tl;dr: Just remember to complete paperwork before coming to your first session (or submit online). Sessions usually last just under an hour. In the first session, we get to know each other and establish a direction for therapy together and what to work on. From there, all other sessions build on the previous, working to your end goals. Therapy ends when you’re ready for it to, and won’t go on indefinitely.
Thinking about Therapy
Whether it’s your first time seeing a therapist, or you’re starting with someone new, the knowing what to expect going in can make starting easier. In this article, I will give some important expectations to have in mind when starting therapy in general, as well as what you can expect when starting to work specifically with me as a new client.
Before the First Session
There’s a lot that leads up to starting therapy. You’ve probably been dealing with a certain problem for a while and it’s got to the point where you need some professional help with it, or something significant has changed or happened in your life and you need an outside perspective to help. You’ve gone through the search for a therapist, and have scheduled that first session. Now what?
Prior to the first session, a therapist will typically send you some paperwork to fill out, similar to how a doctor’s office will have a few documents to fill out and bring to your first appointment as a new patient. This paperwork varies, but likely includes a personal information form, an informed consent document, and a HIPPA privacy notice. Some therapists may just give you these when you come for your first session and have you fill them out in-person.
As my client, I have a secure client portal set up where I can send you the documents electronically to be filled out and sent back, or brought in for the first session. This allows us to spend minimal time reviewing policy and paperwork and more time on getting you some help. The forms I will send depend on if you are coming to me for an individual or couples/family session. They will include a Patient Information Form, HIPPA Disclosure & Acknowledgement, Electronic Intake Form, and an Informed Consent form that has my practice policies described in it. Because my practice is private-pay only, I only have to take minimally necessary information, whereas therapists who are contracted with insurance companies typically have to ask a lot more questions, have lengthier forms, and need things like a SSN that are only necessary to process payments with insurance. This allows for more privacy and a focused approach when working with me.
The First Session
At your first session, you will want to show up on time. This is very important, as it establishes an expectation of respect for both of our time. Some therapists will ask you to show up 15 minutes before the first session, especially if they have you fill out paperwork in-person instead of ahead of time. I personally make it a point to start sessions at the time they are scheduled. This is where therapists differ from other medical professionals, as we can all relate to showing up at a doctor’s office and waiting 30 minutes beyond out scheduled appointment time to be seen. I respect your time, and will start sessions at the time they are scheduled and end when they are scheduled.
You will also want to bring a form of payment and a credit/debit card to place on file. Most therapists do require that a card be on file, as this makes processing payment a lot faster and easier on both parties, and does not take away time from the session. If your therapist takes insurance, bring your insurance card as well. I will ask to keep a credit/debit card on file, and charge on the day of the scheduled session, whether it is that card or another form of payment at the time of our session.
When you show for your first session with me, there is a waiting area with seating. I will come to the waiting area to call you in to the office at your session start. We’ll sit down together (yes there is a couch and you can choose where you sit), and we will start the session. I’ll start by reviewing a few key policies in my Informed Consent form, such as Confidentiality, and ask if you have any questions about the paperwork that was sent to you or the policies I have in place for my practice. If there are any, we will discuss those, and if not, we’ll get started on our work together.
In the first session, we will primarily get to know each other. I’ll ask you to tell me about what made you seek out help from a therapist and we’ll talk about the things that you want to work on in our sessions. Depending on what you’re seeing me for, I may have a technique to teach you or a small piece of homework to work on before the next session. At the end of our session, we will establish a regular appointment time and you will hopefully leave feeling a bit more connected and confident that you will be able to get the help you need.
The Following Sessions
The second and following sessions will build off of each other. By the second or third session, I will have helped you establish some concrete goals for our work together. These will be things you say you want to see happen in your life as a result of therapy, and will inform the direction of our future sessions together. A rough timeline for how long therapy may last will have also been established. Contrary to what is typically depicted in media and film, therapy does not necessarily last your entire life. A select few situations may require ongoing continued work, but the vast majority of therapist-client relationships have an end date. This means that I am not going to keep you coming to therapy if there is no longer a real need for it. After achieving their initial goals, many clients do choose to start working on other areas of their lives or other struggles, and many will check back in with their therapist occasionally for a follow-up session after they have ended their main work together or return if some new struggle pops up.
Therapy is a healing process based on a safe, trusting relationship between a therapist and a client. You can expect to be challenged in some sessions, and some sessions will be much harder than others, especially if you’re dealing with past trauma, or really deep hurts. The work, however, is very much worth it, and the benefit from gaining perspective and a clearer sense of self is something that will stay with you for the rest of your life. Once your treatment goals are met, you will have the tools and skills necessary to continue your personal work on your own if you choose. After we end our initial work together, I will be available if you need to talk again.
cost
We all know that cost is a large factor in accessing professional services, but for some reason this is not openly talked about enough. Therapy is an investment in yourself, and in most instances, the long-term life changing benefits of therapy far outweigh the initial investment. Therapy is putting time, attention, and money toward creating a better life for yourself, whether that is for finding direction, healing from trauma, better handling anxiety, or creating a better relationship. The investment you make in yourself is money well spent.
Unlike most other medical settings, where the cost of procedures, medicine, and interventions can be ambiguous at best, and change based on unpredictable circumstances, therapy typically is a set cost. Most, if not all, therapists will be able to tell you how much to expect to pay per session. Unfortunately, many do not do this before you are a client. Sometimes this has to do with insurance contracts and other circumstances. Since I only work with private pay clients, I am able to tell you my costs up front. For an individual session, I charge $150. For a couple or family session I charge $200. I also work with OpenPathCollective.org for limited discounted sessions based on financial need ranging between $30-$60 for individual and $30-$80 for couple or family sessions. If you want to use your insurance benefits, I am listed on the Reimbursify app for help submitting out-of-network claims.
One way to lower costs is to restructure your treatment. While most clients will benefit from weekly sessions, you may opt to do bi-weekly sessions to help reduce the monthly cost of treatment if cost is truly a prohibitive factor. The frequency of sessions may also naturally reduce based on your progress as you work with me. For example, once most goals have been met and the most intense work has been done, we may reduce session frequency from weekly to bi-weekly, or even monthly. While keeping session frequency low from the beginning may prolong the length of time needed to address the goals for treatment, in some cases this is a good way to make therapy affordable.
Confidentiality
Every therapist has a confidentiality policy, typically covered in what is called “Informed Consent” paperwork. Informed Consent refers to being aware of and agreeing to policies in place when starting therapy.
Confidentiality specifically may be a concern for you. If you’re worried about the fact that you are seeing a therapist will get back to co-workers or a boss, or even a family member, let me put your mind at ease. All states have regulations around confidentiality for mental health professionals. My policies reflect the regulations of the states that I am licensed in. Essentially, all communication between us, including the fact that you are even a client, will be kept strictly confidential, with very limited exceptions. Those exceptions are if you disclose instances of child or elder abuse, neglect, or exploitation, if you disclose that you are an imminent danger to yourself or someone else, or if there is a valid subpoena from a court. These exceptions for confidentiality are spelled out in most state laws, and typically have to do with Mandated Reporting laws that healthcare professionals and some other professions have to follow.
With those few exceptions, everything we talk about in therapy is kept confidential between us. You will find the same practice across all mental health professions, and this should be something that is disclosed to you prior to even starting the first session with any therapist. If, for some reason, you are working with a therapist and something about this is unclear, please ask them about it. It is my personal policy that I discuss these limitations before beginning a professional relationship with you, and I will remind you of them if we ever start talking about things which may be applicable to these limitations.
There are instances where you may want information about your treatment be available to a third party, such as your spouse or your family doctor. In these cases, I have a HIPPA release form that can be completed to allow this.
I’m Ready to Start
I hope this has given you some clarity on what to expect when starting therapy. If you would like to schedule an appointment with me, you can click the Schedule and Appointment button below to be taken to a form to complete and I will be in touch by email or phone. Or you can click the Call Me button to call me at 501-408-8412 and schedule over the phone. I will call you back to schedule if you leave me a voicemail. I am licensed to practice in AR, TX, OH, IL, FL and OR. If you are not in the Little Rock, AR area, but are in one of these states, teletherapy options with me may be available. Contact me for more information on teletherapy services.