What to expect in a first session

What to expect in a first session

If you’re new to therapy, you may be wondering what to expect in your first session.

Feeling excitement, dread, nervousness, embarrassment, hope - or even nothing - are all totally normal and common ways to feel when beginning therapy. In fact, there is no wrong way to feel!

Many therapists offer a consultation, which is shorter than a full session, and typically without a fee associated. The consultation may happen in person or over the phone. Once you and your therapist have connected, you’ll choose a mutually agreeable time to meet.

At your first session, your therapist will greet you at your session start time and lead you to a private office, where the seats are usually facing each other. Your therapist will be responsible for keeping track of the session time, letting you know when the time is coming to an end. Whether you’ve come on your own, or as part of a couple or family, your therapist will spend time understanding what brings each of you to therapy, and what you are hoping to address in therapy early on.

They will likely share some information with you about their approach to therapy, giving you an idea of how they work and what it might be like to engage in the type of therapy they’ve been trained in. You’ll probably be invited to ask questions or share any concerns you might have (both at this time and throughout all therapy sessions).

It’s very common for therapists to present you with some paperwork, which may describe things like confidentiality and its limits, privacy and cancellation policies, and perhaps additional information relating to their unique practice. You may be asked to provide contact information, and it’s likely that you’ll need to sign some form of consent or a client release to begin working together.

Some therapists - but definitely not all therapists - may ask you to fill out a questionnaire to gather some history, or assess suicide risk. If any of the information being gathered is triggering for you, or if you’re uncomfortable providing it, try to let the therapist know if you can. In many cases, providing such information is optional.

The remainder of the first session will vary, depending on the type of therapy you’ve chosen. Many therapies are about talking and listening, while some involve the body, art, sound or other forms of expression and connection.

Determining if the type of therapy and/or the therapist is a fit for you can be a difficult but important part of your therapy journey. Each therapist will bring their own style and personality into the room. There is no one therapist that is a fit for everyone, and finding a therapy and therapist that you feel comfortable with can be a big factor in your desire to continue and what you ultimately get out of the therapy.

Some things to consider might be: Do I feel safe in the space, and/or with the therapeutic approach? Am I being heard? Is there a part of me that feels encouraged to share my story with this therapist? What does my intuition tell me?

Most therapists have been clients themselves, and very much understand that each client will be looking for different things from therapy and in a therapist. It’s okay to decide not to book a second session. In fact, many therapists will encourage you to think about it for a day or two before reaching out to book something. It’s also possible in a first session, as you move more deeply into your story and goals for therapy, that the therapist may refer you to another therapist who is more skilled in the area in which you’re seeking support. For example, a therapist trained in one of the talk based modalities, may suggest a CBT approach for someone looking for practical, more immediate support with anxious thoughts.

As the session draws to a close, you may discuss next steps: things like the preferred frequency and timing of therapy (if this hasn’t been discussed already), and what the plan is for booking another session. You and your therapist may decide to do so immediately, or you may choose to think about it and reach out in the next little while, assuming you opt to proceed.

Your therapist will let you know about their availability and may or may not offer to hold times for you if you’re choosing to get back to them later. If session times are on hold for you, they probably have an expiration time that will be communicated to you. That way there’s no need for an email from you to communicate that you do not want to proceed.

Once you choose a time, it may become your regular session time moving forward, or you and your therapist may agree on a more flexible approach to scheduling.

After the session, you may also have some feelings come up – even if they weren’t there in the session. For some people this can be surprising, so it can be helpful to keep this in mind ahead of time – perhaps building in some space afterward before moving onto the next thing, if that works for you.

At this point, you made it! You took the first step on a path towards greater self discovery and healing.

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