Starting couples therapy is a big step, and your first session is an important part of the process. Whether this is your first time seeking therapy or you’ve tried it before, it’s normal to feel a little nervous or unsure about what to expect. The first consultation is designed to help you understand if it’s the right fit for you and your partner while giving your therapist insight into your relationship dynamics.

Here’s a breakdown of what to expect during that first call or session, and why some therapists choose not to take insurance

1. Finding the Right Fit

The first session is less about diving into deep emotional work and more about getting to know each other and determining if you and your therapist are a good fit. Every therapist has a different style, so it’s essential to see if their approach resonates with both of you.

During this time, I may ask about your goals, what challenges you’re facing in the relationship, and what you hope to accomplish in therapy. This helps me understand your needs and determine if my style and approach will work well for you.

2. Why Not Take Insurance?

When it comes to couples therapy, choosing not to take insurance allows me to focus on the unique dynamics of your relationship. Unlike individual therapy, which often involves diagnosing and treating a specific mental health condition, couples therapy is about the interactions, communication, and emotional patterns between partners. Insurance companies require a formal diagnosis to provide coverage, but in many cases, couples don’t come to therapy because one person has a mental health issue—they come to work on their relationship as a whole.

Confidentiality is another important reason. When we involve insurance, certain details about your therapy sessions may need to be shared with the insurance company. By choosing a private pay option, we keep everything strictly between us, allowing for a more open and honest exploration of the challenges you’re facing. This also means we can approach therapy holistically, considering relational dynamics, family history, and cultural influences without the need to tie everything back to a medical diagnosis.

In short, when it comes to couples therapy, not using insurance provides the freedom to focus entirely on your relationship, ensuring that the process is driven by your goals and not limited by external requirements.

3. The Depth of Work: Getting Real, Fast

In the first session, while we’ll start by getting to know each other, couples therapy often moves into deeper territory quite quickly. I like to take the time to understand what brought you both here and what goals you have for the relationship.

During this session, I’ll be exploring how you and your partner interact—looking at emotional patterns, communication styles, and any recurring conflicts that have been causing tension or misunderstandings. You might find that I ask questions about how you typically express your feelings or handle disagreements. This isn’t to make anyone feel uncomfortable but to help me understand the underlying dynamics that are playing out between you.

4. Work Style and Approach

I use a systemic and relational approach, which means looking at how your current struggles might be connected to family dynamics, cultural background, and patterns of relating. I see your relationship as existing within multiple systems—your families of origin, your cultural identities, and even the larger social context in which you both live.

I’m interested in learning how the experiences from your past, have shaped the way you relate to each other today. For example, how conflict was handled in your family growing up can significantly impact how you communicate or navigate disagreements in your relationship now. I might ask questions about your childhood, how emotions were expressed (or not expressed), and what messages you received about relationships from an early age. These patterns often carry into adulthood, influencing your connection with your partner.

I often find that couples aren't always aware of the ways they might be triggering each other or repeating relational patterns that are no longer serving them.

For some couples, cultural values around gender roles, family expectations, or communication styles play a big part in their struggles, so I’ll always consider those elements as well. 

5. Logistics and Policies

We'll take some time to go over the logistics of therapy. I’ll explain my policies, including how we handle scheduling, fees, cancellation policies, and how we can stay in touch between sessions if needed.  I’ll also cover what you can expect in terms of session length and how often we might meet.

6. First-Time Therapy? That’s Okay!

If this is your first time in therapy, it’s completely normal to feel unsure or a bit hesitant. I understand that starting this process can be daunting. My role is to provide a space where you both feel comfortable and supported as you explore your relationship.

7. What Happens Next?

After the first session, I'll summarize the main goals you and your partner want to work on. You’ll leave with a clearer sense of what the therapy process will look like and how it can support your relationship.

In Summary: What to Expect?

- An interview-style session to assess fit and goals

- A chance to talk about the deeper, systemic factors affecting your relationship (family, culture, upbringing)

- A multidimensional assessment of where you are as a couple and where you want to go

- Insight into your therapist’s approach, policies, and logistics

Couples therapy is a collaborative process. If you're ready to take that step, let's connect.