So, you’ve made the decision to start therapy—first of all, huge kudos to you! Taking that first step toward mental wellness is no small thing, and you should be proud of yourself. But let’s be real: you might be feeling a little nervous or even overwhelmed about what’s going to happen in that first session.
What can you expect?
What should you bring?
What should you prepare for?
You’re not alone in feeling this way, and I’m here to give you a little insider’s guide to help ease your mind and get you feeling more confident.
So, let’s walk through it together. Ready? Let’s dive in.
The Initial Appointment: What Happens?
You’ve made the appointment, you’re nervous, but you’ve got this! Your first therapy session is usually all about getting to know you, and while it might feel a bit like an interview, it’s nothing to worry about. The therapist's goal is to understand who you are and why you’ve come to therapy. Here’s the usual flow:
1. Paperwork and Admin Stuff
Yes, there’s usually some paperwork at the beginning—nothing too crazy, just the basics. You might have a couple of forms to fill out, like:
Consent forms (these just explain how therapy works, confidentiality, and any limits to confidentiality).
Personal information (like your contact info, insurance, etc.).
Mental health history (any diagnoses you’ve had, past treatments, and current symptoms).
It’s nothing you have to stress over. Most of this is to help your therapist understand your background so they can tailor their approach to your needs. It’s kind of like setting up your profile for a treatment plan.
2. The Therapist’s Introduction
Once the paperwork’s out of the way, your therapist will probably introduce themselves. They’ll explain their qualifications, their therapy style, and how they work. This is when they’ll let you know the general structure of therapy (how often you’ll meet, how long the sessions last, etc.), as well as a few ground rules around confidentiality, emergency protocols, and things like that.
They’ll likely ask if you have any questions at this point—feel free to ask anything! This is your time to make sure you're comfortable.
How to Prepare for Your First Therapy Session
Okay, so you’re probably wondering, “What do I do to get ready for all of this?” No worries—I’ve got you covered. Here are a few ways to prepare for your first session and make the most of it:
1. Know Why You’re There
Think about what brought you to therapy in the first place. Is it anxiety, relationship struggles, work stress, or something else? You don’t need a super detailed list, but having a clear idea of what’s bothering you will help your therapist understand your goals for therapy. You can jot down a few bullet points of what you’re hoping to address. If it’s hard to pinpoint, that’s okay too—sometimes just saying “I don’t feel like myself” is a great place to start.
2. Be Open (Even If It’s Hard)
You don’t have to spill your whole life story on the first day. But being as open as you can about what’s going on will help your therapist get to the root of the issue. Trust me, therapists have heard it all. There’s no judgment here. Whether you’re talking about anxiety, grief, or something embarrassing, your therapist will create a safe, nonjudgmental space for you to express yourself.
3. Set Some Goals (Even If They’re Flexible)
While it’s totally fine if you’re unsure of the specifics, think about what you want to get out of therapy. Do you want tools to manage stress? Or maybe you want to better understand your emotions? Goals don’t need to be rigid, but having a rough idea can help both you and your therapist guide the process.
You can always revise these as you go along.
4. Bring Any Questions You Have
If you’ve never been to therapy before, you might have a ton of questions. That’s totally normal. Feel free to ask things like:
“How long will I need therapy?”
“What types of therapy do you use?”
“How will I know if I’m making progress?”
Your therapist is there to help, and answering questions is part of their job.
What Will the Session Be Like?
Let’s talk about the actual session. While every therapist works a little differently, here’s what you can typically expect from the flow of the first session.
1. Getting to Know Each Other
This is when your therapist will ask you about your background, your mental health history, and what’s going on in your life right now.
They may ask questions like:
“What’s been bothering you lately?”
“Have you had therapy before?”
“What are some of your goals for therapy?”
It’s not an interrogation; they’re just trying to get a sense of where you are and how they can best help you. You might talk about your family, your work, your relationships, or anything else that feels relevant.
2. Explaining Therapy Approaches
Your therapist will likely explain a little about how they work—this can be a really important part of the session. For example, they might use Cognitive Behavioral Therapy (CBT) to help you reframe negative thoughts or mindfulness techniques to help with anxiety. They’ll explain the approach so that you’re on the same page. If something doesn’t make sense or you’re unsure, don’t be afraid to ask!
3. A Sense of Relief
Once you’ve talked about some of the challenges you’re facing, you might start to feel a sense of relief—just having someone listen without judgment can be incredibly therapeutic in itself. Even if you don’t dive deep into specific issues in the first session, you’re still starting to build a relationship with your therapist. That’s a powerful first step.
4. Next Steps
At the end of the session, your therapist might summarize what you’ve talked about and suggest a plan moving forward. They may ask about scheduling future appointments, discuss any tools or coping strategies, or offer to explore specific issues in more detail next time. It’s totally normal to feel unsure about everything after your first session, but trust that your therapist will help guide you through the process.
What if I’m Nervous?
It’s completely normal to feel nervous about your first therapy session. The fact that you’re even taking the leap to seek help is already a huge victory, so give yourself some grace. If you find yourself feeling anxious or unsure, here are a few tips to manage that:
Take deep breaths before the session.
Remind yourself why you’re going and what you’re hoping to achieve.
Know that you don’t have to talk about everything all at once. You can take it slow, and your therapist will help guide you at your own pace.
You Got This
Your first therapy session is just the beginning of your journey toward emotional wellness and healing. It might feel a little awkward at first, and that’s okay—you’re human. What matters most is that you’re showing up for yourself and taking the time to get the support you deserve. With each session, you’ll likely feel more comfortable, and therapy will start to feel like a powerful tool in your mental health toolkit.
So, go ahead and take that step. You don’t need to have it all figured out right away, and there’s no “perfect” way to start therapy. Just show up, be open, and trust the process. Your therapist will be there to support you every step of the way, and before you know it, you’ll be well on your way to feeling better.
Take care of yourself—you’ve got this!
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