Your first therapy session with Santos Counseling typically focuses on getting to know you, understanding what brought you to therapy, and discussing what you would like to work on. Your therapist may ask about your current concerns, relationships, family history, mental health history, coping strategies, and goals for therapy.

During your counseling session, you should also have an opportunity to ask your therapist questions. You don’t need to have everything figured out before your first appointment. The first session is a starting point for you and your therapist to determine how you may work together.

For your first session, you may have questions about the process. We encourage you to start with whatever feels most important to you.

For some, this may mean that you might talk about what led you to schedule the counseling appointment, symptoms you’ve been experiencing, a recent challenge, relationship difficulties, stress, or changes you would like to make in your life.

It’s okay if you don’t know where to begin. You can simply tell your therapist during the session, “I’m not sure where to start.” Your therapist can ask questions and help guide the conversation.

You are welcome to ask the counselor many questions. The goal is for you to feel heard and supported. Some helpful questions to ask your therapist include:

• What experience do you have working with concerns like mine?
• What type of therapy do you use?
• What can I expect during our sessions?
• How often do you recommend meeting?
• How will we determine my therapy goals?
• How will we know if therapy is helping?
• What happens if I don’t feel like we’re making progress?
• What should I do if something about therapy isn’t working for me?

Yes, it is normal to feel nervous before the first counseling session. You may notice that your nervousness shows up as uncertainty or discomfort. That’s okay.

You may be preparing to discuss personal experiences with someone you’ve never met before, so some anxiety is understandable. You can tell your counselor during the counseling session that you’re nervous. You don’t have to immediately discuss your most difficult experiences. Building comfort and trust with a therapist can take time.

Please know that you don’t need to arrive at therapy with a prepared topic. Come as you are. If you aren’t sure what to talk about, your counselor can help by asking questions about how you’ve been feeling, what has been happening recently, your relationships, stressors, coping skills, or your goals.

You can also talk about what happened before your last session, something you’ve been thinking about, like a difficult interaction, or even the fact that you don’t know what to talk about.

A good therapeutic relationship should be made up of a space that allows you to feel heard, respected, and comfortable enough to gradually be honest about your experiences.

After several sessions, consider asking yourself:

• Do I feel listened to?
• Does my therapist seem to understand what I want help with?
• Can I ask questions or disagree?
• Do I understand what we’re working toward?
• Do I feel respected rather than judged?
• Does the therapist’s approach make sense to me?

No, you do not have to answer every question that your therapist asks. You can tell your counselor when you aren’t ready to discuss something. You can let them know the topics that you are okay discussing now and those that you prefer to talk about in the future.

Before your appointment, consider writing down:

• Your main reasons for starting therapy
• Symptoms or concerns you’ve noticed
• Questions you want to ask your therapist
• Current medications, if relevant
• Previous counseling or mental health treatment
• Important life changes or stressors
• A few goals you would like to work toward

The length of a therapy session depends on the therapist, practice, and type of appointment. At Santos Counseling, the length of the counseling session is typically 45 to 50 minutes. This can vary if the counseling session is an evaluation or a specialized service.

At Santos Counseling, we offer counseling in-person and online to anyone in North Carolina. For an in-person counseling appointment, you may need a photo ID, insurance information if you’re using insurance card, payment information, and any paperwork requested by the counseling practice.

We also encourage bringing a list of medications, previous diagnoses or treatment information when relevant, and questions you’d like to ask.

Crying during your counseling session is okay and normal. People come to therapy to discuss experiences that can be emotional, stressful, painful, or deeply personal.

Please know that you don’t need to apologize for becoming emotional. Your therapist can give you time to process what you’re feeling and help you continue when you’re ready.

We encourage you to take your time in counseling. Sometimes, it can take several sessions before finding a rhythm in counseling. One session may not always be enough to determine whether a counselor is the right fit, especially if you’re nervous about starting therapy in general or if there are goals and concerns that require longer-term counseling.

However, if something doesn’t feel right in counseling, you can discuss your concerns with your therapist or our administrative team at Santos Counseling. Sometimes a conversation about expectations, communication style, or treatment approach can improve the therapeutic relationship.