Tips/ Advice For First Therapy Session?

[katyjane]

Hi there. I have my first therapy session next week.

Is it weird if I write down my existing diagnoses, ongoing issues, have a timelime of events, goals, and what I'd like to acheive from therapy, and give it to her? My history is complex, and I'm not very good at talking. I was thinking of giving her my clinical assessments letters from previous doctors, to give her a clear insight into what's happened, saying she can read it if she ever has spare time.

I'm really nervous, and when put on the spot sometimes get lost for words.

I don't know the norms for therapy sessions, is doing all this too much??

What do you do when you meet a therapist for the first time? Any advice or tips, or stories of how yours have been would be much appreciated.

 

[claroscuro]

My last GP asked for as much info as possible the first time I went to see him, any old records I still had access to, so he could get as clear a picture as possible. I did the same when I started out with my current T, and she received it very well.

When I went to my GP to get meds for anxiety I had to tell him what was going on, and spent a whole day writing down as much of my psychiatric history as possible. My T also wrote him a letter in support of getting meds. (She's in a foreign country and can't prescribe for me.) The list I'd made helped me get through that appointment without forgetting important things or drawing blanks, and prevented me from going off on tangents. He thanked me for it, and kept the list on file after we were done discussing.

With other doctors and therapists in the past this wasn't well received, and in hindsight that should have been a warning sign to me.

Some therapists will have a problem with it, thinking you're trying to force things a certain way. Others will see it as an aid. It all just depends on the therapist, and possibly the way you approach it.

Your therapist will need a rundown on your history, and will definitely need to know about ongoing issues.

Perhaps tell them you'd prepared these things for them, and then tell them it's your effort to provide thorough and clear information. From the list you mentioned, that's a wealth of info your therapist will need somewhere along the line. Even if they don't take it you can use it as a guide to keep you on track during the session.

First sessions with therapists have always been scary for me, but being prepared as I was for my most recent first session helped with the related anxiety.

Good luck with your first session.

 

[Suzetig]

I don't think any of that would be a problem as such, but I do think it would be overwhelming for the T to try and process all of that quite formal information in a first session without having any relationship with you.

It might be worth writing it all down to get it out of your head and taking it with you to help you decide what you do and don't want to talk about. I know my T would have taken all of that information, read it, and then waited for me to be ready to talk about whatever or she wouldn't come to session saying "I read x in your notes, let's work on that".

I tend to be very respectful of my feigns around being able to talk, or not, and if I can't is because I'm just not ready and no amount of working around that will make a difference. That does mean there are times I feel like I've not used my session well, but it also means when I'm ready to talk I really do it.

I wonder if you could see this first session as a getting to know you, share as much verbally as you feel comfortable doing and maybe ask if she'd like to see all your paperwork. Don't be offended if she doesn't, she may just want to hear from you at your pace.

Is it an NHS or private therapist?

 

[katyjane]

Thank you @Link Removed and @Suzetig, your advice was really helpful . Sorry for not replying sooner, I get shy to post (I know that sounds daft but it's true!) I did what you both said, wrote it all down and just kept it by my side in case I mind blanked.

I'm not quite sure what to think of the appointment.. The lady was really nice and friendly, but didn't seem to have much experience with trauma unfortunately. :/

I was kind of surprised at how full on it was for a first session. I have no idea if that is normal or not? She said she needed to know what all the flashbacks/ events where about, then got me to explain each of the flashbacks and event behind it in graphic detail. (I was fine with giving a general explanation, but going into such detail and her asking questions such as "did he rape you?", brought up other memories I had forgotten about. Ah.. I thought it would of been important to build up a bit of rapport before going into the humiliating events? =/)

On the next appointment, in 2 weeks, she wants me to go back with more events written in even more detail, and then read it back to her out loud. She said "getting it out will make you feel better".. I don't know about that.. ? I know I need to deal with what happened, but the thought of reading out loud these events is making me cringe so hard. Ah..

:/ On looking again at her profile and her qualifications, I can't help but feel more sceptical. I know qualifications aren't everything, but I can't see anything that would be specifically helpful for trauma? (She has a diploma in Counselling, Stress Management and Hynotherapy.) Bit confused as her profile said she did EMDR and CBT, which is what I was hoping for.
Maybe I should add, I have a lot of autistic traits/(was half way through diagnoses of ASD but discharged).-- which might influence my lack of desire and understanding of the benefits of simply talking about traumatic events.

Sorry, I am so confused. Am I just being overly critical and picking holes?

Any advice much appreciated as I have no idea!

 

[theshadowoftheliving]

I haven't read all of these responses, so forgive me if I'm being repetitive.

I've had a lot of therapist changes in the last year and a half, so at this point, I'm so so wary of telling my story over and over. Instead, I use the first session to find out more about the therapist. I need to know if they are committed, conscientious, thoughtful, educated, trauma-informed. If this is all true, then at the second or third session, I'll start to try to talk about myself.

 

[katyjane]

I haven't read all of these responses, so forgive me if I'm being repetitive.

I've had a...

I really, really wish I did that. How do you turn it around when they are asking in depth questions?
The therapist I saw didn't seem to know much about trauma therapy. She didn't know what SNRIS were either.
She got me to go into graphic detail about the events that gave me flashbacks, saying stuff like "ohh dear..", "that's how most victims feel", "that's what most abusers do" etc. I now remember stuff I had somewhat repressed. I feel a bit left hanging, as she's gone for two weeks now.

 

[EveHarrington]

I'm concerned that she's pressing for so much detail so soon. I don't think this is a good approach because she doesn't know how stable you are, she doesn't know how well you use coping skills----and as such, it's putting a patient at risk for going over the edge. (Yes, it happened to me before with a therapist not well trained in trauma.)

 

[Naoru]

Am I just being overly critical and picking holes?

I do not think you are being overly critical! Your t should not have you discuss details and events immediately as you haven't even built a working relationship yet. She hasn't even verified you could even cope after doing so! Yikes. Trust yourself. I would use this time while she's gone to seek out other therapists.

 

[Suzetig]

Id be a bit worried about her in all honesty, she shouldn't be pressing for details until she knows how stable you are, how able you are to ground yourself and there's a good relationship in place.

If you have the opportunity I'd ask for a different counsellor. Is she NHS or private? Bearing in mind the relationship is key in counselling, it's fine to say you're just not feeling a connection with her and ask to change (ie you don't need to say she's incompetent if you don't want to).

If not, and you decide to stay with her, if pick one thing (coping with anxiety for example) that you want to work on, tell her that's what you want to focus on and use your time with her for that one thing. It's ok to say you don't want to talk about X, or you're not ready to tell her about Y or tell she's going far too fast for you.

But mostly, I'd leave.

 

[digger]

I honestly would keep looking. I understand that cost is a factor for you in finding a new therapist, but the uninformed approach to trauma she seems to have could potentially do you more harm than good. Asking for that level of detail from a new client before assessing how stable they are is a red flag to me.

 

[NightSky]

I agree that her approach isn't informed or safe. During my intake session I had to fill out a sheet with 1-10 scales for a bunch of issues and my therapist went through it with me keeping things VERY general. It took 6 or 7 months for me to talk about anything in even a little bit of detail regarding trauma and over a year to talk about all of it. That was partly me, but mostly her, being very careful to see what caused me to dissociate, what my level of anxiety was etc. and even then I had to tell her to push me so I could move forward. I'm sorry you left feeling that way. This past week was the first time I've ever spoken a lot of the details with my therapist and it has been a hard week, and we have a solid trusting relationship. I can't imagine if it were someone new. Take really good care of yourself. And I agree with the others to look elsewhere.