Preparing for your First Appointment
Photo by Kateryna Hliznitsova on Unsplash
Written by, Carley Foster LCPC
You did it! You’ve scheduled your first appointment!
Whether it’s your first or your tenth time seeking mental health support, starting with a new therapist can bring up a lot of emotions. Many people make an appointment with a clinician feeling excited to take positive steps toward their overall wellness. At the same time, beginning a new professional relationship with someone who will come to know so much about you can be anxiety-provoking or even a little intimidating. If your prior experiences in therapy have not been great, there may even be some trepidation about starting again.
Chances are good that the therapist you schedule with has been a client themselves at some point. We can relate to the variety of hopes and concerns stirred up prior to that first appointment. These are all things therapists take into consideration as we get to know you and your unique needs.
You may have noticed that I took a break from contributing to this blog for the last few months. This was partially due to stepping into a new role with the Therapy Collective, which includes being the first point of contact when people reach out to make an appointment. This has me considering what I wish I had known back in the early stages of seeking my own mental health support. As you prepare for your first appointment with a new therapist, here are four things to consider before making your way to the couch, chair, or computer screen:
Check in with yourself about your needs
It can be worthwhile to reflect on your needs prior to a first session. These could include scheduling or other logistics, questions about the clinician’s process, or issues you want to make sure are addressed through the process of therapy. It is common for questions to come up between a phone consultation and the first session once you’ve gotten a little more information.
Asking what has brought someone to therapy is a regular part of any intake process. When I ask what people are hoping to get out of their time in therapy, a response I have often heard from new clients goes something like this: “I’m not really sure, I just know I need help with (fill in the blank).” This uncertainty is a valid response. In fact, I would argue that further uncovering and naming our needs is a natural part of the therapeutic process. You may not yet have the words to describe your experience other than knowing that something feels off, and that is okay. The great news is a therapist can support you with all of this as you get to know one another.
When we enter into new and potentially anxiety-provoking situations, our memory tends to suffer. At the same time, a lot gets covered in that first intake session. It can be easy to forget or miss something you really wanted to say. This is a great time to make a list in case you need to prompt yourself the day of. And speaking of lists…
Know what medications you are taking and information about your provider(s)
If you are being prescribed medication, psychiatric or otherwise, or are taking supplements, it can be helpful to bring a list of these to your session. Some therapists include questions about medication as part of their intake paperwork. Though mental health clinicians are not doctors and therefore cannot prescribe or monitor medication, knowing this information provides your new therapist with a more complete view of what you are experiencing. For example, some medications have side effects that significantly impact someone’s life or ability to function. This would be important for a therapist to know about in the greater context of working with you.
Additionally, telling your new therapist what other providers you see regularly is valuable information. My personal belief is everyone has a “care team” of people and communities who provide support, even if they are not in contact with one another. This could include your doctor, dentist, acupuncturist, a specialist you visit regularly, et cetera. It could also include less obvious members such as your neighborhood gym, a therapy group you are already part of, or even an online community where you receive support. You get to choose who feels like a part of your personal care team. Knowing who you consider to be part of it can alert your new therapist to gaps that may be present or places to lean into for increased support during difficult times. There may even be situations where your therapist would benefit from collaboration with other professionals. For example, a psychiatrist with whom you have a good working relationship and a therapist who you see more regularly can be helpful resources to one another.
Note what you have been experiencing
If you are using insurance to pay for your sessions, diagnosis will be part of your therapy process. You can help this process by noticing what symptoms are causing you distress and thinking about how long you have been experiencing them. Some questions to help get you started include:
What has my sleep been like?
What has my appetite been like?
What has my ability to focus been like?
Overall, what has my mood been like?
What do I find myself thinking about?
Have I noticed any new patterns in the last six months that are not like me?
I like to think of these questions as a sort of “warm up” to therapy. They create mindfulness about aspects of life commonly impacted when mental health difficulties arise. At any point during the process of therapy, you can return to these questions and notice what is changing or not changing. They can be great conversation starters if you are unsure where to begin or if more sensitive topics feel overwhelming to start. You can use them as both a check in for yourself and for sessions where you want to revisit your progress.
Know your insurance copay and/or payment information
If you are using insurance to pay for your sessions, you might be responsible for some or all of the cost. This depends both on your insurance network and your specific plan. Many therapists will verify your benefits for you prior to the first session so both of you are aware of how your insurance works. You can also verify your own benefits by calling the number on the back of your insurance card and speaking to a representative. This representative will be able to confirm the clinician you want to see is in your insurance network and share how much you can expect to pay for sessions. Some terms you might encounter include:
Copay: This is the portion of the cost you are responsible for paying out of pocket. Some companies list your copay on the front of your insurance card. Some insurance plans have no copays at all, while others have copays that vary by the type of provider you are seeking.
Coinsurance: A coinsurance is a type of copay. Rather than a fixed dollar amount, you will be responsible for paying a percentage of the total cost of the service. This means your coinsurance changes based on how much the provider charges.
Deductible: This is the amount you are responsible for paying out of pocket before insurance begins covering costs. Once you meet a deductible, your plan makes you eligible for a copay or coinsurance amount that is lower than what you were paying before.
Preauthorization: Some insurances require your therapist to preauthorize a certain number of sessions before you can access the copay amount. This is less common, but can still happen. Your therapist will usually submit the preauthorization and nothing is required on your part.
If you are not using insurance to pay for sessions, it is still important to have clear expectations about payment and costs. Finances are one of the most challenging conversations to have in a therapeutic context for various reasons. Comfort with your payment situation can free up necessary mental space to do the work you came to therapy for in the first place. If you have any uncertainty or questions about how your therapist processes payment, the first session is an ideal place to resolve those issues.
If you’re reading this post because you’re about to start working with one of our clinicians, congrats! If you’re considering reaching out, as of June 2022, our practice is still accepting new appointments. You can request to speak to a clinician by clicking the link below and completing a form request.