What to Expect from a First Counseling Appointment

Posted by Lauren Presutti in Life After Paralysis on June 13, 2022 # Health

In the early days and weeks after a spinal cord injury, everything is about rehabilitation. Many days are flooded with all types of doctor appointments, physical therapy, occupational therapy, medical equipment appointments, and dedicated time to relearning how to do everything in your life. It’s overwhelming and exhausting, to say the least. For those living with paralysis and their family members, this trauma takes a huge toll on your mental health. You may have had some counseling right after a spinal cord injury, but it’s also important to maintain your mental wellness throughout your whole life.

No matter where you are in your paralysis journey, it’s understandable that starting counseling can be nerve-racking. You might have some nervousness or anxiety about the first appointment. This is completely normal, and your feelings are valid. It’s important to normalize your apprehension but also remind yourself that working through a little bit of discomfort, in the beginning, is worth the positive outcomes you will gain from counseling. To help ease your worries, let’s talk about what to expect from a first appointment.

The first appointment is usually an opportunity to express what brought you to therapy, how you’re feeling, your expectations, and any questions or concerns about the treatment process. You don’t need to “prepare” anything, and it is perfectly okay if you’re feeling unsure how to express yourself. The therapist’s job is to guide you and answer any questions you have about therapy. Therapists don’t expect you to perfectly articulate what’s on your mind, and they don’t want you to recall a rehearsed narrative. Instead, therapy is all about being honest and candid.

Your therapist may ask a series of questions to better understand your needs. For example, your therapist might ask about your mental health history, your family relationships, how you feel about your school/job experiences, or information about the trauma you have experienced. These questions might feel boring, but they help your therapist better understand you so they can make the therapeutic experience as beneficial as possible for you. In addition, your therapist may ask you about any counseling from your past. If you’ve had past treatment, it will be helpful for you to share what you liked and disliked about your past experiences.

Goal setting is also an important part of the first appointment. What do you hope to gain from therapy? If you’re not sure, don’t worry! In most cases, your therapist will help you clarify your goals, and you can expect to leave the first session with a plan for future sessions. Maybe you want to work on stress-management and developing stronger coping skills. Maybe you want to work on paralysis-related trauma, emotional regulation, finding balance in life, building stronger relationships, discovering your life purpose, overcoming school/job challenges, or resolving family conflicts. Or maybe you are starting therapy to establish a safe outlet to vent about day-to-day frustrations or for general processing of who you are and how you relate to the world around you. No matter what your goals are, your therapist will talk through these ideas with you.

The first appointment should also be an opportunity to decide if this is the right therapist for you. It’s extremely important that you feel completely comfortable and connected to your therapist. Sometimes you just don’t click with a person, so it’s really important that you keep searching for other resources if you don’t feel comfortable with the first therapist to try. Therapy can only be productive and successful if you are able to connect deeply and form a strong alliance with your therapist.

As a therapist myself, I truly commend you on your decision to start therapy. It’s so important for all of us to have a safe outlet to talk about what we think and feel. Living with paralysis – or caring for a family member with paralysis – is not easy. It’s okay to be frustrated and experience a wide range of emotions from time to time. But bottling up your feelings will likely make your emotions feel more amplified. This is why therapy can be so helpful. Having a confidential, non-judgmental space to talk about what you’re going through can make a transformative difference.

To learn about River Oaks Psychology, visit www.riveroakspsychology.com and follow River Oaks Psychology on Facebook, Instagram, Twitter, YouTube, and LinkedIn.

The National Paralysis Resource Center website is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $8,700,000 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.