Finding a Therapist in Fairfax, VA: First Session Jitters? What a Local Therapist Wants You to Know

First Session Nerves?

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You’ve made your first appointment for a session with a therapist in Fairfax, VA, but now that the day is approaching, you are getting nervous. Even if you had a great connection during your consultation call, it is normal to have doubts as the appointment approaches. You may feel uncertain about what to say or worried about being judged (especially if you have had less than stellar experiences with therapists in the past!). You may even feel embarrassed about seeking out therapy to begin with.

The thing is, overwhelmed, over-functioning women often worry about taking time for themselves. But your needs are valid too! Seeking support is an important step in beginning to prioritize yourself and it can help with exhaustion and burnout too. Check out my previous post on the surprising ways therapy can improve your life if you still need convincing.

The good news: first session jitters are totally normal, and your therapist will be expecting it. The first session is usually designed to be gentle, collaborative, and more structured as the two of you get to know one another. Read on to find out what to expect and how to prepare.

What To Expect in Your First Session

Before your session, your therapist will have you fill out paperwork, including information about you, a consent form that clarifies the policies of the practice, a notice of privacy practices (HIPAA) form, and possibly a payment form. Your therapist uses this information to set up your file and prepare for your meeting. The therapist should also review of some of these important policies (confidentiality, fees, etc.) in session to ensure that any questions are addressed.

The first session is, above all, an opportunity for you and your therapist to start building a relationship. Your therapist will ask you questions about your current symptoms and concerns, your goals, and your day-to-day functioning (sleep, appetite, etc.). Depending on the modality, they may also ask about your family and relationship history.

Remember that this is not an interrogation. You are building a collaborative, mutual relationship here, so you have a say in how it goes. A good therapist will listen, ask questions, and invite your priorities into the discussion. And you should feel free to interrupt and ask questions or request clarification at any time.

The session typically ends with collaborative goal setting and discussion of next steps for your work together. A good therapist will also check in to see how things are feeling to you as the session is ending.

Practical Ways to Prepare

Some folks want to come into the first session fresh and feel things out as they go. For others, they may feel better having prepared some ahead of time. If that is you, here are some things you can do to feel more “ready” for your first therapy session:

• Jot down your top 3-5 priorities and concerns. This will help to keep the session focused.

• Write a brief timeline of major stressors, recent changes, and what you’ve already tried to avoid rehashing with your therapist.

• Plan ahead to make sure you arrive with plenty of time and don’t feel rushed.

• For virtual sessions, choose a private, comfortable space where you will not be disturbed, and test the connection ahead of time to minimize technical issues.

• Plan a simple aftercare routine post-session (something small and soothing like a walk, a cup of tea, or a brief rest) to manage the emotions that might come up.

  
  

Remember that the first session is just that: the first. You don’t have to get to everything that ever happened to you in that first 45-50 minutes!

Common Worries Therapists Want You to Know

“What if I cry?”

Crying is more than okay, it is welcomed. Crying is your body’s way of releasing emotion out into the world. It is healing and healthy, and therapy is the perfect place for it.

“What if I don’t have the right words?”

Silence is okay too. In fact, silence can be very useful and informative about what might be going on for you. Therapists are trained to be comfortable with silence, so don’t feel like you have to fill the spaces.

“Will my therapist judge me?”

A good therapist prioritizes safety, curiosity, and a nonjudgmental stance. Therapy should feel like a judgement free zone! That being said, fit matters, so if you do feel judged, you should definitely let your therapist know. Depending on their response, it may be worth looking into a new therapist.

"Do I need to be in crisis to come to therapy?”

Absolutely not! In fact, most deep work happens when we are not actively in crisis. Therapy helps with ongoing overwhelm, building healthy relationships, and many more ongoing issues.

“What if therapy doesn’t work?”

Progress often comes in small steps over time. A good therapist will discuss measurable goals and adjust their approach if things seem to be stalling.

Evaluating Fit

Research has repeatedly shown that the fit between the client and therapist is the most robust predictor of success in therapy. If you and your therapist are a good fit, you should feel heard, experience a collaborative tone, and have some sense of a plan. Unless you have a really bad experience up front, you will generally want to give it a few sessions (~3-6 is reasonable) to assess initial progress and working relationship.

If, after a few sessions, you feel that the fit is not there with this therapist, that is okay too! It is totally fine to ask for a referral or try another therapist on your list. This is a common as you try to find the right match for you. Just be polite and kind, but direct. Trust me, your therapist would much rather know what went wrong than have you just disappear. As you go back to your search, keep notes about what the issues were, or what you need to look for next time.

Remember, when you are getting ready to meet with a therapist in Fairfax, VA, nerves and uncertainty are totally normal! And your therapist will know this too. That is why these sessions are designed to be safe, practical, and goal oriented. They may even leave you with something to take back with you into your real life to help you prepare for the next session (e.g., paying attention to patterns that keep you stuck, practicing saying “no” in one small way, or a breathing or mindfulness exercise to experiment with). The most important thing is to begin – it’s always easier the second time!

Rachel W. Friendly, Ph.D. — Clinical Psychologist and Therapist in Fairfax, VA. I specialize in supporting overwhelmed, over-functioning adult women who struggle to center their needs, set boundaries, and manage the chronic exhaustion that ensues. I offer compassionate, evidence based individual therapy designed for busy lives. Click here to learn more about my approach or schedule a confidential consultation today.