5. KNOW WHAT TO EXPECT IN YOUR FIRST MEETING

Your first consultation will set the administrative ground rules for your treatment, and it is there that you will finalize things like fees, schedules, and the length of your sessions.

Some therapists will need payment up-front, and some will bill your insurance, accepting only a co-payment. (A co-payment is a fee you pay yourself in addition to that which is covered by your insurance).

You can generally expect to see your therapist once a week and sessions are usually in the neighborhood of 45-55 minutes long. The important thing is not to be late, though, since most therapists will keep you to your original end time. If the therapist is late, they may give you extra time for that session or tack it on to a later date.

Individual therapists may also have different policies on cancellations, requiring different levels of advance notice. Your insurance provider may also care about missed appointments, so you will want to ask them too.

Mandy Aftel and Robin Tolmach Lakoff, authors of When Talk Is Not Cheap (this great book is unfortunately out of print - try your local library), recommend a set list of questions to ask your therapist on the first visit. Aside from basic scheduling and payment details, they suggest asking your therapist how long he or she thinks your treatment will last, what their theoretical orientation is (cognitive, behavioral, etc.), if they themselves have ever been in therapy, and if they have been in therapy, what they got out of it. Sometimes, a therapist will actually write out this information.

Regardless, the authors say you should avoid any therapist who refuses to discuss the rules, clarify them, or listen to your input when setting them up.

Beyond scheduling, though, there are some basic expectations you must have:

Confidentiality is crucial. You need to be completely comfortable while working out your treatment. This could be greatly compromised if you sense that your comments are leaving the office. It goes without saying that your therapist should not discuss your case, or even your status as a client, with anyone else. That's also why you shouldn't choose a therapist who is somebody that you know socially. (The APA notes that state laws on this do vary. In some instances, confidentiality can be legally broken by a court order, if the therapist finds evidence of the client's intent to harm himself or others, or if the client sues the therapist).

Privacy is also important. Make sure the physical setting of your therapist's office is such that you feel your confidentiality is not being violated. Going to a therapist who shares a waiting room with the local newspaper might not be a good idea.

No Sexual Advances should be made by your therapist. Not hard to figure this one out. If this happens in any way at all, you need to stop seeing this person and report him or her to your state licensing board.

The way your first session unfolds no doubt depends on you and the individual therapist. It could just be you talking the most of the time, explaining the basics of your problem. Or, your therapist could fill the session with a series of questions.

A large study by Consumer Reports published in 1995 suggested that most people are satisfied with their treatment and that it does help people make changes in their lives. But if your therapist is not making a difference in your life, always keep in mind that you can change the situation. If after three sessions you feel you are not being helped enough to continue, switch therapists. Your life is too important and therapy is too expensive to waste that kind of time.