What to Expect in Your First Therapy Session

The very first time you see a therapist can be nerve-wracking. 

You may worry your therapist will judge you (they won’t) or that you’ll be forced to dive right into uncomfortable topics (you won’t). 

But it’s understandable that you may think these things. After all, it’s something you’ve never done before. 

Plus, your only reference is probably from movies or television — which isn’t always the most accurate depiction. (We’re looking at you, The Sopranos!)

One thing that can ease your mind? Knowing a bit about what to expect before your initial visit. Here’s what you should know. 

A few things to know before your first appointment: 

Generally, when people talk about therapy they are referring to talk therapy. This is a process that can help someone deal with psychological issues and live a healthier, happier life.

Usually, a therapist will have an advanced degree of some sort — whether it be a masters degree or a doctorate. 

Beyond a degree, therapists will usually specialize in a type of therapy. Common types of therapy include: 

• Cognitive behavioral therapy (CBT): This involves identifying patterns and behaviors that may not be helpful to your life and using problem-solving skills to cope.

• Dialectical behavior therapy: Originally used for people with borderline personality disorder, this form of CBT has been found to be effective in treating anxiety.

• Interpersonal therapy: People can use this to overcome interpersonal issues that may be affecting mental health — like unhealthy relationship issues or family dynamics.

• Psychodynamic therapy: Past issues may contribute to current feelings, so you’re asked to do lots of reflection in this form of therapy. 

Often, therapy happens in person — but virtual and phone therapy sessions are also options to consider. 

Like the first time you meet anyone, you can expect some small talk in your first professional counselling sessions. 

They may try to break the ice by asking you how your day has been going or if you have any fun plans for the weekend ahead. 

Once the session gets going, expect to be asked to give some background information on yourself. 

For example, a mental health professional may ask you what inspired you to start therapy, what you do for a living or how you may describe yourself to friends. 

Answering these questions will help your therapy provider begin getting to know you. 

After that, they may take over and do some talking. They may explain their credentials, tell you how they like to work, what their confidentiality policy is, how long sessions tend to be and what their cancellation policy is. 

They’ll also discuss billing — payment and payment plans, etc. They may also discuss the initial paperwork you’ll be expected to fill out, should you decide they’re the therapist for you.

After that, they may ask if you have any questions. If you do, feel free to ask them. If nothing comes to you at the moment, you can always email or call them later to ask. 

The final step will likely be to schedule your next appointment. It’s up to you if you’d like to schedule it right then or if you’d like to take some time to reflect on that first meeting before deciding whether or not to move forward. 

You may wonder: how long does therapy take? That depends on a number of factors. Another important reminder: there are many therapists out there. It may take visits with a few potential therapists before you find your therapist — and that’s totally okay. 

You can only be expected to really dive in with someone you share a healthy therapeutic relationship with, and the professionals know this. 

First, know this, you don’t have to prepare for your first appointment at all. If you’d rather wing it, that’s totally ok. 

That said, it may help you feel more confident going in if you’ve given a little thought to what you want to talk about. 

Above, we went over some of the things a therapist may ask during your initial visit. To prepare, you could think about how you want to answer those questions. 

Here, a few more thought-provokers that may get you in the right frame of mind and ready to discuss what you’re looking for in a therapist: 

• What made you want to try therapy? 

• What do you hope to get out of therapy? 

• In what ways would you like to feel different through therapy?

• How have you been feeling in general? 

• Before therapy, what have you done to try and feel better? 

• Have you talked to anyone else about the issues that you want to address in therapy? 

• What qualities are important in someone you confide in? You can also learn the answer to "how long is a therapy session" to better prepare for your first session.

One of the biggest misconceptions surrounding therapy is that nothing need to be catastrophically broken for you to seek it. 

It’s absolutely beneficial for those who struggle with issues like anxiety or depression, but they aren’t prerequisites to seeking help.

In fact, according to the National Institute of Mental Health, therapy can be beneficial for anyone who: 

• Is dealing with stress

• Has symptoms like loss of appetite, lack of sleep or low energy with no physical reason why

• Has difficulty focusing

• Is going through a big life change — like a new career, divorce, or death

• Is overwhelmed by sadness

But here’s the thing: those are fairly broad reasons — which basically means, anyone can try therapy. 

Here’s a helpful analogy:

Think of your mental health as a car you drive around in. You drive over speed bumps, sometimes you accidentally back it into a fire hydrant and there isn’t a person among us who’s thought, “that pot hole’s not that deep” only to escape it with a flat tire and a busted rim.

Wear and tear happens. Our hearts, our brains,  aren’t garage queens that we lock up in museums and only take out to car shows on Friday nights — they’re our daily drivers.

And sure, most of us our competent mechanics. We can check our oil, replace a burnt out blinker, clean the air filter every once in a while. 

But that doesn’t make us mechanics. And it’s good to bring your faithful automobile to a certified mechanic every once in a while — let them look under the hood and see what’s really what. 

That is what therapy is, too. Routine maintenance on pieces of machinery that work long and hard to keep us moving forward down whatever road lies ahead.

Making your first in-person or online therapy appointment is a huge step in the right direction when it comes to nourishing your mental health. 

You may be a little nervous the first time you meet with a mental healthcare provider, but there really is nothing to worry about. 

In your first session, you should expect to be asked about your background and your goals for therapy. 

In that initial session, your therapist will also likely do some talking and fill you in on how they like to work and what your treatment plan may look like. 

There will also be time to ask your therapist questions. 

Whether you’re meeting a mental health professional in person or online, it can do wonders for how you feel and your happiness levels.