What Happens in Your First Therapy Session? What to Expect

Your therapist will likely start by asking some questions about:

• What’s been going on in your life recently
• What led you to seek therapy now
• What you’d like to get out of the process

You don’t need to have a perfect explanation. It’s completely okay to say something like, “I’m not exactly sure, I just know something feels off.” That’s often where therapy starts.

There’s no pressure to share everything right away. Therapists understand that opening up to a new person about your deepest thoughts and feelings is intimidating, and that it takes time to build rapport and trust.

A good therapist will:

• Follow your lead
• Respect your boundaries
• Create a space that feels safe and non-judgmental

Some people naturally open up quickly, while others take more time to warm up. Both are completely okay, and you should never feel pressured to say or do something you aren’t yet comfortable with.

To better understand the full picture, your therapist might ask about related topics in your life. Most common questions are related to your presenting concern, how long it has been an experience for you, and what you have tried already. A sophisticated therapist will go beyond the basics and get to know more about your complete story, including other factors in your life that may be influencing your problems like:

• Your relationships and family background
• Work, school, and hobbies
• Your cultural and religious background
• Specific concerns for women, men, or 2SLGBTQAI+

It shouldn’t be an interrogation, it’s about identifying patterns and contexts that may be relevant to what you’re experiencing now. Sometimes taking a broader look at your life can help you and your therapist discover patterns that have gone unnoticed.

You don’t need a perfectly clear goal yet, but your therapist may gently explore questions with you like:

• What would you like to be different?
• What would “progress” look like for you?
• What do you want your life to look like?

These initial goals can evolve over time, the first session is just a starting point. It’s very common during therapy to adjust or add goals as you gain self awareness and make progress. As a regular part of the process moving forward, your therapist will regularly check-in with you on how you feel you are making progress towards your goals, reflecting on your achievements and tailoring treatment to target your remaining goals.

The first session is also your chance to get a feel for the therapist. If it is your first experience with therapy you may be wondering what to look for in a good therapist. Some general questions you might ask are:

• What is your approach to therapy?
• What does a typical session look like?
• How often do you recommend meeting?
• Have you helped others with similar problems before?

Therapy works best when it feels like a good fit, meaning you feel comfortable talking to them about your thoughts and feelings, and feel as though they are not judging you. It’s normal to feel some hesitation at first, but as you go on, being your authentic, honest self in therapy is what will be the most helpful, so try to make sure your therapist feels like someone that makes that possible.

At the end of the session, you and your therapist may:

• Talk about a treatment plan and targets
• Decide on a schedule (weekly, bi-weekly, monthly.)
• Reflect on whether it feels like a good fit

You’re always allowed to take time to think about it before continuing. Therapy is meant to help you, and you should always feel like you are in control. If you have doubts about any part of therapy, you can inform your therapist. They are there to help you feel supported, no matter what decision you make.