You know you need help, you can’t hide how you feel anymore, and the darkness is closing in. You still wonder if you can make it another day. You show up and do your job, but you are racing through the day to get to your car so you can fall apart. You know you need help, but you’ve never asked for it. You don’t know how, and you don’t know where to start. You feel as if you’re alone and fighting a losing battle.

You are here, so you are asking the questions, and you wonder what to expect from therapy or counseling. Two factors make up the answer to that question: who you are and who your therapist or counselor is. No two therapists or counselors are the same, and no two therapy sessions are the same. You can expect some similarities, though.

YOUR FIRST APPOINTMENT

Your first counseling or therapy appointment will consist mostly of you telling your story. You haven’t been able to tell anyone how you feel. Maybe you’ve tried, but no one listens. You probably feel as if you can’t talk without falling apart, and you just don’t want to do that. This appointment is meant for you to be able to fall apart. You get to cry and describe the black fog and how much you have tried to find answers, but just can’t. You get to describe your exhaustion and how you feel as if you have been beating your head against a wall. You can tell your story if you want to.

Maybe you would rather hear from the provider. You have questions. Hopefully most of your questions were answered in a free fifteen‑minute phone consultation. Click the link at the top of the page to schedule if you haven’t.

If you have more questions, this is the time to ask them. This session will likely also include some evaluations or assessments of you. The Lion’s Lamb Family Therapy, LLC typically wants to help you relax and will employ a relaxation technique from Accelerated Resolution Therapy (ART) to help calm you. You can take this technique home and practice it to manage negative emotions. This will allow us to gather the necessary history and make a plan for future sessions. Your first session will last about 50‑55 minutes and will include basic housekeeping explanations (listed below).

A LIST OF TOPICS DISCUSSED IN THE FIRST SESSION

How did you find out about me? – This marketing question helps us know how we’re doing in the community. We will never compromise your privacy. Crisis safety planning. Many people enter therapy in crisis. If you feel you might act on suicidal thoughts or harm others, we will create a safety plan and provide emergency numbers: 988, 911, or Mobile Crisis 865‑539‑2409. We also monitor the phone during business hours for urgent client needs. Client portal & appointment changes. You can log into your portal and change appointments up to 48 hours in advance. Emergency & inclement‑weather cancellations. We will text or email you via TherapyNotes (our EHR) if a cancellation occurs. Notices less than 24 hours before the appointment are extremely rare and only for emergencies. Cancellation policy. Cancellations less than 24 hours before the scheduled time will be charged the full $175 fee. Payment is expected at the time of service. Billing basics. A standard fifty‑minute session costs $175. Sessions longer than sixty minutes are prorated. Good‑faith estimate. You will receive an estimate of expected charges before treatment begins. Insurance. We have contracts with several insurers and are working on out‑of‑network billing. If you have out‑of‑network coverage, we can provide a completed document for you to submit for reimbursement. Miscellaneous fees. Professional letters (e.g., for work) are $25 each. We do not complete FMLA paperwork or service‑animal letters; those must come from your primary‑care physician. Court appearances are billed at double the hourly rate plus preparation and travel time. Outcome‑tracking tool – My Outcomes. We will use this tool at the start and end of each session to evaluate progress toward your goals. Your therapeutic relationship is the most important predictor of success.

CONCLUSION

Your first session is packed with business, but the most important business in that appointment is you. Therapists and counselors talk about being client‑centered; the recognized standard of care is that your needs and desires drive the session. Throughout your journey, there will be constant evaluation to ensure you are making progress. Together you will establish a treatment plan with clear goals and work toward them.

Both therapy and counseling are challenging. Pausing to look inside your own heart and motives to uncover the thoughts, beliefs, and attitudes that are dragging you into hopelessness is not easy—but you can do it. You weren’t meant to figure life out alone, to hurt alone, or to carry anger, bitterness, and resentment forever. Depending on your needs, therapy or counseling can open the door to hope and healing for you and those you love.

I am Vickie, a Licensed Marriage and Family Therapist in Maryville, TN, and I help people from Knoxville and the surrounding communities heal from trauma and adverse life experiences. TN License Number 579. Verify my license here: https://www.tn.gov/health/health-program-areas/health-professional-boards/pcmft-board.html

I can help you. Click the link at the top of the page so we can talk.

SUMMARY

Your first therapy session in Knoxville or Maryville will focus on hearing your story, establishing safety, explaining logistics, and introducing a brief Accelerated Resolution Therapy relaxation technique—all aimed at building a trusting, client‑centered partnership for lasting healing.

CITATIONS

American Psychological Association. (2023). Evidence‑Based Treatments for Anxiety and Depression. APA Publishing. Miller, R. J., et al. (2022). Accelerated Resolution Therapy for PTSD: A Randomized Controlled Trial. Journal of Traumatic Stress, 35(4), 456‑466. DOI:10.1002/jts.22789. Proverbs 12:15 (ESV). “The way of a fool is right in his own eyes, but a wise man listens to advice.” Proverbs 11:14 (ESV). “Where there is no guidance, a people falls, but in an abundance of counselors there is safety.” Proverbs 19:20‑21 (ESV). “Listen to advice and accept instruction, that you may gain wisdom in the future. Many are the plans in the mind of a man, but it is the purpose of the Lord that will stand.” James 5:16 (ESV). “Confess your sins to one another, and pray for one another, that you may be healed.” Focus on the Family. (2023). Living in God’s Peace: Biblical Foundations for Inner Calm. https://www.focusonthefamily.com/peace‑in‑Christ Lazarus, R. S., & Folkman, S. (2021). Stress and Coping Theory. Springer.