Preparing for Your First Depression Therapy Appointment: A Complete Guide
Taking the step to begin therapy for depression is significant, and it's completely natural to feel a mix of emotions—hope, nervousness, uncertainty, or even relief. If you're preparing for your first depression therapy appointment, you might be wondering what to expect, how to get ready, or whether this approach will truly help you move forward.
I'm Dr. Katrina Kwan, and I work with adults online throughout Washington State and Utah who are ready to explore how their history, patterns, and nervous system responses shape their daily experiences. My approach focuses on recognizing what's already working for you and building from there, rather than viewing therapy as a process of fixing what's broken. In this guide, I'll walk you through how to prepare for your first sessions so you can show up feeling more grounded and ready to begin this work.
Understanding What Depression Therapy Actually Involves
Before your first appointment, it helps to have a realistic sense of what therapy for depression looks like. Many people come to therapy hoping for immediate relief or quick answers, and while meaningful shifts can happen, the process is usually more gradual and layered than we initially expect.
What Happens in Initial Sessions
Your first few sessions with me are primarily about exploration and connection. I'm not rushing to diagnose or prescribe a fixed treatment plan. Instead, I'm listening carefully to understand your unique landscape—how limitations show up in your life, what patterns keep repeating, and what already works for you, even if only occasionally.
During our initial work together, you can expect:
A 30-minute free consultation where we'll determine if my approach aligns with what you're looking for
Simple onboarding with a few documents to sign and an intake form to complete
First session focus on getting to know each other, starting to identify what works for you, and establishing a few initial goals
Psychoeducation about concepts we'll build on throughout our work together
A general plan for targets and directions, though this will evolve based on what emerges
I don't approach depression as something to eliminate or overcome. Instead, my focus is on helping you read your internal landscape better and navigate based on who you are, not who you think you should be.
Therapeutic Approaches I Use
My work integrates body-based and brain-based modalities that go beyond traditional talk therapy. These approaches recognize that depression often lives in your nervous system, not just your thoughts. The modalities I offer include:
Brainspotting: This approach helps you process experiences by identifying where you hold activation in your brain and body. Rather than relying solely on talking, Brainspotting allows your brain to process what it needs to without forcing a narrative.
Safe and Sound Protocol (SSP): This is an evidence-based listening therapy designed to reduce auditory sensitivity and help regulate your autonomic nervous system, making it easier to feel safe and present.
Accelerated Resourcing: This modality helps you build and strengthen internal resources quickly, giving you access to feelings of calm, safety, and capacity even when facing difficult emotions or situations.
Somatic Experiencing: This body-oriented approach helps you tune into physical sensations and release stored stress and trauma from your nervous system, supporting regulation and resilience.
These modalities share a common thread: they recognize that depression isn't just about negative thinking patterns. It's often connected to how your nervous system has learned to respond to stress, how your body holds experiences, and how your innate capacities have been limited by past circumstances.
My Role in Your Healing Process
I see my role as a guide rather than an expert who has all the answers about your life. My job is to:
Help you connect with your innate abilities and recognize what you already do well
Notice patterns and limitations that keep you stuck
Offer perspectives you might not see from inside your experience
Introduce tools and approaches that support your nervous system regulation
Create a space where you can feel, explore, and experiment without judgment
I'm not here to change who you fundamentally are or to push you toward predetermined outcomes. Instead, I help you learn to navigate your internal world more skillfully, tolerate uncertainty when it arises, and respond in ways that align with who you actually are rather than who you think you should be.
Getting Emotionally Ready for Your First Appointment
The emotional preparation for therapy matters just as much as the logistical preparation. Most adults I work with experience some level of nervousness before beginning, and that's not just normal—it's actually information about how your system responds to vulnerability and uncertainty.
Acknowledging Your Nervousness
If you're feeling anxious about your first session, that anxiety is worth paying attention to rather than pushing away. Your nervous system might be signaling:
Uncertainty about opening up to someone new
Past experiences where vulnerability didn't feel safe
Hope mixed with doubt about whether therapy will actually help
Discomfort with the idea of focusing on yourself
Rather than trying to eliminate these feelings before we start, consider bringing them into the session. How you experience nervousness—where you feel it in your body, what stories accompany it, how you typically manage it—becomes valuable information for our work together.
Some adults find it helpful to:
Notice where nervousness shows up physically (chest tightness, shallow breathing, restlessness)
Write down any specific worries beforehand so they don't circle in your mind
Remind yourself that you're not expected to have everything figured out
Give yourself permission to move at your own pace
Setting Realistic Expectations About Progress
Depression therapy isn't about achieving constant improvement or measuring success by symptom elimination. In my experience, healing looks more like:
Some sessions where you feel lighter and others where you feel heavier
Gradual recognition of patterns rather than sudden revelations
Building capacity to tolerate difficult emotions rather than avoiding them
Increased ability to respond intentionally rather than react automatically
Moments of clarity mixed with periods of uncertainty
I don't measure progress by whether you feel happy or whether your depression symptoms disappear. Instead, I look for shifts in how you relate to your experience, how you navigate challenges, and how you access your own resources when things get difficult.
Expectation vs. Reality in Early Therapy
Opening to Vulnerability in a Safe Way
Vulnerability in therapy doesn't mean forcing yourself to share everything immediately or pushing past your limits. It means gradually allowing yourself to be seen as you actually are, not as you think you should be.
In my sessions, I encourage you to:
Notice when you're holding back and explore why, without judgment
Share what feels manageable in the moment rather than forcing disclosure
Recognize that "I'm not sure" or "I don't know" are completely valid responses
Pay attention to what your body is telling you about safety and comfort
The adults I work with often discover that vulnerability isn't about revealing your deepest wounds immediately. Sometimes it's as simple as admitting you're confused, acknowledging you're struggling, or saying you don't feel ready to discuss something yet.
Clarifying Your Personal Goals and Intentions
Coming into therapy with some sense of direction helps, though your goals will likely evolve as we work together. The key is identifying what brought you to this point and what you hope might shift.
Identifying What You Want to Change
Rather than asking "What's wrong with me?" consider exploring "What patterns keep me stuck?" Many adults I work with initially describe wanting to feel less depressed, less anxious, or more motivated. As we dig deeper, we often discover more specific targets:
"I want to understand why I shut down when things get overwhelming"
"I need help figuring out why nothing feels satisfying anymore"
"I want to stop abandoning myself to please others"
"I'm tired of the same conflicts showing up in every relationship"
Take some time before your first session to consider:
What experiences or feelings prompted you to seek therapy now?
If therapy helps, what would be different in your daily life?
What patterns do you notice repeating, even when you try to change them?
What aspects of yourself do you feel disconnected from?
You don't need polished answers. Rough observations and half-formed thoughts are completely welcome.
Recognizing What Hasn't Worked Before
If you've tried therapy previously, or other approaches to managing depression, bringing that history into our conversation helps me understand what to avoid and what might be worth revisiting differently.
Consider reflecting on:
Previous therapy experiences—what felt helpful and what didn't
Approaches you've tried independently (meditation, exercise, routine changes)
What worked temporarily but couldn't be sustained
Patterns in what hasn't worked (e.g., approaches that relied solely on willpower or positive thinking)
I won't judge what hasn't worked. Instead, this information helps me understand your unique needs and tailor our approach accordingly.
Documenting Your Primary Concerns
You don't need a formal list, but having some notes about your main concerns can help you feel more organized, especially if you tend to go blank when nervous. Consider jotting down:
Your three most troubling symptoms or experiences right now
Specific situations where depression impacts you most (work, relationships, alone time)
Any changes in sleep, appetite, energy, or interest in activities
Physical sensations connected to your depression (heaviness, numbness, tension)
This documentation isn't about impressing anyone with thorough notes. It's simply a tool to help you stay grounded when you might otherwise forget what you wanted to address.
Questions to Ask During Your Consultation
Our 30-minute free consultation exists so you can determine whether my approach feels right for you. This isn't a formality—it's a genuine opportunity for you to ask questions and assess fit before committing to ongoing work.
Understanding My Approach to Depression
Feel free to ask specific questions about how I work:
"How do your modalities differ from traditional talk therapy?"
"What does a typical session look like after we establish our working relationship?"
"How do you decide which approach to use at different points in treatment?"
"What's your perspective on depression—do you see it as something to eliminate?"
I focus on connecting you with your innate abilities, recognizing limitations as what keeps you stuck, and building on what's already working. This might sound abstract, so asking for concrete examples can help you understand whether this resonates with your needs.
Session Structure and What to Expect
Practical questions help you know what you're agreeing to:
"How long are sessions, and how frequently do we typically meet?"
"Do you assign homework between sessions?"
"How do you handle communication between sessions?"
"What happens if I need to cancel or reschedule?"
After we establish care, you can expect:
The ability to schedule your own appointments or schedule them during our sessions
Generally no homework, though I may suggest practices when they clearly fit
Email responses within one business day for non-urgent matters
Session targets discussed at the start, follow-up from the prior session, middle processing time, and debriefing at the end
Integration of psychoeducation or skills as relevant to what emerges
Assessing Whether We're a Good Match
Not every therapist is right for every person, and that's not a failure on either side—it's about fit. Consider asking:
"What types of clients do you work best with?"
"Have you worked with adults dealing with [your specific situation]?"
"What would you say your limitations are as a therapist?"
The adults who tend to benefit most from my approach are those willing to explore alternative treatment modalities beyond talking, shift into feeling and focusing on actions and intentions, and experiment with new ways of conceptualizing what's present rather than seeking relief as the primary measure of success.
If you're someone who prefers structured CBT protocols, wants weekly homework assignments, or is primarily seeking symptom management strategies, my approach might not be the best fit—and that's valuable information to discover during our consultation.
Preparing Practical Information for Your Intake
The intake process helps me understand your background and current situation so we can begin our work with appropriate context. The more prepared you are, the more time we can spend on meaningful conversation rather than administrative details.
Gathering Your Personal History
I'll ask about your background, but you don't need to memorize dates or create a detailed timeline. Instead, consider reflecting on:
Significant life events that shaped you (childhood experiences, losses, major transitions)
Family patterns around emotions, conflict, and connection
Previous experiences with mental health treatment
Medical history, particularly anything affecting your nervous system
This isn't about having perfect recall. It's about identifying experiences that might be relevant to understanding your current patterns and limitations.
Describing Your Current Experience
Rather than trying to fit your experience into diagnostic categories, focus on describing what your daily life actually feels like:
Mood patterns: When do you feel worst? When do you have glimpses of feeling better?
Energy levels: How does your energy shift throughout the day or week?
Sleep and appetite: What's changed, and what patterns have you noticed?
Physical sensations: Where do you feel depression in your body?
Relationships: How has depression affected your connections with others?
Activities: What have you stopped doing? What do you still manage?
Bringing Information About Other Treatments
If you're currently working with other providers or have in the past, I need to know:
Other therapists or practitioners you're seeing
Previous therapy experiences (what worked, what didn't)
Any body-based or somatic work you've done
Self-help approaches you've tried
I don't offer crisis services, so if you're currently in need of emergency support, I'll help you connect with appropriate resources before we begin ongoing work together.
Making Online Therapy Work for You
Since I provide online sessions exclusively, setting yourself up for success with this format matters. Many adults I work with initially wonder whether online therapy can feel as meaningful as in-person work. In my experience, when you create the right environment, online sessions offer both connection and convenience.
Creating Your Private Session Space
You need a space where you can be honest without worrying about being overheard. This doesn't require a dedicated office—just a place where you feel safe enough to let your guard down.
Consider:
Privacy: Can you close a door? Are there times when your home is quieter?
Comfort: Can you sit comfortably for 50 minutes without distraction?
Lighting: Can I see your face clearly? Natural light works best.
Background: A neutral background with minimal distractions helps us both stay focused.
Some adults use their bedroom, others their car in the driveway, some even a quiet outdoor space. What matters most is that you feel protected enough to be vulnerable.
Managing Technology Requirements
Technical difficulties can disrupt our work, so testing your setup beforehand reduces stress:
Internet connection: Strong, stable WiFi or hardwired connection
Device: Laptop or computer with webcam works best (phone as backup)
Audio: Headphones help with privacy and sound quality
Platform familiarity: We'll use a secure video platform; I'll send instructions before our first session
If you encounter technical issues during a session, don't panic. We'll troubleshoot together, and if needed, we can switch to phone temporarily.
Building Connection Through a Screen
Some people worry that online therapy will feel distant or impersonal. While it's true that online work has a different quality than in-person sessions, meaningful connection is absolutely possible when both people are present and engaged.
I pay attention to:
Subtle shifts in your facial expressions and body language
Pauses and what they might mean
The energy you bring to sessions
What you're comfortable showing and what remains hidden
You can support connection by:
Keeping your camera on when possible (though occasional camera breaks are fine)
Finding a setup where you're not distracted by seeing yourself on screen
Letting me know when something feels off about the online format
Remembering that awkward moments happen in all therapy, not just online
The modalities I use—particularly Brainspotting and Somatic Experiencing—translate well to online work because they focus on your internal experience rather than requiring physical touch or proximity.
Developing Trust in Our Therapeutic Relationship
Therapy works best when you feel safe enough to be honest—not just about your experiences, but about the therapy itself. Building this kind of trust takes time, and it's normal for it to feel uncertain at first.
Communicating What You Need
I can't read your mind, and I don't expect you to intuitively know how therapy should work. If something isn't working for you, that's valuable information for us to explore together.
You might need to communicate:
"I need more explanation about what we're doing and why"
"This pace feels too fast/too slow"
"I'm not sure I'm ready to go there yet"
"I don't understand how this connects to why I came here"
These aren't complaints—they're part of the work. My approach is client-led, meaning you have significant say in where we go and how quickly we move.
Working Through Discomfort
Therapy brings up uncomfortable moments. Sometimes you'll feel exposed, confused, frustrated, or even worse before you feel better. These experiences aren't signs that therapy is failing—they're often signs that we're touching something important.
When discomfort arises:
Notice it rather than pushing it away immediately
Mention it in session so we can work with it rather than around it
Ask yourself what this discomfort might be protecting you from
Remember that growth rarely feels comfortable
I'm not here to force you through discomfort, but I will invite you to stay with it when doing so seems valuable. You always have the option to slow down or redirect.
Tracking How You're Changing
Progress in depression therapy isn't always obvious. You might not feel dramatically different week to week, but over time, subtle shifts accumulate into meaningful change.
Pay attention to:
Moments when you respond differently to familiar situations
Increased capacity to tolerate difficult feelings without collapsing
Greater awareness of your patterns before you're fully caught in them
Access to resources and capacities you couldn't reach before
Shifts in how harsh or kind you are toward yourself
Progress isn't linear. Some weeks you'll feel like you're moving backward. That's part of the process, not evidence that therapy isn't working.
Building Resources Between Sessions
What happens between our sessions matters as much as what happens during them. I generally don't assign homework, but there are ways you can support your own process outside our work together.
Developing Self-Compassion
Depression often comes with harsh self-judgment. Learning to notice this internal criticism and respond with compassion shifts your relationship with yourself in fundamental ways.
This doesn't mean:
Forcing positive affirmations you don't believe
Pretending everything is fine when it isn't
Eliminating all critical thoughts
It does mean:
Noticing when you're being cruel to yourself
Asking whether you'd speak this way to someone you care about
Recognizing that struggling doesn't make you defective
Allowing yourself to be imperfect without catastrophizing
Practical Ways to Support Your Nervous System
Since much of my work focuses on nervous system regulation, simple daily practices can support what we do in session:
Movement: Walking, stretching, or any physical activity that feels manageable
Rhythm: Activities with natural rhythm (rocking, swaying, drumming) can be regulating
Nature: Time outside, even briefly, often settles an activated system
Connection: Brief, low-demand contact with safe people
Rest: Actually resting rather than productive "self-care"
These aren't assignments or requirements. They're simply options that many adults find helpful when building capacity for regulation.
When to Reach Out Between Sessions
I respond to emails within one business day, and you're welcome to reach out with:
Questions about scheduling or logistics
Brief updates if something significant happens
Questions about approaches or concepts we've discussed
I don't provide crisis support between sessions. If you're in crisis, you'll need to contact emergency services or crisis resources appropriate to your situation.
Understanding Practical Aspects of Working Together
Before we begin, it helps to have clarity about the practical details of our work together.
Investment in Your Care
Therapy is an investment of time, money, and emotional energy. While I can't quote specific fees here, I encourage you to reach out through my website for current information about session rates and payment.
What you should know:
I do not accept insurance directly
Payment is expected at the time of service
Some clients seek reimbursement through out-of-network benefits with their insurance
I can provide documentation to support reimbursement requests when applicable
Financial concerns are valid and worth discussing during our consultation so you can make an informed decision about whether this work fits your current resources.
Cancellation and Scheduling
Respecting both our time matters. My cancellation policy ensures that the time reserved for you remains protected:
Cancellations require adequate notice (specific timeframe discussed during consultation)
Late cancellations may result in fees
You're welcome to schedule appointments during sessions or independently through my scheduling system
Consistent scheduling often supports better outcomes
Time Commitment and Flexibility
Most adults I work with meet weekly or biweekly, though frequency can vary based on your needs and availability. Some people work intensively for a period, then space sessions out. Others maintain consistent weekly work for months.
What works best depends on:
The depth of work you're doing
Your capacity outside of sessions
Your schedule and availability
Financial considerations
What your nervous system needs
We'll discuss this during our initial sessions and adjust as needed. Flexibility is built into my approach because rigid structures often don't serve the complexity of real human lives.
Recognizing Progress in Your Depression Work
Progress in depression therapy looks different from what many people expect. I don't measure success by whether you're "cured" or consistently happy. Instead, I look for meaningful shifts in how you relate to yourself and your experience.
What Progress Actually Looks Like
You might notice:
Increased awareness of patterns before you're fully caught in them
Greater capacity to feel difficult emotions without collapsing
More moments of choice rather than automatic reaction
Better understanding of what your symptoms are trying to communicate
Access to your own resources more consistently
Shifts in how you treat yourself when struggling
These changes often emerge gradually. Sometimes you won't notice them until you look back and realize you handled something differently than you would have before.
Adjusting Goals as You Grow
The goals you start with will likely evolve. As you gain clarity about your patterns and develop new capacities, what you're working toward often shifts.
We'll regularly revisit:
Whether current goals still resonate
What's emerged that you didn't initially recognize
Whether the pace and approach still serve you
What you're discovering about your limitations and resources
This isn't about abandoning your original intentions. It's about allowing your understanding to deepen and your goals to reflect that growth.
Knowing When to Adjust Our Approach
If you're feeling stuck or unsure whether our work together is helping, that's important to bring into session. Some signs that adjustment might be valuable:
You're consistently leaving sessions feeling worse without eventual relief
Patterns remain unchanged after consistent engagement over time
You're not feeling safe or understood
The modalities I'm using don't seem to resonate with your experience
Adjustments might mean:
Shifting which modalities we emphasize
Changing session frequency
Clarifying goals or focus areas
Honestly assessing whether we're a good fit
I view these conversations as part of the work, not as failure. Your willingness to be honest about what's not working demonstrates the kind of self-awareness that makes therapy effective.
Moving Forward: Your Next Steps
If you're considering working with me, the next step is straightforward: reach out for a free 30-minute consultation. This conversation helps us both determine whether my approach aligns with what you need and whether we're a good fit.
During our consultation, we'll discuss:
What brought you to consider therapy now
Your previous experiences with therapy or other approaches
What you're hoping might shift
Whether my modalities and approach resonate with your needs
Practical details about working together
You can reach me through my website at drkatrinakwan.com to schedule your consultation or ask questions about getting started.
What Makes This Approach Different
My work differs from more traditional therapy in several key ways:
Focus on what works: Rather than only examining what's wrong, I help you recognize and build on your existing capacities
Body and brain integration: The modalities I use address depression at the nervous system level, not just cognitively
Client-led process: You have significant input into pace, focus, and approach
Limitations as information: Rather than viewing your limitations as obstacles to overcome, we explore them as information about your system
This approach tends to resonate with adults who are tired of feeling like they need fixing and who are ready to develop a more sophisticated understanding of their internal landscape.
Creating Space for Healing
Depression can feel isolating, and starting therapy takes courage. Whether we end up working together or not, the fact that you're reading this guide suggests you're ready for something to shift.
Healing doesn't mean eliminating all difficult feelings or achieving constant happiness. It means developing the capacity to navigate your internal world with more skill, accessing your resources when you need them, and responding to challenges in ways that align with who you actually are.
I work with adults throughout Washington State and Utah who are ready for this kind of exploration. If you're curious whether my approach might serve you, I invite you to reach out and begin with a conversation.
Ready to take the next step? Visit drkatrinakwan.com/contact to schedule your free 30-minute consultation or learn more about how I work with adults experiencing depression.
