Notes for people who have not done this before

A first appointment is mostly a conversation about what brought you and what you are hoping for. You will not be asked to produce a history you have not thought about, and you can decline any question.

It also runs in the other direction: it is the point at which you assess the clinician. Ask how they work, what training they hold and where they are registered. Leaving a first appointment unsure is a normal outcome.

By the end you should know the fee, the likely frequency, and the limits of confidentiality. If you do not, ask before agreeing to a second.

What you say in a session is held in confidence. That is the basis of the work, and it is a professional obligation rather than a courtesy.

There are narrow exceptions, which any clinician should set out at the start: situations involving a serious risk of harm, certain legal requirements, and (in some jurisdictions) specific duties concerning children. The precise exceptions depend on where the clinician practises.

Notes are kept, securely and for a defined period, because professional standards require it. You can ask what is recorded, how it is stored and what your rights of access are.

People often wait until a situation is severe, on the reasoning that therapy is for crises. It is not; nor does waiting make the work simpler.

There are also good reasons to wait. If your circumstances are about to change substantially, or you have no capacity for regular appointments, a short delay may serve you better than an interrupted start.

If deciding is itself the difficulty, a single appointment to think it through is a legitimate reason to make contact. You are not committing to a course of work by asking.

Online questionnaires that appear to identify a condition are widespread and are, at best, a rough screening instrument used out of context.

At worst they invite a person to adopt a diagnostic label from a website, which then shapes how they describe themselves to a clinician. That makes careful assessment harder, not easier.

Describing what is happening in your own words is more useful to a professional than any score. That is what a first appointment is for.