Most people come into a first therapy session with some combination of relief at having made the call and anxiety about what’s going to happen. Both are understandable. Here’s what the first session actually involves — at least in this practice.
What happens in a first therapy session?
The first session is a structured conversation designed to get a clear picture of what’s going on, what’s brought you in now, and what you’re hoping to change. It is not a session where you are expected to emotionally disclose everything at once. You are not going to be pushed to tell the full story of something difficult before we’ve established any working relationship.
What the intake covers:
- Your history with the presenting issue — when it started, how it’s developed, what you’ve noticed about what makes it better or worse
- What you’ve already tried — past therapy, medication, self-help approaches, and what did or didn’t help
- Relevant background — not a comprehensive life history, but enough context to understand your situation
- What matters to you about getting better — what would actually change in your life if treatment worked
What will you take away from the first session?
By the end of the first session, you should have a clearer picture of what we’d be working on and how. I’ll share my clinical read on what’s going on and what treatment approach makes sense. If that doesn’t fit with how you see things, or if you have questions about direction, that’s the time to raise them.
A good first session doesn’t leave you feeling like you opened up for nothing. There should be a sense of direction — not certainty about everything, but a reasonable picture of what the work looks like.
What if you don’t know how to explain what’s wrong?
A lot of people delay making the first appointment because they’re not sure how to explain what’s going on. They worry they won’t describe it correctly, or that what they’re dealing with won’t “count.” This is almost never the barrier people fear it will be. Part of the therapist’s job in the first session is to help you articulate what’s going on — you don’t need to arrive with a prepared summary.
If you can describe roughly what’s been happening and what made you finally reach out, that’s enough to get started.
What happens in the free 15-minute consultation?
Before the first full session, I offer a free 15-minute phone consultation. This is a low-stakes way to ask basic questions, get a sense of whether this feels like a fit, and decide whether you want to schedule. You don’t need to make any decisions during the consultation — it’s just a conversation.
Frequently asked questions
How do I schedule a first session or consultation?
Use the contact page to reach out, or call (719) 224-9846 or email ryan@decookmhs.com directly. The first step is a free 15-minute consultation where we can talk through what you are dealing with and whether this is likely to be a good fit.
How long does therapy usually take?
It depends on what you are working on. For panic disorder, meaningful improvement often happens within 8–20 sessions of structured CBT and mindfulness. Trauma work varies more — some people with less complex events move through processing relatively quickly, while others need more time. I will give you an honest picture of what to expect as we go.