Even though I had nearly 5,000 hours of clinical experience across four agency settings by the time I finished grad school, I was completely freaked out by the prospect of doing my first therapy session in private practice. I felt like I didn’t have any tips for the first therapy session at all.
With no one handing me a systematized intake process to follow, it seemed like a giant black box with the potential to make so many mistakes.
So in this article, I’ll offer my top tips for the first therapy session for therapists, so you can feel ready to see clients for their very first session with you!
Part of the beauty of private practice is that you get to create your own system – within the laws and guidelines of your governing board, of course.
But that degree of freedom can also feel really scary: how do you create an entire intake process from scratch?
Be sure to check in with your governing board to ensure you include all the required components in your intake process with therapy clients.
With that said, here are the steps I take for the first therapy session with every new client. Feel free to tailor it to make it your own:
7 tips for a great first therapy session for therapists
Believe it or not, much of the work that goes into a successful first therapy session happens before a new client ever steps foot into your office. So you’ll notice most of these tools apply to before the first session even begins:
1. respond to basic logistical questions
Nearly all potential clients contact me through email. So after responding to the initial email answering any logistical questions, such as whether I’m accepting new clients and what my availability is, I offer to chat over the phone if they’re interested in exploring whether we’re a good fit to work together.
At this point, not everyone responds back. Keep in mind that reaching out to a stranger in order to seek help for your most private concerns is incredibly daunting. I used to follow up if I hadn’t heard back from someone after a week or so, but I stopped doing this after realizing that usually, people had a good reason for not returning my message.
2. schedule an initial phone screening
For those who reply saying they’re interested in a free initial call, we set up a time for that call via email.
I have a whole article about the initial phone call, so I’ll link to that here if you’d like help with that portion of the intake process. You can find that article here: Initial Phone Screen in Counseling Private Practice.
3. send a confirmation email
If after the call they decide to schedule an initial therapy session, I ask for their permission to send further details via email, including my process for completing the intake paperwork.
It took me forever to fine-tune this initial email so it struck a balance between serving as a reminder of key details such as the appointment time, location, and cost, without it feeling like an overwhelming dump of information.
I really think having this email helps mitigate no-shows because it lays out all the logistical information clearly, and offers an opportunity to know what to expect when they arrive. Here are some items you might consider addressing in that email confirmation:
- Do you have a waiting room?
- Can they expect to cross paths with someone like a receptionist?
- Is there anything special they should know about directions or parking?
- If you offer teletherapy, how can they access your virtual therapy office?
- How can they access and complete your intake paperwork before the appointment?
Laying out these details in advance makes it more likely that clients will show up to the first session.
To help you get the ball rolling, I have a free template of that initial email. Feel free to take a look at mine and tailor it to your own needs. You can find that template here: Free Appointment Confirmation Email Template.
4. send clients instructions for your intake paperwork
During that initial call, I also ask for permission to input clients’ information into my HIPAA-secure EHR platform so they can access the intake paperwork and receive reminders of our upcoming appointment.
Here are a few options for how you can invite your clients to complete their intake paperwork:
- Have the forms available in the waiting room for the client to complete a few minutes before they arrive
- Send the forms in an email attachment for the client to print and complete in their own time
- Use HIPAA-secure online software like TherapyNotes to invite potential clients to complete the paperwork online
If you do go with the option of having your clients fill out the forms in your waiting room, just be aware that most of the time, despite your best efforts to ask clients to arrive early, they will show up right at the start of their appointment time. Then they need 5-15 minutes to complete the paperwork and you’ll have a pretty short intake assessment.
5. help clients feel comfortable on arrival
Once clients arrive in the waiting room, I make every effort to greet them a few minutes before our session, offer a glass of water, and point out the restroom. If I’m not available to do this, I give instructions to our receptionist to make these offerings to my client on my behalf and to let them know that I’ll be with them shortly.
6. start with hospitality
I believe the first few seconds of interaction with new clients are really important. Most clients feel incredibly nervous when they first arrive, so I find it valuable to lean on hospitality for just a few seconds when they first walk into my office and take a seat.
I like to ask if they found the office alright and I offer to adjust the temperature of the room. I also ask if they had any questions about the intake paperwork. If a client appears especially nervous, I let them know that they can take a breather for a second since I have a little spiel that I go over with everyone.
7. go over the initial spiel
Of course, the “spiel” is going over the limits of confidentiality, reminding clients that they have no obligation to schedule a follow-up appointment after our first session, and reiterating my cancellation policy as outlined in the informed consent. I also go over what I do if I cross paths with a client outside the office because, I’m telling you, it happens ALL THE TIME.
And then I go through my intake assessment. This is based on your own style and training. My personal structure is to spend about 10 minutes reiterating the presenting issue, about 30 minutes going through the client’s history, about 10 minutes collaborating on a treatment plan, and a buffer of 10 final minutes to answer any questions, schedule a follow-up session if they wish, and to pay for the session.
Whew! And that’s about it!
I hope you found these 7 tips for the first therapy session helpful as you prepare to see clients in your practice. Here are a few other resources related to the initial session you might find useful:
If you’d like some help with your intake paperwork, check out the Private Practice Startup’s awesome paperwork package. Grab your customizable, attorney-approved private practice forms here with these sweet coupon codes (these are affiliate links):
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And until next time, from one therapist to another: I wish you well!