Taking the step to start therapy can feel both empowering and intimidating. For many, the idea of opening up to a therapist about personal struggles brings about a mix of emotions—curiosity, anxiety, and perhaps a bit of fear of the unknown. Whether seeking therapy for the first time or returning after a long break, understanding what to expect from your first session can ease some of the uncertainty and help you feel more prepared.
Why Therapy?
People come to therapy for various reasons—stress, anxiety, depression, relationship issues, grief, or even to better understand themselves. Therapy offers a safe, non-judgmental space where you can explore your thoughts, emotions, and behaviors with the guidance of a trained professional. It’s a proactive step toward healing, personal growth, and improved mental health.
If you’ve never been to therapy, you might wonder what that first session looks like. Here’s a guide to help you understand what happens during your initial visit and how to make the most of it.
What Happens Before the Session?
Before your first therapy session, there are a few things you’ll typically go through:
- Initial Intake or Consultation: Some therapists offer a short phone or video consultation to discuss your needs and goals. This helps you both determine if you’re a good fit for one another. You can ask about the therapist’s approach, fees, and availability during this conversation.
- Paperwork: Just like visiting a doctor, you’ll often need to complete intake forms before the first session. These forms gather basic information such as your medical history, current symptoms, and background, and might include consent forms regarding confidentiality.
- Setting Your Expectations: It’s helpful to think about what you want to achieve from therapy. Are you looking for coping strategies? Better communication skills? Relief from anxiety or depression? Defining your goals will give the therapist a better understanding of how to help you.
What to Expect During the First Therapy Session
Your first therapy session is often referred to as an “intake session.” It’s an opportunity for your therapist to get to know you, your history, and what brought you to therapy. Here’s what you can typically expect:
1. Introduction and Rapport Building
The first few minutes of the session will likely be focused on introductions and setting the tone for the session. Your therapist will want to make sure you feel comfortable and safe in the environment. They’ll explain their role and how therapy will work. You can expect your therapist to be warm, welcoming, and professional.
2. Exploration of Why You’re Seeking Therapy
Your therapist will ask you questions about the main issues that brought you to therapy. These might include:
- What led you to seek therapy at this time?
- Are there specific situations, thoughts, or feelings that you’d like to work on?
- How are these issues affecting your daily life, relationships, or work?
It’s okay if you’re not sure how to answer everything yet—this is the beginning of the process, and your therapist is there to guide you.
3. Your Personal and Medical History
To get a comprehensive understanding of you, your therapist may ask about your history, such as:
- Family background and relationships
- Past trauma or significant life events
- Medical history and any previous therapy or mental health treatment
This helps the therapist understand the broader context of your life and how past experiences might be impacting you today. Some of these questions can feel personal, but remember, the information you share is confidential, and you only need to disclose what you feel comfortable with at the time.
4. Goal Setting
After discussing your reasons for seeking therapy, you and your therapist will likely set some initial goals. These goals can evolve, but setting them early helps establish direction and focus for your sessions.
For example, if you’re dealing with anxiety, a goal might be to learn coping mechanisms to reduce anxiety in your daily life. If you’re struggling with self-esteem, a goal might be to improve your sense of self-worth and confidence.
5. Explaining the Process and Next Steps
Toward the end of the session, your therapist will likely explain how therapy will proceed. They may give you an overview of the approach they use (such as cognitive-behavioral therapy, psychodynamic therapy, etc.) and what you can expect in future sessions. You’ll also have the chance to ask questions or express any concerns about the process.
Your therapist may also provide you with some immediate strategies to try or recommend further assessments or evaluations, depending on your situation.
Common Emotions During Your First Session
It’s normal to feel a range of emotions during your first therapy session. You might feel relieved to finally talk about your struggles, anxious about what the therapist thinks, or even unsure about opening up. It’s also common to feel drained afterward—therapy can be emotionally intense, especially when discussing difficult topics.
Remember, it’s okay to feel however you feel. Therapy is a process, and it takes time to build trust and fully explore your thoughts and emotions.
How to Prepare for Your First Therapy Session
If you want to feel more prepared going into your first session, here are a few tips:
- Be open and honest: Therapy works best when you’re open about your feelings and experiences, even if they’re uncomfortable to talk about. Your therapist is there to support, not judge.
- Bring questions: If you have any concerns or curiosities about how therapy works, feel free to ask your therapist. This helps clarify expectations and can make you feel more at ease.
- Reflect on your goals: Think about what you hope to get out of therapy. Having a general idea of your goals can help guide the conversation during your first session.
What If You Don’t Feel a Connection?
The therapeutic relationship is an essential part of successful therapy. It’s important to feel comfortable and safe with your therapist. If, after the first session, you don’t feel that connection or you think the therapist’s approach isn’t right for you, that’s okay. It’s perfectly normal to try a few different therapists before finding the right fit. Don’t hesitate to discuss your concerns with the therapist or explore other options if needed.
Moving Forward: What Comes Next?
After your first session, you and your therapist will schedule future appointments, and the real work of therapy will begin. Each session will build on the last, helping you explore deeper thoughts, emotions, and patterns of behavior. With time, therapy can help you develop new skills, gain clarity, and work through challenges in a safe and supportive environment.
Conclusion
Starting therapy is a courageous step toward better mental health and personal growth. While the first session may feel a bit nerve-wracking, knowing what to expect can help ease those initial anxieties. Remember, therapy is a collaborative process, and the goal is to support you in living a healthier, more fulfilling life. Be patient with yourself and the process—it’s a journey worth taking.
