a therapist, where did they grow up, what do they like to do for fun? These are fair game," says Howes, as long as you're not using these questions to stay off track.

12. In general, embracing the fact that therapy is really weird can help a lot.

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"It's really strange to go into someone's office that you don't know and tell them all these personal things," says Smith. "So it's completely normal to feel nervous or weird."

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13. You shouldn't expect to make any huge life-changing strides the first session.

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"Most problems don't occur overnight and they're not going to go away overnight," says Howes. So you're not going to walk away with a solution to all your problems and be a changed person after an hour. "It might get worse before it gets better from opening cans of worms."

14. That said, in a good therapy session, you’ll at least leave feeling like you gained something.

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According to Howes, you should leave with something, whether that's a feeling of empathy, a new mindset, some coping skills, or even some homework. "All therapists are different, but no matter what, you should end the session with the feeling that you can make progress," he says.

15. After your first session, evaluate how it went.

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When deciding whether or not the therapist is someone you want to go back to, Howes suggests considering: Did you feel understood? Were you able to speak freely? Did you like the feedback? What's your gut feeling?

"It sounds so unscientific but if your gut says, 'I don't feel comfortable opening up to this person,' then you're not going to get the most out of your therapy," says Howes.

And even if it went well, think about the things you wish you would have said and consider why you didn't. Then, Howes suggests trying to say them next time.

16. It might help to debrief by journaling or talking to someone you trust.

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"There's so much that happens in that first session that it can feel overwhelming," says Howes. "But writing it down has a way of containing it and giving it a narrative so it's easier to digest." If you're not really a journaling person, going over it with a trusted friend or family member is helpful too — as long as they'll only listen, not give you more advice or pass judgment on the session.

17. Be proud that you took that first step.

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"Therapy is a journey that has incredible payoff," says Howes. "And it's an act of bravery to take the first step. You'll be learning so much about yourself. It's not easy all the time and it's not always fun, but in the end, you'll have more awareness and therefore more power in your life."

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