Starting therapy can feel both exciting and a little nerve-wracking. Whether you’re seeking support for a specific issue or simply exploring ways to improve your mental health, understanding what to expect during your first therapy session can ease some uncertainties and help you feel more prepared.

This guide outlines the key steps involved in your initial therapy or counseling session, from finding the right licensed therapist to beginning the collaborative process of building a better future.

Finding the Right Therapist

Before your first therapy appointment, it’s essential to find a therapist who suits your needs. This involves researching professionals with expertise in the areas you want to address, such as anxiety, depression, relationship challenges, or stress management. Factors like location, availability, and insurance compatibility (or out-of-pocket cost) can also play a role in your decision.

Most importantly, look for a licensed therapist whose approach aligns with your preferences. There are many types of therapy, such as existential therapy, integrative therapy, cognitive-behavioral therapy (CBT), psychodynamic therapy, or solution-focused therapy. Hundreds more “brands” of therapy mean that sometimes having a conversation with a potential therapist about the way they do therapy can make it easier to know what their approach is really like. Understanding these methods and asking some questions can help you choose someone whose techniques or philosophy of therapy resonate with you.

Preparing for Your First Therapy Session

Is it therapy or counseling? People in our profession can use these words in different ways: some of us see psychotherapy and counseling as synonyms for the same process, whereas other therapists say that ‘counseling’ means a more practical approach, while ‘therapy’ means a deeper (or more complex) dive into understanding your patterns, or a more comprehensive working through of a longstanding difficulty. Your first counseling session (or psychotherapy session) is an opportunity to establish a connection with your therapist and lay the groundwork for your treatment plan. What are you here for? What do you want to be different in your life or in how you feel? It’s common to feel a mix of emotions beforehand—curiosity, apprehension, and even relief.

To make the most of this session:

• Reflect on your reasons for seeking therapy and your goals.
• Think about any specific concerns or challenges you’d like to address.
• Bring a list of questions if there are things you’re unsure about, such as how the process works, how often do you (or the therapist) expect to schedule sessions, or what your therapist specializes in.

What to Expect During Your First Therapy Session

1. Introductions and Setting Expectations

The session typically begins with introductions. Your therapist will explain their role, their approach to therapy, and what you can expect from the process. This is also a time to review any confidentiality policies and logistical details, such as session length and frequency.

Your therapist will aim to create a supportive environment where you feel safe and comfortable sharing your experiences. This first meeting is about building rapport and trust, both essential for a successful therapeutic relationship. Some therapists may start by leaving things ‘wide open’ for you to start talking about what you want to talk about, but that can be intimidating. You can ALWAYS ask the therapist to talk about how therapy works, how they tend to work, what you will be doing in this first session, etc. In other words, feel free to put your therapist on the spot!

2. Sharing Your Story

Your therapist will invite you to share why you’re starting therapy and what brought you to this session. You might discuss current struggles, personal challenges, or specific goals you want to achieve.

It’s common for therapists to ask about your family history and background, as these factors can provide valuable insights into your experiences. If you’re not ready to share everything right away, that’s okay. Therapy is a process, and you can work through your story at your own pace.

3. Clarifying Goals and Expectations

Your therapist will work with you to clarify your goals for therapy. These goals can be broad, such as improving overall emotional well-being, or more specific, like managing stress at work or navigating relationship challenges or letting go of something that you feel “stuck” on.

This discussion helps your therapist tailor their approach to your needs and ensures you’re both on the same page about the direction of your sessions.

4. Exploring Types of Therapy

Your therapist may explain the types of therapy they use and how these methods can help address your concerns. There are hundreds of approaches to therapy. For example:

• Existential therapy emphasizes that we all have to deal with certain “givens” that make life hard, and how we can adjust and adapt to these givens to find a satisfying life that has real meaning.
• CBT focuses on identifying and changing negative thought patterns.
• Psychodynamic therapy explores how past experiences shape current behaviors.
• Solution-focused therapy emphasizes setting and achieving immediate goals.
• Integrative therapy combines several approaches in a way that adapt to who you are and what you resonate with (the truth is that most therapists have an integrative approach—even if they emphasize one approach—because most of us are trained in multiple methods and want to make sure that we are working in line with what is helpful to you!)

Understanding these approaches can help you feel more informed and engaged in the process.

5. Establishing the Collaborative Process

Therapy is a partnership. During your first session, your therapist will emphasize that progress depends on the work you both put into the process. You’ll discuss how you can work with your therapist to explore challenges, build coping skills, and create meaningful change.

Your feedback is important throughout the process. If something doesn’t feel right or you’re unsure about a particular method, your therapist will want to know so adjustments can be made. In our sessions, we use a method called “Feedback-Informed Treatment” (FIT) to make sure we are checking regularly about whether our approach to working with you is a good one or if we need to change it in some way.

Feeling Comfortable and Supported

It’s natural to feel a bit vulnerable during your first session, but your therapist’s priority is to ensure you feel comfortable and supported. They’ll approach your concerns with empathy and understanding, allowing you to open up at your own pace.

If something feels overwhelming, let your therapist know. They can guide the conversation in a way that feels manageable while still addressing your needs.

After Your First Session

Once your first therapy appointment is complete, take some time to reflect on how it went:

• Did you feel comfortable with your therapist?
• Did you feel heard and understood?
• Were the therapist’s methods and approach a good fit for you?

If the session felt like a good start, you can schedule follow-ups and begin to build a road together toward what you want to change in your life. If not, it’s okay to explore other options. Finding the right therapist is a personal journey, and it’s important to work with someone who meets your needs.

The Value of Starting Therapy

Your first session is just the beginning of a meaningful journey toward self-discovery and healing. Over time, therapy can help you:

• Gain clarity about your thoughts and emotions.
• Build healthy coping skills.
• Improve your relationships and communication skills.
• Navigate life’s challenges with greater confidence.

Starting therapy is an investment in your mental and emotional well-being, offering tools and insights to help you thrive.

Conclusion

Your first counseling session is an essential step in improving your mental health and creating positive change. By knowing what to expect during your first therapy session, you can approach it with greater confidence and ease. Therapy provides a space to explore your thoughts and feelings, build resilience, and achieve your goals.

If you’re considering starting therapy, take the first step by reaching out to a licensed therapist. With their guidance and support, you can create a path toward healing, growth, and a fulfilling life.