Your first anxiety counseling session

What happens in a first counseling session for anxiety?

A first session for anxiety is a conversation about what the anxiety is like for you, not a test you can fail. Expect questions about what has been happening, how long it has been going on, where you feel it in your body, and how it affects your sleep, your work and the people around you. You talk; the counselor listens, asks, and starts to understand the shape of things.

By the end you should have a rough sense of what you might work on together and what the next few sessions could look like. Nothing has to be solved in the first hour, and no honest counselor will promise that it will be.

This page is about anxiety in particular. For the general practicalities of starting with Laura at her Columbus office, such as paperwork and how couples sessions begin, see what to expect at the Healing Cottage.

What might Laura ask about your anxiety?

Every counselor has their own way of starting, so ask Laura how she likes to structure a first session. These are the kinds of questions that commonly come up when anxiety is the reason someone calls:

• What made you get in touch now, rather than six months ago?
• What does the anxiety feel like? Racing thoughts, a tight chest, a churning stomach, trouble sleeping, a sense of dread?
• When does it get worse, and when does it ease? Are there places, people or times of day that set it off?
• What have you started avoiding because of it?
• What have you already tried, from exercise or prayer to medication or another counselor, and what helped even a little?
• Who knows about it, and who would you like to know?
• What would be different in your life if the anxiety took up less room?

You do not need the right words

Many people with anxiety rehearse a first session in their head and then forget half of it in the room. That is normal. You can say that you are nervous. You can read from notes. You can say that something is too hard to talk about yet, and come back to it later or not at all.

You also do not need a diagnosis. The National Institute of Mental Health describes feeling anxious as a normal part of life, and says anxiety becomes something to bring to a professional when it does not go away, gets worse over time, or interferes with daily activities such as work and relationships. That is enough of a reason to come in.

Laura works with the whole person: mind, body and spirit. In practice that means you can talk about what is happening in your thoughts, what is happening in your body and, if it matters to you, what is happening in your faith or spiritual life. You choose how much of each belongs in your sessions, and it is fine to want talk therapy alone.

What to bring and how to prepare

The National Institute of Mental Health offers a short set of tips for talking with a health care provider about mental health. Its advice works well for a first counseling appointment too:

• Prepare your questions. Write down what you want to say and anything you want to ask, because nerves make it easy to forget.
• Bring a list of your medications, including over-the-counter drugs, vitamins, herbal remedies and supplements.
• Be honest, including about alcohol, sleep and anything you feel embarrassed about.
• Ask questions about anything you do not understand.
• Bring your insurance card if you plan to use insurance, and the names of any doctors you would like Laura to be able to contact with your permission.

Talking about privacy at the start

In Polk County, privacy is often part of the anxiety. A first session is the right time to ask how confidentiality works, what its legal limits are, how records are kept and what happens if you run into each other in town. Any licensed counselor should explain these things plainly, and you can ask follow-up questions until the answers make sense.

If you would like to read about this beforehand, the pillar page on anxiety and privacy in a small town covers the common questions, and what therapists can and cannot share goes into the limits in more detail.

After the first session

It is common to feel tired, relieved, raw or a little more anxious for a day or so after talking about things you usually keep to yourself. That does not mean counseling is making things worse. It is worth mentioning at the next session, because how you felt afterward is useful information.

Give yourself a few sessions before deciding whether the fit is right. The National Alliance on Mental Illness suggests asking yourself whether you feel comfortable with the person and whether they seem to be on your side. If the answer is no after a fair try, it is fine to say so and look elsewhere. A good counselor will not take it personally.

If you are wondering how long counseling for anxiety usually lasts, how long anxiety counseling takes looks at what affects the length. Laura does not promise particular results, and no honest therapist will.

How to book a first session with Laura

Laura Bass is a psychotherapist who works with adults in individual counseling, and anxiety is among the concerns she lists. Her main practice is in Charlotte, and she has a part-time office at The Healing Cottage in Columbus. Call 704-706-3264 or use the contact page. A short message is enough: your name, the best way to reach you, and that you would like to talk about anxiety.

When you get in touch, ask which days she is in Columbus, how long a first session lasts, what it costs and whether your insurance applies. Questions to ask before you start has a longer list.

Counseling is not crisis care. If you are in crisis, call or text 988 at any hour, or call Vaya Health's crisis line for Polk County at 1-800-849-6127. If anyone is in immediate danger, call 911.

Common questions