What to Expect in Your First DBT Session: A Complete Guide for New Clients
Starting therapy can feel intimidating, especially when you're unsure what to expect. If you've scheduled your first Dialectical Behavior Therapy session, you're taking an important step toward better mental health. Knowing what happens during that initial appointment can help ease anxiety and prepare you to get the most from treatment.
Research shows that structured therapy approaches like DBT demonstrate significant effectiveness, with early engagement being a key factor in successful outcomes. DBT has proven particularly effective for people dealing with emotional regulation challenges, anxiety, depression and interpersonal difficulties.
Understanding the Initial Assessment Process
Your first DBT session focuses primarily on gathering information. Your therapist will ask about your current symptoms, mental health history and what brought you to seek treatment. This conversation helps determine if DBT is the right approach for your specific needs.
Expect to discuss your treatment goals in detail. Be honest about what you hope to achieve. Some clients want to reduce self-harm behaviors, while others seek better relationships or improved emotional stability. Your therapist needs this information to create a personalized treatment plan.
The initial session typically lasts 60 minutes. Your therapist will explain how DBT works and what makes it different from other therapy approaches. They'll outline the treatment structure, including individual sessions, skills training groups and phone coaching availability
What Questions Your Therapist Will Ask
During your first appointment, your therapist will conduct a comprehensive assessment. They'll ask about your current life situation, including work, relationships and living arrangements. They may inquire about past trauma, previous therapy experiences and any medications you're taking.
Current Challenges and Triggers
You'll discuss specific behaviors or patterns that cause distress. Your therapist wants to understand the situations that trigger difficult emotions and how you typically respond. This information helps identify which DBT skills will benefit you most.
Be prepared to talk about recent difficult experiences. Your therapist might ask you to describe a recent conflict, moment of intense emotion or situation where you felt overwhelmed. These examples give your therapist insight into your patterns and help shape your treatment plan.
Assessment Tools and Questionnaires
Many therapists use standardized questionnaires during the first session. These forms measure symptoms of depression, anxiety and other mental health concerns. The results give your therapist baseline data to track your progress throughout treatment. You may complete these forms before your appointment or during the session.
Learning About the Structure of DBT Treatment
A significant portion of your first session covers education about DBT's framework. Your therapist will explain the Four Pillars of DBT, which form the foundation of comprehensive treatment.
The Four Components Explained
Individual therapy sessions occur weekly and focus on your specific challenges, helping you apply skills to real-life situations
Skills training groups teach practical techniques you can use in daily life, typically meeting weekly for two to three hours
Phone coaching offers support between sessions when you're struggling to apply skills in the moment
Consultation team meetings allow your therapist to collaborate with colleagues for the best possible care
DBT differs from traditional talk therapy in its active, skills-focused approach rather than purely exploratory methods. Your therapist will clarify how each component works together to support your progress and answer questions about the time commitment.
Discussing Treatment Commitment and Expectations
Your therapist will talk about what's expected from you as a client. DBT requires active participation, including completing homework assignments and attending both individual and group sessions regularly. Success depends on your willingness to practice new skills outside therapy.
You'll discuss practical matters like scheduling, fees and cancellation policies. Many programs require a minimum commitment period, often six months to a year. This timeframe gives you sufficient practice to master and integrate new skills into daily life.
Your therapist may also address safety concerns during this first meeting. If you're experiencing suicidal thoughts or engaging in self-harm, you'll work together to create a crisis management plan. This plan identifies warning signs, coping strategies and resources available when you need immediate support.
What Happens After the First Session
Following your initial appointment, you'll schedule regular sessions. Most clients attend individual therapy weekly and join a skills training group. The group component teaches the core DBT modules: mindfulness, interpersonal effectiveness, distress tolerance and emotion regulation.
You'll receive materials to use between sessions. Many therapists provide handouts, worksheets or access to online resources. These tools help you practice and reinforce what you learn during therapy. Some programs use diary cards to track emotions, urges and skill use between appointments.
Your therapist will check in regularly about your progress and adjust the treatment plan as needed. DBT responds to your changing needs throughout the process. As you develop proficiency in certain skills, your therapist will introduce more advanced techniques and applications.
Preparing for Your First Appointment
Think about your treatment goals beforehand so you can articulate what you hope to achieve.
Consider writing down questions you want to ask. Common concerns include how long treatment typically lasts, what group sessions involve and how to reach your therapist in a crisis. Ask for clarification about anything you don't understand.
Building trust takes time. You may not feel completely comfortable opening up during your first session, and that's normal. Your therapist knows this and will work at a pace that feels manageable. The therapeutic relationship develops gradually as you continue meeting and working together.
FAQs
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Initial DBT sessions usually run 60, longer than standard ongoing appointments. This extra time lets your therapist complete a thorough assessment, explain the DBT approach and answer your questions about treatment.
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The first session focuses primarily on assessment and treatment planning rather than skills training. Your therapist may introduce basic concepts or suggest simple techniques you can try before your next appointment. Formal skills training typically begins after you've completed the initial evaluation and enrolled in a group.
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Feeling anxious during your first therapy appointment is normal. Your therapist expects this and won't push you to share more than you're comfortable discussing. You can take things at your own pace and gradually open up as you build trust. Let your therapist know if you're feeling overwhelmed.
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Contact your therapist's office beforehand to ask about specific requirements. A notebook for taking notes can also be helpful.
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Contact the office directly to discuss fees, insurance acceptance and payment options before your appointment. The initial evaluation appointment is $250-295 depending on the clinician you’re paired with. Subsequent appointments are at the therapist’s individual therapy rate.
Ready to begin your DBT journey? Contact us for a free assessment at DBT Center of Long Beach to schedule your first session and learn more about our comprehensive Dialectical Behavior Therapy in Long Beach & Irvine, CA programs.