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In person in Natick and telehealth across Massachusetts
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Aurora Counseling Associates
Young female therapist sitting on chair and discussing problem with patients during psychotherapy session in group

Your First Therapy Session at Aurora Counseling

Starting therapy is uncomfortable for almost everyone, even the people who decided to do it weeks ago. This page is for you if you have decided to start (or are close to deciding) and want to know what happens. We will walk you through it from the first call to the end of session one.

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How it goes

From first call to first session

Five steps, start to finish. Most people are in a first session within a week or two of reaching out.

  1. 5 to 10 minutes

    The first phone call

    You reach our intake person. They ask what brings you in, what kind of work you want, your insurance and schedule, and any preferences, then match you with a clinician who fits and book your first session.

  2. 15 to 20 minutes

    Paperwork, beforehand

    Consent, the HIPAA notice, a short history, and insurance, all done electronically. Complete them a day or two ahead so the first session is about you, not logistics.

  3. The day itself

    Bring your insurance card and a rough idea of what you want to work on. In person: 20 N Main St, Natick, a few minutes early. By telehealth: click your secure link about five minutes before, from a quiet, private space.

  4. 45 to 55 minutes

    The first session

    A real therapy session, the same length and rate as any other, not a separate evaluation. You do not need to perform, have a coherent story, or commit to anything.

  5. After

    You leave with a clearer picture of the work and whether the fit is right, and usually book the next session then. In the days after, notice whether you felt heard. If it is not a fit, tell us; switching early is fine.

Step by step

How the hour usually goes

  1. The frame, about 15 minutes

    Confidentiality and its limits, cancellations, contact between sessions, and how you would like to be reached.

  2. What brought you in

    Mostly you talking and your clinician listening. Why now, what you have tried, what helped and what did not.

  3. The routine questions

    Sleep, appetite, substance use, and whether you have thought about hurting yourself. Asked of everyone, not a judgement about you.

  4. What happens next

    Agreeing whether to meet again, roughly what you are working on, and how often. Sometimes a referral elsewhere, which is a good outcome rather than a rejection.

What the therapist will do

  • Welcome you and walk you through logistics (where the bathroom is, how the session structure works, confidentiality limits)

  • Ask what brings you in

    Some version of "Where would you like to start?" You can start anywhere. You do not have to start at the beginning.

  • Ask about background as it becomes relevant

    Family of origin, prior therapy, current life context, anything that helps them understand the picture.

  • Ask about safety if relevant

    Suicidal thoughts, self-harm, anything urgent. Asking does not make these things more likely; it makes them treatable.

  • Begin to map what you are working with

    Patterns, strengths, what you have tried, what you want.

  • Discuss next steps

    Frequency, structure, what the next few sessions will focus on.

What you might feel

  • Nervous beforehand

    Almost everyone is.

  • Relief once you start

    Saying things out loud to a person whose job it is to listen often takes pressure off.

  • Tired afterward

    Sessions take more energy than you expect.

  • Some feelings later

    Sessions can stir things up. Plan a low-key evening if you can.

  • Uncertainty about whether this is the right therapist

    Normal in session one. Give it 2-3 sessions before you decide.

None of this is a sign that something is wrong. It is what starting therapy usually feels like, and it settles as you and your clinician find a rhythm.

We do not offer free consultations as a general practice, though the initial 5-10 minute phone call is free.

Questions

Common questions

What if it is telehealth?
You will get a secure link the day before. Click it about 5 minutes before your session. You will need a private, quiet space, a device with camera and microphone, and a reasonably stable internet connection. Headphones help.
Is the first session free?
No. The first session is a regular session, billed at the regular rate. We do not offer free consultations as a general practice, though the initial 5-10 minute phone call is free.
Should I prepare anything?
No formal preparation needed. Some clients find it useful to jot down what they want to make sure they cover; others prefer to come in cold. Either is fine.
What if I freeze in session?
Tell the therapist. They are experienced with this. Often saying "I do not know where to start" is the perfect place to start.
What if I cry?
That is fine. Crying is not what therapy is for, but it sometimes happens. There are tissues. No one is judging.
What if I do not cry?
That is also fine. Therapy is not measured by whether you cry.
What if I think the therapist is not the right fit?
Say so. Either in session ("I am not sure this is going to work") or to our intake person after. We will help you transition to a different clinician.
Can I bring my partner / friend / parent?
For individual therapy intake, the session is typically just you and the clinician. For couples or family intakes, bring whoever is part of the work. Discuss any exceptions with intake when you book.
Will the first session "fix" anything?
No. The first session begins the work. Most clients feel a small amount of relief after the first session and a clearer sense of direction. Substantive change tends to happen over weeks or months.
Do I have to commit to ongoing therapy?
No. You can do one session and decide it is not the right time for you. You can decide after three sessions to stop. You can take a break and come back. All of this is normal.
What if my insurance does not cover this?
We will tell you before your first session if there is a coverage issue. If self-pay is not feasible for you and we are not in-network with your insurance, we will help you find practices that fit.
What if I am in crisis right now?
Do not start with a first session if you are in active crisis. Call 911 or 988 (Suicide and Crisis Lifeline) or go to the nearest emergency department, or call the Advocates emergency line for MetroWest. After the immediate crisis is addressed, outpatient therapy with us can be the next step.
What happens in the first therapy session?
Mostly listening. Your clinician asks what brought you in now, what you have already tried, and what you want to be different, along with routine questions about sleep, appetite, substance use and safety. The first fifteen minutes usually cover confidentiality, cancellations and contact. It is an assessment rather than treatment.
Do I have to tell my whole story in the first session?
No. Say what you can. People often arrive braced to deliver a full chronological account and it is rarely what the hour needs. A clinician who pushes for more than you want to give in week one is doing it wrong.
How long is the first session?
Typically 45 to 55 minutes, the same as any other session.
What should I bring?
Nothing is required. A note of what you want them to know is useful because people forget the thing they most meant to say. Your medication list and the names of your prescriber and primary care doctor help if we are going to coordinate care.
Is what I say confidential?
Yes, with narrow exceptions your clinician will name at the start: a serious risk of harm to yourself or someone else, suspected abuse or neglect of a child or vulnerable adult, and a court order. If you are using insurance, a diagnosis is recorded for billing and your clinician will tell you what it is.
Will I get a diagnosis in the first session?
Sometimes, if you are using insurance, since a diagnosis is required for the session to be billable. Your clinician will tell you what they are recording. A first-session diagnosis is a working judgement rather than a permanent label.
What if I do not know what to say?
That is common and it is your clinician's job to make the hour work anyway. "I do not know where to start" is a perfectly good opening line.
What if it does not feel right?
Say so. How you feel after two or three sessions is real information. Changing clinicians within the practice is straightforward and is not something anyone takes personally.

Get started

Ready when you are

If you have read this far, you are probably ready. Request an appointment or call (508) 650-0991. The first call is short, and we will figure out the rest from there.

Book a free 15-minute consultCall 508-650-0991