What Will Happen during Our First Family Therapy Session?

Margaret Nichols, PhD: There are different approaches in family therapy and therapists use different methods to obtain the information gathering that takes place in the first session. Some or all of the following will probably take place:

• The therapist will have you all together for at least part of the session, both to hear everyone’s view of the problem that brought you to treatment, and to see how you all interact with each other and what roles you play in the family. She or he will attempt to get the perspective of each family member on a number of important dimensions, not just the presenting problem.
• The therapist may interview sub-units separately, like the parents, for example, or even spend time with everyone individually.
• The therapist will explain his or her rules for sessions—like confidentiality of information disclosed within the family, or who needs to attend ongoing sessions and who perhaps does not. It is sometimes not practical or necessary for everyone to be present.

More important than what happens, is how you feel during and after the session. Everyone needs to see the therapist as on the side of the family, not on the side of a particular member. No one should feel that the therapist blames them for the problem unfairly, or that the counselor has favorites. You should see the therapist as caring—but also as competent. You should have some feelings of hopefulness, that the therapist might be able to help, that it’s worth coming back next time.

Stuart A. Kaplowitz, MFT: During the first family counseling session, I will review the intake paperwork I would have you fill out just prior to us sitting down and talking. I will briefly talk with you about my experience and share how I work with families, specifically how I see myself as part of the team in front of me.

After gaining your consent, I will stress how our work together is indeed confidential and share how if you are motivated, I will have homework and outside of session exercises to try. These tools are geared to reinforce our work together in session. Then, after reviewing some of the concerns you may have pointed out in the intake paperwork, I want to highlight any and all of the things going well in your relationships.

Too often, especially in the face of a challenge, we seem to forget or discount all of the good things and focus solely on the negative. I want to highlight all these good things (your strengths, your partner’s strengths, etc.) and share how we will then use them as tools to best address the concerns you share.

Ruth Hoffman Cooper, MFT: The focus of the first session is on getting to know your family. Your therapist will ask you a lot of questions. What brought you to seek help? When did the problem begin? What seemed to trigger it?

He or she will ask about recent stressors and details of your lives. There will be some forms to fill out, usually in advance of the first session. Your therapist will also be trying to help you feel comfortable and demonstrate to you that he or she cares and understands. Of course, a lot gets communicated without words. The therapist will observe how family members interact with each other, and how they respond in terms of body language to what is said.