Starting individual therapy can feel overwhelming, especially if it’s your first time. Many people worry about what to say, how the therapist will respond, or whether therapy will help. The good news is that your first session is designed to make you feel comfortable and supported.
This guide will walk you through everything you can expect in your first therapy session—from paperwork to setting goals—so you feel prepared and confident.
What to Expect in Your First Therapy Session
The first therapy session is mainly about introductions and getting to know each other. Your therapist will ask you questions about your background, emotions, and reasons for seeking therapy. It’s also a great opportunity for you to ask any questions you may have.
Here’s a simple breakdown of what typically happens in a first session:
| Step | What Happens |
|---|---|
| Filling Out Forms | Complete intake paperwork about your history and concerns. |
| Discussing Confidentiality | Learn about privacy rules and when confidentiality may be broken. |
| Talking About Your Concerns | Share why you decided to seek therapy. |
| Setting Therapy Goals | Define what you want to work on with the therapist. |
| Exploring Therapy Approaches | Understand different therapy techniques that might be used. |
| Asking Questions | Ask about the therapy process, duration, or anything else on your mind. |
| Planning Next Steps | Discuss future sessions and possible exercises to work on. |
Filling Out Forms
Before diving into your feelings, you’ll likely fill out some paperwork. These forms help your therapist understand your history, concerns, and needs. They typically include:
- Basic personal details (name, contact info)
- Medical and mental health history
- Current symptoms or struggles
- Consent forms explaining confidentiality
If you’re seeing an online therapist, you may receive these forms ahead of time to complete before your session.
Understanding Confidentiality in Therapy
One of the first things your therapist will explain is confidentiality. Everything you share in therapy is private, with a few exceptions:
- If you’re at risk of harming yourself or others
- If there’s suspected abuse of a child or vulnerable adult
- If required by law (such as in a court case)
Understanding confidentiality helps you feel safe and comfortable opening up.
Talking About Your Concerns
The main part of the session involves discussing why you decided to seek therapy. Your therapist might ask questions like:
- “What brings you to therapy today?”
- “How have you been feeling lately?”
- “Have you had therapy before?”
There’s no right or wrong answer. You can share as much or as little as you feel comfortable. If you’re unsure what to say, your therapist will guide the conversation.
Common reasons people seek therapy include:
- Feeling overwhelmed or anxious
- Depression or mood swings
- Relationship struggles
- Work-related stress
- Low self-esteem
- Grief or trauma
If you don’t know exactly what’s wrong, that’s okay! Your therapist is there to help you figure it out.
Setting Therapy Goals
After discussing your concerns, your therapist will help you set goals. Goals give therapy a clear direction and help track progress over time.
Examples of therapy goals include:
- Reducing anxiety or stress
- Building self-confidence
- Improving relationships
- Managing anger or emotional reactions
- Healing from past trauma
Your therapist will work with you to create realistic and achievable goals that match your needs.
Exploring Different Therapy Approaches
Therapists use various approaches based on your concerns and goals. During the first session, your therapist may introduce a few methods they might use in future sessions.
Some common therapy approaches include:
- Cognitive Behavioral Therapy (CBT) – Helps identify and change negative thought patterns.
- Mindfulness-Based Therapy – Encourages relaxation and stress management.
- Psychodynamic Therapy – Focuses on understanding past experiences and their impact on current behavior.
- Solution-Focused Therapy – Concentrates on finding practical solutions to problems.
Your therapist will tailor their approach to your unique needs and personality.
Asking Questions
Your first session is also your chance to ask questions. Some common questions include:
- How long will therapy take?
- How often should I come?
- What if I don’t feel comfortable with my therapist?
- Will I get homework or exercises to do between sessions?
It’s important to feel comfortable with your therapist, so don’t hesitate to ask anything that’s on your mind.
Planning Your Next Steps
At the end of the session, you and your therapist will discuss what comes next. If you feel comfortable, you can schedule another session. Your therapist might also suggest things to think about or small exercises to try before the next session.
Examples of next steps might include:
- Journaling about your feelings
- Practicing mindfulness exercises
- Noticing thought patterns and writing them down
Each session builds on the last, so over time, you’ll start to notice progress in your emotions and behaviors.
How to Make the Most of Therapy
Here are some tips to get the most out of therapy:
- Be honest. Therapy is a safe space, so share openly.
- Stay patient. Progress takes time—healing doesn’t happen overnight.
- Ask questions. If you’re unsure about anything, ask your therapist.
- Practice outside of sessions. Apply what you learn in therapy to your daily life.
The more you engage in the process, the more benefits you’ll see.
Final Thoughts
Your first therapy session is just the beginning of a journey toward self-awareness, healing, and personal growth. It’s okay to feel nervous, but remember that therapy is a supportive and judgment-free space. Over time, as you build a connection with your therapist, you’ll gain tools to manage challenges and improve your well-being.
If you’re thinking about starting therapy, take that first step—it might be one of the best decisions you ever make.
