[August7682]

I am going to my first appointment ever with a therapist in about a week. What should I expect? I am being taken by my mom for possible PTSD, but I am really needing it for depression and self harm too. My mom doesn't know about the SH..
Anyway, will I be expected to express all the issues in this one meeting? Also, what else will I be asked? Do you usually get diagnosed the first visit? And is the therapist in charge of recommending medication? Sorry I have so many questions, but I am super anxious about it and I have literally no clue what to expect.

[kecanoe]

At your first appointment you will probably be asked why you are there. This will probably include some "history"-what events in your life have led you to the point of seeking help. I don't think that anyone ever gives the whole picture at the first appointment, your therapist will not expect you to fully disclose everything. It takes time to build trust and they know it.

You will probably not get a diagnosis at your first appointment. If your therapist thinks you would benefit from medication s/he will likely recommend you see a psychiatrist. Psychiatrists can prescribe medication. Your therapist may or may not have an opinion about what meds will help you-that really depends on their experience and interests.

Everyone is anxious at their first appointment. It's totally normal. But you can share what you want to share and keep to yourself what you want to keep to yourself. You can always say that you don't want to answer a question.

I try to be as truthful as I can, but I also understand that there are some things that I am just not ready to say.

[Argonautomobile]

I think it's awesome that you're going to see someone; it takes a lot of courage to put yourself out there like that, and I think it's a good sign that your mum cares enough to set this up, even though she might not know the extent of everything.

It's normal to feel nervous--who wouldn't? But if the T is any good at all they should be able to help you feel at ease. Don't worry; you're not expected to talk about EVERYTHING on the first visit. Often the T will take a history, ask generally what brings you to therapy, and offer to talk a bit about him/herself and what s/he offers. If I could go back in time I'd take advantage of this; it's an excellent opportunity to ask questions.

You could be diagnosed in the first visit, sure--but this is really just a general observation and the diagnosis is really about getting insurance to pay for visits. It sort of depends on the therapist and the situation--this is a great question to ask!

Therapists can recommend medication--most likely they will if a patient seems floridly psychotic or something serious like that, but in general I don't think they're very aggressive about this. Another excellent question for the T.

I hope it goes well and try your best not to be anxious.

Firstly, you deserve a great pat on the back for taking on this first step.

Any first session I have had has more been devoted to getting to know one another. Your therapist will also make an assessment of your needs and what perhaps she/he should put on the agenda for future appointments.

My advisement is to be open rather than close up a like a clam. The more they know what they are dealing with the less prodding you will experience.

Remember that therapy is work; and as such, you need to be a participant. The experience will go much more smoothly and be less of a negative experience.

Also realize they will have likely dealt with far worse. You may experience some degree of 'performance anxiety' but remember they will not be critical of whether you are 'sick enough' to attend. It is also your choice whether you want to attend with or without your support person.

I am sure we on PC are all quite proud of you.

Good luck!

[naia]

You've gotten good responses so I hope I don't repeat. It really depends on the T and what kind of approach they take, whether it is in an agency or not, whether they are a psychiatrist (MD), psychologist (PhD or PsyD), MFT or Social Worker (MA).

Only an MD can suggest and prescribe medications. Others may have ideas, may have even good ideas, but generally they are not really allowed to do that or only do it very carefully.

A psychologist often will do a whole range of tests before they make a diagnosis. Others may have to put something down on paper, especially if they work at an agency or take insurance that requires them too.

You said that you may have PTSD, maybe depression too, plus SH. If you go in with the PTSD as the main thing, probably nothing heavy will be talked about, just a general history. People know that trauma work takes time and won't go into that right away.

If you also go in with depression, then probably more questions will be asked to find out if you do need to see an MD for meds.

I wouldn't worry about the SH right now. Well, try not to anyway. That kind of thing is more common than people tend to think, but it is very private and not something to talk about right away. Even if you wanted to, it's probably better to wait and see. It does take trust, as people have said. You need to see if you like the T, if you feel it will help or not.

I think the main thing to remember when going for the first time, or for any time, is that you are checking them out to see if they will be a match. It may feel like the other way around, but you are the one who is in charge, who sees what it's like, and then can decide if it is right for you.

Even though it's good that you have support from family, therapy is yours and private, even if your mother pays (unless you are under age). The T cannot tell anyone anything. That is the main thing that happens the first time, lots of paperwork, to protect your confidentiality, to protect the T, to make agreements. This takes time though not all T's do it, but they usually have to.

The whole story of your life unfolds over time. I wouldn't go into things deeply until you feel that this is the right T, that you feel safety and trust, that you are clear on what the T is offering.