What To Expect During Your First Therapy Session

You finally did it. You made the call, sent the email, and booked your first therapy session. The first step is officially behind you!

And now you may be thinking, Wait… I actually have to go to the appointment.

A variety of emotions may come up before your first session. You may feel excited about taking a new step in your healing journey. You may also feel nervous, uncertain, or overwhelmed by all the “what ifs.” What will the therapist ask? Will you have to talk about everything right away? What if you do not know what to say?

Take a breath. Your first therapy session is not a test, and you do not have to arrive with everything figured out. Let’s walk through what a first session typically looks like.

Getting to Know Each Other

I like to tell my clients that the first session is primarily about getting to know one another. Your therapist will likely begin by reviewing a few housekeeping items, such as consent forms, confidentiality, communication expectations, attendance policies, and other important practice information.

The rest of the session will usually focus on introducing you to the therapy process and reviewing your intake information. Your therapist may ask about your background, what brought you to therapy, the symptoms or concerns you are currently experiencing, and any significant experiences that may be affecting you.

I also like to include more relaxed topics, such as hobbies, relationships, interests, and what you enjoy doing for fun. You are a whole person, not simply a collection of symptoms or difficult experiences.

Discussing Your Therapy Goals

One of the most important parts of the first session is discussing what you would like to get out of therapy.

Do not worry if you do not have a clear answer yet. Some people begin therapy knowing exactly what they want to address. Others simply know that something does not feel right and they need support figuring it out.

Both are completely okay.

Your goals can become clearer over time as you learn more about yourself, your patterns, and what you need from the therapy process.

You Control the Pace

Everything moves at your pace.

Your therapist may ask follow-up questions about something you included on your intake paperwork. However, you are allowed to say, “Can we skip that for now?” or “I’m not ready to talk about that today.”

A supportive therapist should not feel offended by this. In fact, I appreciate when clients communicate that they need more time before discussing a difficult topic. It tells me that they are listening to themselves and recognizing what they are ready to handle in that moment.

Therapy is not about forcing you to reveal your most painful experiences before you feel safe. Trust is built gradually.

What Is the Goal of the First Session?

The main goal of the first session is to begin building rapport, establish a foundation of trust, and set the tone for what therapy may look like moving forward.

Toward the end of the session, I typically provide a brief summary of what I learned, share my initial clinical impressions, and discuss what a possible treatment plan could look like. This gives us an opportunity to make sure we are on the same page and begin identifying what may be most helpful for you.

For many people, the first session ends up passing much faster than they expected. Once the conversation begins, the time can seem to breeze by.

A Few Things to Remember

You are in charge of the pace.

You are allowed to set boundaries around what you feel comfortable sharing.

You are encouraged to ask questions.

After the session, take some time to reflect. How did you feel while speaking with the therapist? Did you feel heard, respected, and emotionally safe? How did you feel after the session ended?

You do not always have to know after one appointment whether a therapist is the right fit. Consider giving yourself a few sessions to gather information and notice how the relationship develops.

And finally, take another deep breath. You just completed your first therapy session, and that is something worth acknowledging.