What Happens in a First Therapy Session?

"I know I need help, but I have no idea what to say."

If that thought has kept you from hitting the "Book Now" button, you aren't alone. It can be so intimidating to start a counseling relationship. Here is the good news: even if you feel like you don’t know how to “do therapy”, I do!

Here is exactly what happens during our first 50 minutes together.

1. Building Connection

Before we dive into your history, we start with the basics. I’ll introduce myself, and we’ll handle the "housekeeping". These are things like confidentiality, how telehealth works, and any lingering questions you have about the process.

The most important part of this first session isn't the information we gather; it's the therapeutic alliance. Research consistently shows that the bond between therapist and client is the biggest predictor of success. This is your time to see if I feel like a "safe" person to talk to.

2. Mapping the Landscape

I often use a Biopsychosocial Assessment to begin to understand the 360-degree view of your life. We aren't just looking at your thoughts; we’re looking at your whole ecosystem.

We will briefly touch on:

• Biological: Your sleep patterns, energy levels, and how things feel in your body.

• Psychological: Your internal dialogue, self-esteem, emotional experiences, and any history of trauma.

• Social: Your support system, work environment, and those tricky boundaries we talked about in the last post.

3. Identifying the "Root" vs. the "Fruit"

You might come in saying, "I’m just so angry at my coworkers" (the fruit). During the first session, we start looking for the "root." Is it a lack of boundaries? Is it a life transition that has left you feeling lost? Or is it a trauma response from a high-pressure past?

Note: In a trauma-informed practice, you are in the driver's seat. You do not have to recount your entire life story or relive painful memories in the first session (or ever!). We go at the pace you and your nervous system set for us.

4. Setting the Compass (Your Goals)

We’ll wrap up by asking: “If therapy works, what will be different in your life three months from now?”

• Maybe you’ll be able to turn off your laptop at 5:00 PM without a panic attack.

• Maybe you’ll feel more present during your weekend hikes instead of mentally rehearsing Monday’s meetings.

• Maybe you’ll simply feel like you again.

Frequently Asked Questions":

Do I have to talk about my trauma right away?

No. In a trauma-informed practice, your safety is the priority. We work at the pace of your nervous system. In the first session, we focus on stabilization and resources. You only share what you feel comfortable sharing, and we will never "force" a breakthrough.

Is telehealth as effective as in-person therapy for burnout?

Yes. Research shows that online therapy is just as effective for treating burnout, anxiety, and trauma. For many high-achievers in Colorado, telehealth reduces stress by eliminating the commute, allowing you to settle into a session from the comfort of your home or office.

What if I don't know what to say?

That is completely normal! Part of my job is to guide the conversation. I’ll ask specific questions about your life transitions, your physical symptoms of stress, and your goals. You don’t need to have a "script" prepared; just showing up is enough.

How long does a session last?

Standard sessions are 50 minutes. This gives us enough time to check in, do the deep work, and "ground" you before you head back into your day.

Can you see me if I live outside of Colorado?

Because I am a licensed professional counselor in Colorado, you must be physically located in the state at the time of our telehealth session. This allows me to provide specialized care tailored to our unique local culture and uphold state regulations.