During your first appointment for psychotherapy or counseling, your counselor will need a summary of the problems or questions that have brought you to counseling in order to work with you to establish goals and an appropriate treatment plan for your counseling. Adults will meet alone with the counselor. Children and adolescents will usually have some time with the parent present and some time alone with the counselor; a session that allows observation of and discussion among family members may also be held. The counselor will want to hear your history, including: family history and dynamics, significant relationships, work, substance use, cultural background, major losses, traumas, medical issues and any other information that may prove helpful. Parents will be asked to provide information about their child’s developmental history, schooling and social relationships, as well as other information that may be relevant to the difficulties the child is experiencing.
If your referral question is very specific (for example, a fear of flying) one session will usually be enough to provide the necessary information to develop a treatment plan. If it is more complicated (for example, serious marital conflict or a long history of unsuccessful relationships) more time will be needed for the two of you to develop a plan.
Therapy sessions are 45-50 minutes in length. This leaves your counselor 10 minutes to take notes and prepare for his or her next appointment. Although your counselor will likely ask questions and lead the discussion during the first appointment it is important for you to take the lead as much as possible in future appointments. Your counselor will often wait to see if you have important issues you would like to bring up in any given session. It is a good idea for you to report on progress or setbacks and to let your counselor know of any significant events since your last appointment, and provide honest feedback to the counselor regarding your treatment.