It’s important to understand what to expect during your first therapy session.
You’ve made the decision to consult a therapist. Perhaps you’ve been thinking about it for months or maybe it just now made sense. In any case, there is likely a combination of hope and fear. What will they ask? Will they judge? What do I say if I don’t know where to begin?
Here is a bit of an idea of what a first session is like and why it is important.
The First Few Minutes – Setting the Tone
As you enter, one of the first things you notice is the environment. A good therapy room is quiet, has soft lighting, comfortable chairs, and maybe a plant or two. This isn’t accidental. The room itself is conveying a message: “You are safe here.”
You will be greeted with a friendly tone, some pleasantries and will be asked whether you feel comfortable or not. Not small talk – it is a part of building trust. For some of us, we didn’t have a family that talked about feelings, and asking for assistance was seen as weakness. It can be intimidating when you enter a therapy office. A warm welcome helps to put that at ease.
Getting Started – The Life Story Question
What do you think the answer to the question “What was your life story?” is?
Typically, the first sessions will be open-ended, such as “Tell me what brought you here” or “What made you come see a therapist now?”
You don’t have to get an answer correct. There’s no need to have everything worked out. In fact, many will say that they feel like “I don’t know where to begin” or “Things are heavy these days.” That’s enough.
The therapist will listen and take notes. They’re not judging, they are understanding. They may ask probing questions in a gentle way to get the whole story:
At what time did this start?
What is your average day at work like?
What are the people in your life who can support you?
What have you done up to now?
It is important to collect this data. It gives the therapist insight into your symptoms, as well as your life context.
This is a normal part of the therapy session process.
The Middle – Your History & Patterns
Typically, the discussion continues to grow throughout the session. The therapist may ask questions about:
Your family background and relationships
What experiences you have had in the past and how they have impacted you
Strategies you know to use to cope
Your physical well-being, sleep, diet (Mental and physical health go together!)
Any experience of therapy before
This might feel personal. That’s normal. Therapy is a very intimate process – you’re sharing information with someone that you may not have shared with anyone else. If it’s too much information to share in the initial session, you can state it. It’s fine to say “not yet” when it comes to the conversation.
Establishing Expectations – The Key Component
At the end of the initial session, a competent therapist will say:
How therapy works: Togetherness! You are not in a doctor-patient relationship where the therapist simply “fixes” you.
Going forward: Sessions are usually 45-60 minutes in length per week (may be more or less depending on the client). It’s not a quick and easy solution – positive change typically happens over time.
Confidentiality: All information shared in the room will be kept confidential (unless it is a safety issue).
Therapy style: Every therapist has his or her own method of therapy. As one example, I employ RE-CBT (Rational Emotive Cognitive Behavioral Therapy) which concentrates on the impact of our thoughts, feelings, and beliefs on our experiences.
Payment: How to pay for the cost, how to cancel, scheduling future sessions.
This helps the first counseling session experience feel more predictable and safe.
The End – How You’ll Feel
Many people don’t realize this, but you may feel tired after your initial session. You have been thinking, talking and processing – it is work. That’s normal. Others feel relief, as if they have said things that they had been thinking about, but never out loud.
You may not feel ‘better’ right away. Therapy is not the answer to all problems. However, you may feel heard – and sometimes that alone can help.
What is a Successful First Session?
Criteria for a good first session!
✓ They are listening to you and not judging you
✓ They explain how they work and don’t assume they know the way you want it to work
✓ They ask you if it is OK to go deeper into the issue and then prompt you to answer
✓ They are curious about your life, not just your symptoms and ask questions that lead you to the answers
✓ You know what to do next, e.g., explore the issue further
This is a key component of quality mental health counseling.
Some Reminders
There are a couple of things to be aware of:
The first session is no exception: there is no right or wrong. There doesn’t need to be a clear picture.
That’s fine if you do not feel a connection. You may need to see a couple of therapists to find the right one for you.
It’s okay you’re here. You’re taking steps to take care of your health.
We all feel nervous, excited, and maybe even skeptical at times – it is ok to feel any of these emotions.
Key Takeaway
The first therapy session will be a session of exploring together. It’s a trial period — the therapist is getting to know you, and you are getting to know the therapist. Don’t be afraid to not know everything. You’re showing up, you’re being honest and you’re making a step towards understanding yourself.
That takes courage.
Follow Tanu Choksi on Instagram, LinkedIn, and Facebook for expert insights on therapy and self-understanding.
