Once you have secured your first appointment, think about how you ideally wish it to begin. Is it helpful for you to write down some points you want to cover and share those with the therapist at the start of the appointment? Or does that feel like too much pressure? It might be more helpful to begin that appointment with something like, “I’m not at all sure where to start, and I’m feeling pretty disorganized. Will you please guide me with short questions, and I can try to answer them?”
Generally, first appointments cover introductions and begin obtaining some background history and information about where you’re at right now. An hour can go by fast, and there’s the potential to leave not knowing much about the therapist’s personality and style or how you feel about her or him.
At the start of the first appointment, ask the therapist to reserve the last 10 or 15 minutes to obtain his or her feedback, which may include initial goals and a treatment plan. This can also help you confirm the therapist’s understanding and perspective of where you’re at and what you are willing to work on.
Pay attention to personality. Having a rapport and comfort level with this person early on is essential to the progress of your work. If you don’t feel a connection within the first several appointments, say so. In so doing, you create an opportunity for both of you to discuss what might be going on. Sometimes this reaction is more a reflection of painful or uncomfortable session content than about the therapist. In this case, the therapist can make recommendations to make the work feel more manageable and tolerable, perhaps limiting the time spent on a particular topic during each session.
In the event there really isn’t a connection, the therapist may be able to identify alternative referrals for you, now armed with more clinical information about your circumstances. That might feel disappointing to begin again, but it’s worth the time invested in finding the right person for you.