How to select a therapist who will help and not hurt. A project of Metanoia Communications


12 - What Happens In The First Contact?

You've selected a therapist to call for an appointment. For most people, the hardest part is now: that first phone call. I thought it would be helpful to let you know what ought to happen when you call. This might decrease your anxiety about the unknown. It also gives you additional means to evaluate the therapist's professional competence.

Keep in mind what I said before: I am describing here a "perfect" encounter, and your experience can be helpful if it is a little less than perfect. Use the following scenario as a guideline to judge the relative competence of your prospective therapist.

In your very first phone call, you will probably encounter either an answering machine or (less likely) a receptionist. With either, you only need to leave the following information:

  1. that you want to talk to the therapist
  2. your name and telephone number
  3. briefly, when you can be reached

That's it. At this time, it is not necessary to explain the reason for your call. You should never have to discuss the reason that you want to talk to the therapist with anyone except the therapist. A receptionist is NOT entitled to know and should not ask. If he/she does, a red flag should go up for you because the secure frame is already being broken.

You also shouldn't have to convince the therapist to see you. I think it would be extremely unusual that any therapist in private practice would not agree to see you at least once, as long as they have time available. Don't feel that you have to "qualify" for the appointment by offering a suitable reason. If you are dealing with an HMO or a community mental health clinic, this may, unfortunately, be compromised.

Okay: you've left the message, and now you are waiting anxiously for the therapist to call you back. He/she should call within a few hours, certainly the same day (unless you have called in the evening, in which case he/she may return the call the following morning). When he/she calls you back, ideally, the following should happen:

  • The therapist identifies him/herself.
  • You say that you want to make an appointment.
  • You mention where you heard about the therapist.
  • The therapist proposes a day and time no more than a week away.
  • You agree on a day and time. (Note: you have to be flexible here; be aware that good therapists' schedules are usually full, especially evening hours. However, if this is an emergency, say so.)
  • The therapist gives you clear directions to his/her office.
  • You confirm the appointment, say goodbye and hang up.

That's it. The first contact is for the sole purpose of arranging an appointment as soon as reasonably possible. Everything else is superfluous at this point and should be left until the first session (the exception being that you should make clear any emergencies, such as suicidal feelings or acute personal crises). There may be some need for working out difficulties related to the appointment, but it is best not to barrage the therapist with extensive details at this time. These are better worked on in the first session. Likewise, the therapist should not ask you lots of questions or get into an extended conversation. Though you may perceive this as caring, it isn't; it says far more about the therapist's own needs than about his/her true caring.

It may be necessary for you to ask what the therapist charges, though this is better left to the first session unless you are extremely limited. If the therapist has no hours available for an appointment, he/she should give you one or more alternate phone numbers for other therapists.

The therapist's manner should be professional and to the point. Unacceptable practices to watch out for:

  • the therapist answers the phone while in session with another client, and worse, proceeds to discuss an appointment with you;
  • the appointment is made for you by a friend or relative or other person, and worse, the other person goes to the first session with you;
  • the therapist asks you to make the appointment with his/her secretary;
  • the therapist offers to send you something in the mail.
All of these situations contaminate the frame by admitting other persons to it and compromising your privacy.

Now that you have made the appointment, KEEP IT. Nothing short of a major unexpected emergency should make you call to cancel or reschedule. Anything else might be a reflection of your anxiety and resistance to getting help.

Next: Your first session: what should happen >>

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Table of Contents


  1. Why I wrote this article
  2. How to tell if a therapist is competent, or not
  3. What psychotherapy isand why you need to know
  4. The secret that you already know
  5. How a good therapist makes you feel safe
  6. The perfect therapist
  7. Privacy: the essential ingredient
  8. Non-judgmental acceptance: you deserve it
  9. How to choose a therapist to call
  10. How you find out about the therapist
  11. Therapist credentials: the truth revealed
  12. First contact. Watch out for these red flags!
  13. Your first session: what should happen
  14. Safety is in the details
  15. Now what?

Copyright 1991,1996, 1999 Martha Ainsworth. All rights reserved. Please refer to reprint information before reprinting or distributing all or any part of this text.


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