This content was created by Natalie Moore, LMFT. This content was uploaded by Natalie Moore, LMFT. This is a YouTube video titled "What Happens in a First Therapy Session? ☝️" (uploaded April 10, 2017) featuring therapist Natalie Moore speaking directly to viewers about what to expect in an initial therapy appointment. The speaker (a therapist in Pasadena) explains informed consent and confidentiality (including mandated-reporting limits in California), describes how she establishes safety and trust through reflective listening and validation, and outlines how treatment goals are identified or emerge during the first session. The content is an informational/educational solo-presenter video aimed at people curious about starting therapy.
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Hey guys, I'm Natalie Moore, a therapist in Pasadena, and today's video is going to go into what exactly happens in a first therapy session. This video is for those of you who have not tried therapy yet and are curious what exactly happens in a first session. Of course, it depends on the therapist, so I'll give you a sense of what it's like to to have a first session with me. So the first thing I do with clients before anything else is I go over with them what's called an informed consent document. This sounds really boring, but I go over it super briefly, and the idea is that we're both starting the therapeutic relationship on the same page, literally and figuratively. So the first thing that I talk about with the informed consent is confidentiality. I talk about what's confidential and what isn't. So basically, in therapy, everything that the client tells the therapist is confidential except for 5 situations: if they disclose child abuse, elder abuse, dependent adult abuse, or if there is serious harm to themselves or others. In the state of California, therapists are mandated to report any of these 5 instances. Other than that, everything is completely confidential. After reviewing informed consent with a client, I mainly want to help the client feel as comfortable as possible. So I'll probably ask them, "How are you doing?" or "What brought you to therapy?" Something simple like that to get conversation started. When I ask clients what it is that brought them to therapy, it's usually a very long answer. And so typically in a first session, I find that I don't even have a chance to do much talking. Usually the client has so much that they want to share that they take up the majority of the first session, and that's fine. I'll have plenty of opportunities to use interventions and to share my opinions and feedback later on. In order for therapy to work, the client has to trust the therapist. So my main job in a first session is to make sure the client feels safe. So what I'll do is I will attend to the client and what they're talking about. I will reflect for them what they're expressing to me so that they know I get them and hear them, and I'll validate any of the concerns and feelings that they have. This really helps build trust in that first session. Lastly, by the end of the session, I will figure out a way to help the client develop some treatment goals for moving forward. This might be in the form of asking the question, "If we work together and things were going well and you were getting better, how would you know? What would be different in your life?" Or it could be simply asking, "What are your goals for therapy?" Sometimes therapeutic goals come about organically in the first session without even having to ask. Some clients don't know what their goals are for therapy. They just know that they don't feel right and they need some help and guidance, and that's okay too. If you were curious about what a first therapy session is like, I hope this video took away some of the mystery. Please stay tuned for future videos. See ya!
