Ask Dr. P. | What can I expect when I see a counselor for the first time?

Ask Dr. P.


What can I expect when I see a counselor for the first time?


Once you’ve decided to seek counseling, you’ll set up your first appointment.

You can do this by contacting the counseling center over the phone, in person, or sometimes online. At different campuses, the counseling center may go by different names, such as “Psychological Services” or “Psychological Clinic.”

If you need help right away, tell the contact person that you need to talk to someone right now. That person will see if anyone is available and, if not, they may refer you to a phone hotline that is staffed by volunteers to help students in crisis.

Your student fees usually cover on-campus counseling services, but the number of sessions per semester may be limited depending on the counseling center’s policy. If you prefer to seek psychological help off-campus, just ask for an approved list of counselors in the area from the counseling center or the Dean of Students. For off-campus assistance, you will need to use your health insurance to pay for services.


Now that you have taken the courageous and often trembling first step of making an appointment, what can you expect from this point on?


1. Paperwork

Generally, the first thing you will encounter at the counseling center is some paperwork. Sometimes this is done by phone but it usually occurs during the first visit, which is typically called an “intake session.” You will be asked to share basic demographic information and to complete a checklist of symptoms or presenting problems. The checklist covers a range of concerns college students typically bring to counseling centers, from concentration difficulty to sleeping problems. Occasionally, intake paperwork will also include a brief personality assessment that is designed to get a snapshot of how you usually operate.


2. A meeting with an intake counselor

Once you're finished with paperwork, you will meet a counselor for the intake session, which usually takes about an hour. The purpose of this meeting is to get a sense of how serious your problems are and what kind of help you need. The intake person may be a different person from the one you will eventually be assigned. If you have a preference as to the sex, race, or cultural background of your assigned counselor, you can make that request at this time. If such a counselor is available, the counseling center will try to accommodate you.

The counselor will ask you questions such as, “What brings you to the counseling center?” or “How can I help?” to get an idea about what you have been struggling with. The counselor will ask about the severity of the problem, duration (how long it has been going on), and what you have tried to do in the past to solve the problem. The counselor will also ask about your family, friends, interests, school history (how well you did in the past), medical history, and your strengths/ weaknesses.


3. Exploring solutions together

From this broad array of information, including the paperwork you completed earlier, your counselor will gain an understanding of your problem as well as what can be done to improve your situation. For example, if you went to the counseling center because you’re anxious and worried about failing out of school, you and the counselor will decide how widespread your fears are, how realistic they are, and what can be done about them.

In this example, questions that a counselor may consider include:

  • Is your anxiety keeping you up at night and /or interfering with your ability to study?

  • Will relaxation training help or is your anxiety too severe?

  • Will cognitive-behavioral strategies, such as examining your thoughts about failing and working to change them, be worthwhile?

  • Would medication for anxiety be useful?

Exploring these and related issues are among the many considerations in trying to help you, but what will work best for you is a function of personal factors, including your personality style and your motivation to change. Typically, at the end of the intake process, your counselor will make recommendations that you're free to accept, modify, or reject. While you alone can make the decision as what will work best for you, it is wise to be open to the counselor's recommendations.

In spite of the normal anxiety you may feel in starting this whole process, going to see a counselor is often the start of a marvelous journey towards personal growth and greater overall satisfaction in life.

I'm Dr. Geraldine K. Piorkowski, a clinical psychologist with many years of experience working with college students. I was the Director of two University Counseling Centers in Chicago, and was the first in my family to go to college. Click here to learn more.

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