What to Expect in Your First Therapy Session
Perhaps you are starting therapy and you don’t know where to start. Or you have an appointment for your first therapy session and don’t know what to expect. Taking the first step can be nervewracking, but knowing where to start and what to expect during your first session can help you feel more confident and comfortable.
It’s important to remember that the first session is not about having all the answers right away. Instead, it’s a starting point to sharing what’s bringing you in, getting to know your therapist, and beginning building a non-judgemental, supportive environment.
In this article:
Is it normal to feel nervous before your first therapy session?
Absolutely, feeling nervous before your first session is normal, and many people experience this feeling. It is common to worry about what you should say, if you will feel comfortable, or if therapy will actually help.
Therapists regularly work with clients who feel anxious, hesitant, and unsure at the beginning. These feelings are expected, and there’s no reason to hide them. Oftentimes, telling your therapist that you feel nervous may help ease tension and pave the way for an open, honest conversation. Remember that you are taking a meaningful step toward caring for your mental health, and it is reasonable to feel nervous about it in the beginning.
How should I prepare for my first therapy session?
While there is no “right” way to prepare for therapy, there are ways to feel more grounded before going in.
You might consider writing down, or taking a mental note, of:
What led you to seek therapy at this point in your life
Any symptoms, stressors, or challenges you’ve been experiencing
When these symptoms, stressors, or challenges may have arose
Your goals for what therapy might help you with, even if it is vague right now
It is completely okay if you don’t have any clear answers just yet. It is enough to just know that something feels “off”, overwhelming, or unstable. Any reason, no matter how vague, for beginning therapy is valid and welcomed.
On a practical level, make sure you know whether your first session is in person or online, and if you have a clear preference towards one. For virtual sessions, try to find a private, quiet space where you can feel comfortable talking openly. For in-person sessions, try to give yourself several extra minutes to arrive, settle in, and take a few deep breaths.
Remind yourself that therapy is your space to share, feel supported, and work towards your goals. You’re not expected to share everything right away, and you are always in control of what you choose to talk about.
What happens during your first therapy session?
The first session is foundational, it is about getting to know your therapist and discussing your history and what brought you in. When you get to the therapist’s office, expect an experience similar to a doctor’s appointment: you will likely sign your name in, sit in the waiting room and wait to be called.
While waiting, you may be asked to fill out some paperwork, including:
HIPPA forms
Insurance information
Medical history
Symptoms
Record release form
Therapist-patient services agreement
If you feel uncomfortable or unsure answering any of the questions, you can wait until you are with your therapist to ask. It is okay to be unsure and have questions about the process.
To understand what a typical first appointment looks like at Careful Counseling and how we will cater our care to your needs, click here.
Introductions and Building Comfort:
Your first session typically begins with introductions. Your therapist may explain their role and what you can expect moving forward. They will answer any questions you have about the process.
Discussing What Brings You to Therapy:
Next, you may share what led you to seek therapy. This could include symptoms or concerns related to anxiety, stress, depression, sleep, relationships, work, or life transitions.
There is no pressure to tell your entire story or explain perfectly – your therapist’s role is to listen, ask insightful questions, and begin identifying your goals together.
Intake Questions and Background Information:
Your therapist may ask some background questions to better understand you. These topics can include: medical history, family or relationship dynamics, work, school, or life stressors, and previous therapy experiences.
This will help your therapist tailor their approach to you. You can ask for clarification, or let your therapist know if you feel uncomfortable discussing something right away.
Our diverse team at Careful Counseling will ensure you are matched with a therapist that suits your needs and addresses your concerns appropriately.
In-Person vs Online Therapy – What should I expect?
Many clients in the Boston and Brookline area choose between in-person and online therapy depending on their schedule and their needs. Both options offer effective, high-quality support.
In-Person Therapy:
In-person sessions take place in a private and comfortable office environment. For some people, being physically present in the session helps them establish a deeper connection and communicate better. Different treatment options, such as Virtual Reality Exposure Therapy (VRET) may require the patient to be in-person.
Online Therapy (Telehealth):
Online therapy can offer more flexibility and convenience for busy schedules. Sessions are conducted on a secure platform, and this feels just as supportive for many clients. Many forms of therapy, such as Cognitive Behavioral Therapy (CBT), can be just as effective in-person and online.
Your therapist will help you feel comfortable and secure with whichever format you choose
How do I know if my therapist is the right fit for me?
Finding a therapist who specializes in what you need and that provides the right support is an important part of the therapy process. Every therapist’s approach is different, and it is okay to decide if it is not the right fit for you.
After your first session, you may reflect on questions like:
Did I feel listened to and validated?
Did the therapist explain things clearly?
Are we on the same page about my goals and direction?
Do I feel respected in my boundaries and identity?
Did I feel safe being honest, even if I was nervous?
It’s okay to not feel 100% comfortable right away as trust builds over time. That being said, your therapist should feel supportive and collaborative. If something doesn’t feel right away, you can talk to your therapist about it or explore working with someone else.
Getting Started with Therapy at Careful Counseling
Starting therapy can feel like a daunting step, but you don’t have to take it alone. At Careful Counseling, our team of licensed clinicians are committed to a warm, supportive, and non-judgemental environment for every client.
Careful Counseling can provide you with a Neuropsychological Assessment to gain insight into how your brain is functioning and how it impacts your daily life. We can help you understand any learning difficulties, memory problems, attention challenges, or emotional concerns you may be dealing with, and create a plan to move forward with clarity and confidence.
Your first therapy session is about beginning a conversation at your own pace. Whether you’re seeking support for anxiety, depression, relationships, or life transitions, we’re here to meet you where you are and help you move forward.
