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Experts answer: What to expect from your first therapy session

"There is still a lot of stigma associated not only with seeking therapy but the overall mental health domain as people often don't recognise mental health issues as clinical issues that require treatment," said Dr Madhusudan Singh Solanki

therapyKnow what you can expect from your first therapy session. (Photo: Pexels)

While increasing conversations around mental health during the pandemic have definitely helped lift some of the stigma associated with talking about it and seeking help, the work is far from done. A lot of people still feel hesitant to reach out for professional help when undergoing mental and emotional distress. However, it’s important to do so for a life that is holistically healthy and nurturing, and therapy is essential for that.

Who should seek therapy?

“Therapy is an intensive process of reflection and introspection to bring about requisite changes for self-growth and acquiring healthy coping skills for better adjustment in life,” said Mimansa Singh Tanwar, clinical psychologist and head, Fortis School Mental Health Program, Fortis Healthcare Ltd. She added that “therapy is not only for clinical disorders, but also when you recognise that you are struggling with life situations which are impacting your emotions, thoughts and actions.”

Dr Madhusudan Singh Solanki clarified that therapy is a broad term including various forms of “talk therapies” like short term supportive counselling, cognitive behavioral therapy, behavioral therapy, client-centred therapy to long term psychoanalytic psychotherapy, to mention a few. “Depending on the participants, it can be categorised as individual, couple, family or group therapy. When it comes to recommending therapy, there is no one size fits all formula; it depends on a client’s overall profile including clinical diagnosis, types of extrinsic or intrinsic stressors, psychological mindedness and readiness for treatment or therapy,” he said. 

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How to overcome the stigma?

Dr Solanki said that there is still a lot of stigma associated not only with seeking therapy but the overall mental health domain as people often don’t recognise mental health issues as clinical issues that require treatment. He said, “People need to understand that mental health issues are real issues like physical health issues and can be treated. There is no harm in talking about your issues with a professional as that’s the least one can do to begin with, without the fear of being judged or any invasive treatment.”

Tanwar also pointed out that while talking to and sharing your feelings with friends and family is important, it’s not the same as therapy. She emphasised that “therapy is a non-judgmental, empathetic space where the therapist is a trained professional in evidence-based scientific treatment modalities.”

What to expect from the first session?


“The first session is about meeting your therapist, getting comfortable with your therapist, talking about your issues, including the most pressing issues that made you see a therapist,” explained Dr Solanki. He added that if you are seeing a psychiatrist instead of a counselor or therapist, the first session, most of the times, is about detailed clinical history including psychological issues, medical history, past and family history, and a mental status examination, and based on all that, coming to a probable framework of a working clinical diagnosis, treatment plan, deciding whether one needs medications or therapy or a combination of both. 

Tanwar agreed and said, “You may have several questions and doubts both about the process and how it is going to help. It is essential that voice your concerns and be cognizant that whether they are being responded to or not.”

Dr Solanki also suggested to “keep your expectations reasonable and realistic” as “therapy is never a one session thing and usually the benefits of therapy start becoming evident after client and therapist have worked closely over multiple sessions investing time and effort in the therapeutic process.”


If you are feeling nervous before your first session…

Tanwar said that it is normal to feel so, and he pointed out that “what’s comforting to know is that the process is completely confidential and a good therapist would never judge you for whatever you share during your sessions. Empathetic and non-judgmental listening on the part of therapist is what makes a therapy session healing and comforting for the client. That’s why most of the clients feel a sense of relief after their first session through ventilation of their feelings, thoughts and emotions in a conducive environment.” 

Dr Solanki added that even though you may not be fully ready, willingness to seek help and the entailing process is essential for a fruitful endeavor.

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First published on: 21-02-2022 at 21:40 IST
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