What Actually Happens in a First Therapy Session

The first appointment is the one people rehearse for, and it is almost never what they rehearsed.

I get a lot of questions before a first session. What am I supposed to say. How much detail do you need. What if I get there and go blank. So here is a plain description of how I run one, in case knowing takes some of the weight off. Trauma therapy in Washington DC.

You do not need to arrive with a summary

Plenty of people start with some version of this has gone on long enough and I would like it to be different. That is a completely workable place to begin.

You do not need a diagnosis, a tidy chronology, or a theory about what is wrong with you. If you had all that worked out you probably would not need the appointment.

Most of the first hour is me listening

I am mostly trying to understand two things. What is happening now, and what your system is doing about it.

That second part matters more than people expect. Two people can describe the same event and be in completely different situations, because one nervous system has filed it as over and the other has filed it as still happening.

So I will ask about sleep, about where you feel it physically, about what you have stopped doing. Not to be thorough for its own sake. Those answers tell me what we are actually working with.

We go at a pace your system can handle

This is the part I want to be most clear about. You are not required to tell me the worst thing in the first hour.

I care less about the story details than about what the body and mind still treat as current threat. Flooding someone with a full memory before their system can handle it is usually counterproductive. If something is too much to open yet, we leave it closed and come back when there is more support around it.

Nobody has ever lost my respect for saying not yet.

It is also an assessment of me

A first conversation is mostly about whether the way I work fits what you are carrying. That runs in both directions.

You are allowed to decide I am not the right person. If I think that too, I will say so and try to point you somewhere more useful. Fit does a lot of work in this, and a bad fit wastes your time and money.

What we do at the end

Usually we land on something small and specific. Not a treatment plan in a binder. More like a shared sentence about what we are working on, and a first place to start.

Sometimes that is a piece of the loop we can interrupt. Sometimes it is simply agreeing that the thing you have been calling laziness is worth looking at more carefully.

Practical details

True North Psychotherapy is a solo practice, so the person you speak with to schedule is me. There is no intake team, and you are not handed off to someone else after the first appointment.

My office is at 1555 Connecticut Avenue NW, Suite 401A, just north of Dupont Circle. I am a Licensed Professional Counselor in the District of Columbia, license LPC #PRC 14494.

If you want to ask a question before deciding anything, that is a fine reason to get in touch. There is no pressure on the other side of that call.

Ariel VanDoren, LPC

True North Psychotherapy

1555 Connecticut Avenue NW, Suite 401A, Washington DC 20036

202.599.0522