What to expect during your first therapy session

Starting therapy can feel both exciting and nerve-wracking, especially if it’s your first time. You’re taking a big step towards improving your mental health and well-being, but you probably have lots of questions.

Any new beginning comes with a bit of anxiety, but learning more about what to expect can ease your nerves. You might’ve seen depictions of therapy in movies or on TV — but the reality is often very different. Therapy is a deeply personal journey. Learning more ahead of time can help ease your mind before you head into your session.

Read on to learn about what typically happens in a first therapy session, how to prepare for your appointment, cope with first-time nerves, and make the most out of therapy.

What happens in a first therapy session

If you’ve never gone to therapy, you might be afraid of the unknown. Here’s what the typical structure of an initial psychotherapy (otherwise known as talk therapy) appointment will look like:

1. Initial introductions

Your licensed therapist will start your first session by introducing themself and explaining how they approach therapy, since every mental health professional is different. For example, they might briefly discuss the type of therapy modalities they use.

You’ll also learn a bit about what to expect going forward. “The introduction includes expectations such as what the therapist expects of the client, what the client should expect from the therapist, and boundaries,” says Dr. Melissa Galica, Ph.D., a licensed professional counselor with Grow Therapy.

2. Confidentiality discussion

Confidentiality policies ensure therapy is a safe place to share whatever’s on your mind. Your provider will explain that you can rest assured that whatever you say in therapy stays in therapy.

However, there’s one caveat. By law, a therapist must notify the authorities if someone poses an imminent threat to themselves or another person, or if they learn about child or elder abuse occurring.

3. Intake process

Intake is typically a combination of paperwork and verbal conversation. Depending on the therapist, you might fill out some paperwork before your first session, too. These forms may include:

• Your address and contact information
• Emergency contact information
• Your healthcare information (insurance card and applicable documents)
• Your personal history of medical and mental health
• Your family history of medical and mental health
• Demographics
• HIPAA forms
• Consent to treatment forms (required in most states prior to treatment)

Expect to answer a good amount of questions so your therapist can learn about you. They will likely ask about your living arrangement, relationships, employment, and of course, what brings you into therapy today. “This is not the most fun thing ever because it can be super long and feel like an interrogation sometimes. But it’s a very important document in a client’s file,” Dr. Galica says.

Rest assured that future appointments will not be so heavy on the questions. The first session will help the therapist understand your history and current symptoms. Future sessions will be much more of an open conversation.

4. Goal-setting

Therapy is goal-oriented. Your therapist might ask you, “What are you looking to get out of therapy?” or “What are you hoping to achieve?” This way, they can understand exactly what you’re seeking therapy for.  This will help them develop the best treatment plan with you, setting the stage for appointments to come.

5. Goodbyes

To close out the session, your therapist will likely ask if you have any questions for them. They may also give you information about how you can contact them in between sessions if necessary, information about billing processes, and any other necessary logistics.

Lastly, you’ll schedule your next session!

Coping with common emotions before your first visit

It’s normal to experience a wide range of feelings before your first session — whatever you may be feeling is valid. Here are some common emotions you might feel:

• Nervousness or anxiety: Especially if you’ve never been to therapy before, you might feel nervous or anxious for several reasons. Talking to a stranger about your problems or opening up about things you’ve never discussed can bring up uncomfortable feelings.
• Excitement: Besides feeling nervous, you might also feel excited about starting a new journey, knowing that you’re embarking on a path of personal growth, self-awareness, and healing.
• Embarrassment or shame: If you’re opening up about deeply personal things, you might feel embarrassed or shameful. However, your therapist has heard it all. They will never judge you or make you feel ashamed.
• Worried that you won’t know what to talk about: If you hate awkward silences, you might worry that you won’t have enough to talk about. However, especially during the first appointment, there will be plenty of questions to keep the conversation going.

Tips for handling nervousness or discomfort in the first meeting with your new therapist

Here are a few quick tips to manage your nerves during your first session:

• Don’t stress about sounding perfect: Feel free to speak in an unfiltered way. “Just breathe and let your thoughts flow. Don’t worry about finding the perfect words. Just say what’s on your mind,” Dr. Galica says.
• Don’t feel like you need to share everything right away: Think of therapy as a marathon, not a sprint. You don’t have to give your therapist your life story, open up about your trauma, or tell them everything about your past experiences in the first session. Although your therapist will have many questions for you, you can move at your own pace.
• Let them know you’re nervous: Sometimes, the act of simply letting your therapist know you’re nervous can help you feel a bit more at ease. They’ll likely assure you that this is a normal way to feel and that they’re here for you. Recognize that discomfort in sharing personal stories is normal but will lessen with time.

How to prepare for your first therapy appointment

If you want to make the most of therapy, here are a few things you can do to prepare.

Reflect on what you want to work on in therapy

Why exactly are you seeking therapy? Think about what you want to achieve. Here are some examples of things you might share with your therapist to help the two of you develop goals:

• Developing better coping skills
• Dealing with a major life transition
• Processing unresolved trauma
• Getting over a painful breakup or divorce
• Learning to manage anxiety and everyday stressors
• Having healthier relationships
• Building confidence and self-esteem
• Practicing self-compassion
• Improving symptoms of a diagnosed mental health condition

Not sure exactly what your goals are? That’s okay, too. Let your therapist know, and you can come up with some applicable goals together.

Prepare questions for your therapist

Your therapist will ask if you have any questions for them. Feel free to ask them about their approach, the therapy process, or any concerns you have. These can be logistical questions or questions about therapy itself.

Here are some questions you might want to ask:

Logistics

• Are you available between sessions for questions?
• If so, how can I reach you between sessions? (Text messaging, emailing, calling?)
• What is your cancellation policy?
• How can I reschedule or cancel an appointment?

About the therapist

• Do you have life experiences similar to mine?
• What are your specialties?
• Have you helped clients in similar situations as me?
• What is your education and training?

While it’s not wrong for clients to ask for more personal information about their therapist, such as if they are a parent or participate in any religion, be prepared for them to let you know to what degree they’re comfortable discussing these topics. They also may ask questions about your questions, as it could be relevant to treatment.

About therapy

• Will our sessions always be online or in-person?
• What type of therapy do you think is best for me?
• Will there be “homework” in between sessions?
• How long will it take for me to make progress?
• How many sessions do you think I’ll need?
• How will we know when it’s time to stop therapy?
• How often will we revisit my goals to see if I’m progressing?
• Do you think I could benefit from any complementary treatments, like psychiatric medications?

Consider logistics for in-person and online therapy

To reduce stress on the day of, consider logistics ahead of time.

If your appointment is in person:

• Plan how you’ll get to the therapist’s office (Are you driving yourself? Getting a ride? Taking public transportation?)
• Dress comfortably
• Bring payment (whether you’re paying out-of-pocket or an insurance copay)
• Print out any intake documents to bring with you (if you didn’t submit them online)

If you’re opting for online therapy, AKA teletherapy:

• Ensure privacy: You won’t be able to fully open up in therapy if your setup isn’t private. You want to be in a space where you feel safe to speak freely.
• Address technical issues: Make sure your internet connection is good, and your camera and computer microphone are working.
• Set up a comfortable space: Get everything you need ready. Decide if you prefer to be at your desk or a comfy chair. It’s up to you. Have anything else handy that’ll keep you comfortable, like a cup of tea or coffee and a blanket.
• Submit documents: Make sure you submit intake forms, questionnaires, or other forms.

Of course, these are all just suggestions. For many people, starting therapy is an overwhelming and even upsetting experience. If all you can do is get yourself to your appointment, that’s enough — your therapist will help you sort out the rest.

What to expect after your first therapy session — and what not to expect

After your first session, you could feel a variety of things — especially if you were talking about difficult topics:

• Emotionally raw or exhausted
• Lighter, or a sense of relief
• Remembering something you wish you’d mentioned
• Positive feelings or a strong connection to your therapist
• Understood or grateful that someone took the time to listen to you

Don’t underestimate the importance of post-therapy self-care. You might want to plan some time after therapy to do something comforting or relaxing, like taking a walk or engaging in your favorite hobby. Use this time to decompress. Give yourself grace.

Additionally, you might have some thoughts, feelings, or opinions about your therapist or the therapy process in general. It’s normal to wonder whether the therapist is a good match for you. In this way, finding a therapist can feel like dating. However, it’s important to give the relationship time to grow –– unless your therapist acts unethically or makes you feel unsafe.

As for what not to expect…

• Don’t expect to “click” immediately: It might take a few sessions to feel like this is the right therapist for you, and that’s okay. It takes time to build rapport and comfort.
• Don’t expect to feel “fixed” right away: Therapy is a gradual process, and progress might not be visible after just one session. The first few sessions are more about getting to know you rather than actually carrying out treatment.

Making the most of therapy moving forward

After the first session is out of the way, what’s next? Here are a few ways to make the most out of therapy.

Be open and honest

This is the most important thing. Even though it can feel difficult, transparency can lead to better outcomes. The more you share about your struggles and the more vulnerable you get, the better your therapist can help you. If you feel closed off or want to avoid certain topics, discuss this with your therapist.

Commit to the process

If you want the best results, attending sessions regularly is crucial. Understand that you need to be patient and trust the process since you won’t feel better right away. It takes time for therapy to work. If you have a mental health condition, you may see small changes after a few sessions, it often takes upwards of 12 sessions for significant improvements to symptoms. That means you should give it at least three months.

Set clear goals and revisit them

Setting clear, specific goals helps you navigate therapy intentionally. Goals help you and your therapist work towards the same thing. Additionally, it’s important to revisit your goals, not just talk about them at the beginning of therapy. Your therapist might check in and ask about how you feel your progress is going toward your goal, or you can always start that conversation, too. If you feel like you aren’t making the progress you hoped for, voice this concern to your therapist.

Do your homework and between-session work

Your provider might assign “homework” or tasks to work on before your next appointment. This helps reinforce progress and keep momentum going between sessions. Homework is more common in certain types of therapy, like cognitive behavioral therapy (CBT). Your therapist might give you worksheets to complete, journaling prompts, or have you practice relaxation techniques, like breathing exercises.

Your first therapy session is just the first step

It takes a lot of courage to start therapy, so give yourself a pat on the back. The first step is often the hardest, but it’s a meaningful investment in your well-being. The more you attend therapy sessions, the more comfortable you will get with your therapist. Opening up and getting vulnerable will feel more and more natural to you, and you’ll be a therapy pro in no time!

If you’re looking for a therapist, Grow Therapy can help. Finding the right therapist isn’t always easy, but Grow Therapy simplifies the process. On our site, you can use our filters to search for potential therapists in your state who accept your insurance and specialize in your unique needs. Get started today.