What to Expect in Your First Therapy Session

Starting therapy can be a nerve-wracking experience, especially if it’s your very first time. You might have a general idea of what to expect based on TV or movies, but those often gloss over the first session and get right to the deeper stuff. To lower your anxiety and help you prepare, here’s a quick rundown of what you can expect in your first therapy session:

Paperwork

Lots of paperwork. Unless your therapist had you complete intake forms online ahead of time, you’re in for at least 10 minutes of reading about confidentiality and privacy practices, filling out forms with your contact info, and explaining a bit about why you’re seeking therapy.

“So what brings you here?”

Speaking of therapy goals, your therapist is going to want to know why you’re coming to therapy right now. Did something specific happen, like a traumatic accident or death? Have you been having issues in your relationship? Maybe you’re wanting to talk about the bullying you experienced in middle school. Whatever the reason, be prepared to share at least a bit about why you’re there.

If you can’t think of a specific reason, ask yourself what you’d like to change about your life. This could be getting better sleep, managing your anger, improving your social skills, anything at all that you would like to improve. Don’t worry if your goal seems impossible or you have no idea how to get there--that’s the reason people come to therapy. While the therapist won’t have all the answers, their job is to help you create a roadmap to your best self and guide you along the way.

Building rapport

In the first couple of sessions, you’re just getting to know your therapist, feel out their vibes, and decide if this is a good fit. Considering the relationship between therapist and client is one of the most important factors contributing to success in therapy, you’ll want to make sure this is someone you can trust. Feel free to ask questions--how long they’ve been counseling, where they’re from, what they do for fun. I encourage my clients to ask me any questions they’d like, and if I don’t feel comfortable or it feels too personal, I let them know. Therapists shouldn’t spend most of the session talking about themselves, but it makes sense to want to get to know who they are as a person before spilling your deep, dark secrets. And don’t worry about getting to those shameful, heavy issues at the beginning--you will get there eventually, I promise.

It will probably end sooner than you think

Most sessions are “an hour” but that’s a therapy hour, meaning closer to 45 or 50 minutes. This is so your therapist has time to write notes and decompress before their next session. Even so, those 50 minutes will likely fly by as you start to talk about your life. If you get stuck or don't know what to say, don't worry. Your therapist will have plenty of questions for you and will keep the conversation going.

Scheduling

Before you leave, your therapist will ask about scheduling your next appointment. Most therapy sessions are weekly, but it’s not unusual to have anywhere between 2 sessions a week and 2 sessions a month, depending on your level of need or crisis. If the therapist suggests weekly but financially you can only afford every other week, tell them that. A good therapist will understand and either be flexible with scheduling, offer sliding scale (a lower session fee), or refer you to a therapist within your budget.

If you don’t feel like this therapist is a good fit for you, please say so. We’ve heard this before and understand that we’re not going to be the perfect person for every client. Saying this after the first session means we can recommend a different counselor and you don’t have to waste time or money doing something that doesn’t feel right. It's normal to see a couple therapists before finding the right one for you. Although you might not feel totally at ease after one session, you should feel like you “click” with the therapist.