Your First Therapy Session: What Really Happens (and What Doesn't)

Starting therapy is a big step. For many people, the thought of a first session comes with a mix of hope, nerves, and a lot of questions. What will it be like? Will I have to share everything right away? What if I don’t know what to say?

The good news is that a first therapy session isn’t about having all the answers, it’s about beginning a conversation.

Before Your Session

Much like a doctor’s visit, there’s usually a bit of paperwork before you get started. You might fill out forms that cover your mental health history, family background, and the reasons you’re seeking therapy. There will also be documents like a therapist-client agreement, consent forms, and privacy policies.

This information gives your therapist a sense of who you are and what you’re hoping to work on.You can expect that in your first session, your therapist will ask questions that build on what you wrote, inviting you to share more details at your own pace.

What Happens in the First Session

The first meeting feels different from later sessions. Instead of diving immediately into strategies or solutions, the focus is on connection and understanding. You’ll likely spend time:

• Talking about what brought you to therapy and what you’d like to get out of it
• Hearing your therapist explain how they work and reviewing confidentiality (and its limits)
• Exploring your background, relationships, and any current stressors
• Asking your therapist questions about the process- like how often to meet, what happens if you don’t know what to say, or what their approach looks like

Think of it as a “getting to know you” conversation where both of you are deciding if this feels like a good fit.

Common Questions to Ask Your Therapist

Your first session isn’t just about answering questions, it’s also a time for you to ask them. Bringing your own questions can help you feel more comfortable and clarify what the process will look like. Examples include:

• What’s your approach to therapy?
• Have you worked with people who have challenges like mine?
• How often should I come to therapy?
• How will I know if therapy is working?
• What are the limits of confidentiality?
• Can I contact you between sessions if I need support?
• Do you give homework or things to work on between sessions?
• What if I don’t feel like this is the right fit?

Asking these kinds of questions helps you understand what to expect and sets the tone for acollaborative relationship.

What It’s Not

Many people worry that therapy will feel like an interrogation, or that they’ll have to reveal their deepest secrets right away. That’s not the case. A first session isn’t about judgement, pressure, or fixing everything at once. Here’s what therapy is not:

• Not only for people with “serious problems”: Therapy is for anyone who wants support, clarity, or growth– whether you're facing major life challenges or just feeling stuck.
• Not about instant solutions: Therapy is a process. You won’t leave the first session with every problem solved, and that's okay.
• Not a one-size-fits-all approach: Every therapist has their style, and every client has their unique needs. Your sessions are tailored to you.
• Not an interrogation: You won’t be quizzed or forced to share anything you’reuncomfortable with. You set the pace. 

After the First Session

Walking out of your first therapy session, you may feel relieved to have started, tired from talking about yourself in new ways, or even unsure about what comes next. All of those reactions are normal. The rhythm of therapy builds over time– the first session is simply the beginning of a partnership.

In your next session, the focus usually shifts from introductions to building momentum. You and your therapist may:

• Highlight key themes from your first session
• Begin exploring your goals in more depth
• Notice patterns in your thoughts, emotions, or relationships
• Try out tools or strategies that can support your day-to-day life

Therapy is a process, and each session adds another layer. Over time, you’ll likely notice shifts in how you think, feel, and respond to challenges.

Final Thought

Therapy is not about having the “right” words or doing it perfectly; it’s about showing up. The first session is your chance to take that initial step, meet your therapist, and start a conversation that can grow into real change.

If you’re curious about starting therapy, We’d be happy to answer your questions and help you begin.