What to Expect from Therapy and Your First Therapy Session

Does your teenager know what to expect from therapy? Do you know how to prepare

for your first therapy session, and how to be more open? Are there ways you as a parent can make that intimidating first visit less stressful? Indeed, these are all appropriate questions that make sense before starting the therapeutic process. Also, they are questions that teenagers might ask when given the option of going to therapy. For parents, it helps to have some viable answers.

A Teenager Going to a Therapist for the First Time

Going to a therapist for the first time and going to your first therapy session with a new therapist can be scary because a lot of it is unknown. After all, it’s hard to be more open and talk to a stranger about the most intimate details of your life and your biggest challenges. Even if that stranger is a professional, and the location is an official office, the difficulty remains because the strangeness does not disappear. Indeed, it’s a challenge for anyone. One goal when starting a constructive therapeutic relationship is to reduce the difficulty of this transition.

First, when preparing yourself for your first therapy session or a teenager for their therapy session, it helps to remove the stigma. Many people think that you have to be seriously messed-up or severely mentally ill to see a therapist. However, this belief is not valid. The majority of therapists focus on helping clients work through everyday life challenges. Indeed, psychotherapists serve a very diverse set of clients with a wide range of therapeutic goals.

Be sure to remind your teenager know that many people that see a therapist regularly are successful, high-achieving professionals. Overall, the majority are healthy, and all of them are normal for seeking help. They choose to see a therapist to work on specific challenges and achieve desired goals. Often depression and anxiety disorders are the results of the kind of stress that most people experience. To avoid these detrimental effects, working with a therapist helps pinpoint the challenge, then develop tools to manage it effectively.

Going to a Therapist for The First Time and Your First Therapy Session

According to the National Institute on Mental Health, “Psychotherapy (sometimes called ‘talk therapy’) is a term for a variety of treatment techniques that aim to help a person identify and change troubling emotions, thoughts, and behavior.” Before going to a therapist for the first time, it makes sense to put together a list of questions to ask about a professional’s background and the various treatment techniques used by a therapist. Such initial questions provide orientation and start the process of building trust.

Here are some basic questions to ask:

1. What are the credentials and experience of the therapist?
2. Does the therapist have a specialty? What approach will the therapist take to help you? Is the therapist’s approach a good fit for your difficulties?
3. If the therapist is working with your teenager, do they have experience working with teens? What is different about working with someone underage?
4. What are the goals of therapy, and how will the success of the treatment be assessed? Are the treatment techniques evidence-based (meaning their effectiveness is proven based on research studies)?
5. Are psychiatric medications an option? If the therapist is not a doctor like a psychiatrist, how will any prescription drugs be prescribed?
6. Are the sessions confidential? How can this be assured?

For teenagers, the last question can be a big deal. They want to know the limits of confidentiality and how safe they will be in a therapeutic relationship. Hence, teenagers often want to make sure the therapist won’t be “reporting” or “telling” on them to their parents. Indeed, they need certain assurances to open up.

Your First Therapy Session and Teen Confidentiality

Before exploring the nuances of confidentiality, it’s essential to understand the laws. Except in particular circumstances, the vast majority of conversations with a therapist are confidential. A therapist may break confidentiality if there is an immediate threat to a client’s safety like suicidal thoughts or if there is a possibility of danger to another person. Also, if an adolescent reports child abuse, a therapist can be required by state or federal law to report such concerns to authorities.

When it comes to underage children in therapy and their parents, the question of privacy is complicated.

In an article about the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and confidentiality for adolescents, Abigail English from the Center for Adolescent Health & the Law writes, “Parents… are considered to be the ‘personal representatives’ of their unemancipated minor children if they have the right to make health care decisions for them. As personal representatives, parents generally have access to their children’s protected health information.”

At the same time, the American Academy of Family Physicians expresses in an online policy statement, “The AAFP believes that adolescents’ access to confidential healthcare is important for their health and well-being, while also recognizing the benefit of supportive parental involvement.”

Following this guideline, most therapists will gently let an adolescent know their parent’s role in the therapeutic process, particularly when it comes to decision-making with regard to treatment options. They also might ask the permission of an adolescent to speak with their parents. Sometimes a therapist brings the parents in for a family session to discuss such inclusion.

Ultimately, a good therapist will have the experience and the expertise to navigate this issue. Thus, the question of confidentiality with underage clients rarely undermines the treatment process.

What Does a First Therapy Session Look and Feel Like

Therapy is not like taking an aspirin to cure a headache; the results are not necessarily immediate. Please don’t expect your adolescent to change and act “cured” after the first session. It often takes time until a breakthrough happens. Thus, lowering your expectations before a first therapy session makes sense.

A first therapy session often involves filling out paperwork before the work begins. If you are a parent, please give yourself time to help your adolescent navigate this process. Beyond the paperwork, first sessions often feel like a casual meet-and-greet. You are testing the waters, and the therapist is there to help you get comfortable. This is an opportunity for you and your teen to decide whether or not the therapist is a good fit for them.

During the first therapy session, questions will be asked to help orient the therapist. These questions can include the following:

• A teenager’s background and childhood
• What a teen likes and dislikes in school
• Friends and social relationships, both in and after school
• Family life, including parents and siblings
• What a teen hopes to achieve in the therapeutic process

If you are a bit nervous, you are not alone. In truth, it’s a typical response to yourself or your teen starting therapy. Rather than let the nervousness get the best of you, act curious like an explorer learning about a new experience. By learning how to be more open, a teenager can walk through new doors and start unexpected adventures.

Indeed, therapy is widespread in American society because it works and shows results. Please have faith in the therapeutic process, because your faith is contagious. When an adolescent sees that their parent believes in therapy, then they will be more likely to have confidence in the process as well.