What to expect during the first therapy session.

Illustration for What to expect during the first therapy session.

Stepping into your first therapy session can feel like venturing into the unknown. It’s normal to feel a mix of anticipation, nervousness, and curiosity. But don’t worry, we’re here to demystify the process and help you understand what to expect. Keep reading to gain insights into the structure, process, and emotional aspects of your first therapy session.

Key Takeaways

  • The first therapy session is crucial in establishing a therapeutic relationship.
  • It involves initial paperwork, therapist’s introduction, and discussion of confidentiality.
  • The session will include a therapeutic conversation to understand your background, current situation, and therapy goals.
  • Emotional responses and adjustments are part of the process.
  • Practical considerations like session modalities, payment options, and therapy homework expectations are discussed.
  • The first session sets the stage for future sessions.

Introduction to the First Therapy Session

Overview of what to expect

Your first therapy session is a significant step towards self-improvement and healing. It’s a space where you can express your thoughts, feelings, and concerns without judgment. It’s also an opportunity to establish a connection with your therapist, who will guide you through your therapeutic journey.

Importance of the first session in establishing a therapeutic relationship

The first session lays the foundation for a therapeutic relationship. It’s a chance for you and your therapist to get to know each other, build trust, and set the tone for future sessions. This relationship is crucial as it significantly influences the therapy outcomes.

therapist and client during the first session

The Process of the First Session

Initial paperwork and formalities

The first session often begins with paperwork. This includes providing your personal information, medical history, and signing consent forms. It’s essential to read these documents carefully and ask any questions if something is unclear.

The Therapist’s Introduction

Therapist’s background and qualifications

Your therapist will introduce themselves, sharing their background, qualifications, and areas of specialization. This information can help you feel more comfortable and confident in their expertise.

Overview of the therapist’s approach to therapy

The therapist will also explain their approach to therapy, which might include techniques from interpersonal therapy, problem-solving therapy, or holistic counseling. Understanding their approach can help you know what to expect in the sessions ahead.

Discussion of confidentiality and session structure

Your therapist will discuss the confidentiality of your sessions, ensuring that what you share remains private. They will also explain the structure of the sessions, including their duration and frequency.

Communication guidelines

Clear communication is key in therapy. Your therapist will guide you on how to express your thoughts and feelings effectively and will encourage open and honest communication.

therapist explaining the communication guidelines

The Therapeutic Conversation

Therapist’s inquiries

Understanding your background

Your therapist will ask about your background, including your family, relationships, and past experiences. This information helps them understand you better and tailor the therapy to your needs.

Assessing your current situation

The therapist will also want to know about your current situation, including any challenges or stressors you’re facing. This helps them assess your mental and emotional state.

Identifying your therapy goals

Together, you and your therapist will identify your therapy goals. These could be anything from managing anxiety to improving relationships or coping with life changes.

Your opportunity to ask questions

Therapist’s experience and specialization

Feel free to ask your therapist about their experience and specialization. This can help you understand their expertise and how they can assist you in your therapeutic journey.

Therapy logistics (session frequency, duration, etc.)

You can also ask about the logistics of therapy, such as the frequency and duration of sessions, and the expected length of the therapy process.

client asking questions to the therapist

Emotional Responses and Adjustments

Common emotional reactions


It’s normal to feel nervous during your first therapy session. Remember, it’s a new experience, and it’s okay to feel anxious.


Many people also feel a sense of relief after sharing their thoughts and feelings with a professional who understands and can help.

Crying or not crying

Some people may cry during their first session, while others may not. Both reactions are perfectly normal and are part of the emotional process.

Establishing comfort and trust

The first session is also about establishing comfort and trust with your therapist. It’s important to feel safe and understood, as this fosters a productive therapeutic relationship.

Assessing the fit between therapist and client

The first session is also a time to assess if you and your therapist are a good fit. If you feel comfortable and understood, it’s a good sign that you’ve found the right therapist.

client and therapist assessing their fit

Practical Considerations

Session modalities


In-person sessions are traditional face-to-face meetings with your therapist in their office.


Online therapy, also known as teletherapy, involves conducting sessions over the internet using video calls.

Phone therapy

Phone therapy involves conducting sessions over the phone. It’s a convenient option for those who prefer not to use video calls.

Therapy homework expectations

Your therapist may assign “therapy homework” – tasks or exercises to do between sessions. These assignments can help reinforce what you’ve learned in therapy.

Discussing payment options

Private pay

Private pay involves paying out-of-pocket for therapy sessions.

Health insurance

Some therapists accept health insurance, which can cover a portion of the therapy cost.


Certain therapists accept Medicaid/Medicare, government-provided health insurance for eligible individuals.

Addressing misconceptions about therapy

There are many misconceptions about therapy, and your therapist can help clarify any misunderstandings. For instance, therapy is not just for people with severe mental health issues; it’s a tool for anyone seeking to improve their mental and emotional well-being.

What Happens in a First Therapy Session? ☝️

Setting the Stage for Future Sessions

Establishing therapy goals

By the end of the first session, you and your therapist will have established some therapy goals. These goals will guide your future sessions and help track your progress.

Planning the therapeutic journey

Your therapist will also discuss the plan for your therapeutic journey, including the techniques and approaches they’ll use to help you achieve your goals.

Discussing the potential for trying different therapists if needed

If you feel that the therapist is not a good fit for you, it’s okay to consider trying a different therapist. It’s important to find a therapist with whom you feel comfortable and understood.

In conclusion, the first therapy session is a crucial step in your therapeutic journey. It’s a time to establish a connection with your therapist, discuss your concerns, and set goals for your therapy. Remember, it’s okay to feel nervous, and it’s important to ask questions and express your thoughts and feelings. With the right therapist and approach, therapy can be a transformative experience.

For more information on therapy and counseling, visit our counseling and therapy page and learn more about the role of a psychotherapist.

(source: PsychCentral, GoodTherapy, Psycom)

What to expect in your first therapy session

Diving Into Healing: Your FAQ Guide to the First Therapy Session

What should I bring to my first therapy session?

It’s a good idea to bring a form of identification, your insurance card if applicable, and any forms the therapist’s office may have requested you to fill out in advance. Additionally, consider bringing a notebook and a pen for jotting down thoughts or questions you might have during the session.

How long does the first session usually last?

The first therapy session typically lasts between 50 to 60 minutes. This initial meeting is an opportunity for both you and your therapist to get to know each other and to discuss the reasons you’re seeking therapy.

What kinds of questions will the therapist ask?

During the first session, your therapist might ask about your personal history, your current situation, and what you hope to achieve through therapy. Expect questions about your mental health, family history, relationships, and any specific issues you’re facing. This helps them understand your needs and how best to support you.

Is it normal to feel nervous before the first session?

Absolutely. It’s completely normal to feel anxious or nervous before your first therapy session. Remember, this is a step towards self-care, and it’s okay to be vulnerable. Therapists understand this and are trained to make you feel as comfortable as possible.

What if I don’t know what to talk about?

Don’t worry if you’re not sure what to talk about. Your therapist can guide the conversation with questions and prompts. The first session is often about gathering information and getting to know each other, so even just talking about your day-to-day life can be very helpful.

How should I prepare for my first session?

Consider taking some time to reflect on what you hope to achieve through therapy and any particular issues you’d like to address. Writing down your thoughts, feelings, and any questions you have for your therapist can also be a great way to prepare.

Will everything I say be kept confidential?

Yes, therapists are bound by confidentiality agreements to keep everything you say private, with a few exceptions related to harm to yourself or others. This ensures a safe space for you to share openly.

What happens after the first session?

After the first session, you and your therapist will likely discuss the next steps, which may include scheduling future sessions and setting some initial goals for your therapy. It’s also a time for you to reflect on how you felt about the session and whether you feel comfortable with the therapist.

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