What to Expect When Starting Therapy
Many people are unsure what to expect from their first therapy session. Let's will explore some of the common things you might find in your first therapy session, why they are important, and the difference between therapy and assessment.
Wondering what your first therapy session will be like?
You’re not alone. Starting therapy can feel overwhelming, especially when you’re not sure what to expect. It’s completely normal to feel nervous, hesitant, or unsure about opening up to someone new.
Whether you're dealing with a big life change, emotional distress, or just curious about your mental health, that first session can feel like a leap into the unknown. But understanding how it works can ease anxiety and give you more control.
In this guide, you’ll learn:
- What actually happens in a first therapy session
- The difference between therapy and psychological assessment
- How therapists typically work with new clients
- Tips for managing symptoms between sessions
By the end, you’ll feel more confident about starting therapy—and more empowered on your mental health journey.
Table of Contents | Jump Ahead
Why Starting Therapy Can Feel Intimidating?
What to Expect in Your First Therapy Session: Questions & Process
First Therapy Session: What Forms, Rights, and Consent You Can Expect
How to Prepare for Your First Therapy Session?
Therapy vs Assessment: What’s the Difference?
What Are the Risks of Therapy?
How Can I Manage My Symptoms Between Therapy Sessions?
Feeling Nervous About Your First Therapy Session? Let TherapyRoute Help You Find the Right Fit
Why Starting Therapy Can Feel Intimidating?
Seeking therapy is a courageous decision. But even if you're sure it's the right step, you might still feel hesitant or vulnerable. Common concerns include:
- What if I don’t know what to say?
- Will I be judged?
- What if I get too emotional, or not emotional enough?
- Is my problem “serious” enough for therapy?
Here’s the truth: You’re not expected to show up fixed.
You don’t need to have the “right” words.
You don’t have to prove your pain to earn support.
Therapy is a space where you get to be messy, real, and unfinished—because that’s where healing starts. In the next section, we’ll walk you through what to expect from your first session and how to find someone who makes you feel safe being yourself.
Still unsure? Try a no-pressure 15-minute consultation to see if therapy feels like a good fit.
What to Expect in Your first therapy session: Questions & Process
Think of your first session as a gentle introduction. It’s a chance for your therapist to learn more about you, explain how therapy works, and begin creating a safe, supportive space.
First Therapy Session Questions
To get a clear picture of your current mental health and emotional landscape, your therapist may ask:
- What is therapy to you?
- What brings you to therapy?
- Are there specific issues you’d like to work on?
- How have you been feeling lately, emotionally and physically?
- Have there been any major changes in your life recently?
- What are your personal goals for therapy?
- What are your strengths or coping strategies?
- Are you currently taking any medications?
- Have you ever tried therapy before?
Don’t worry, this isn’t a quiz. You can answer at your own pace and skip questions you’re not ready to discuss.
You’re always in control of what you choose to share — there’s no pressure to open up more than feels comfortable. The pace is yours to set.
First Therapy Session: What Forms, Rights, and Consent You Can Expect
During your first therapy appointment, whether in-person or through an online therapy platform, you’ll go through a few essential steps to begin the therapy process. Here's what typically happens:
Intake Forms and Basic Information
Before your first session begins, you'll be asked to complete a few forms. These aren’t tests, they simply help your therapist get a clearer picture of your background and needs.
- You’ll fill out forms that collect basic information, such as your name, contact details, and emergency contact information.
- Your licensed therapist will ask about your mental health history, current difficulties, and any physical health conditions or medications you're taking.
- If you're using insurance, you'll need to provide your policy details for mental health treatment.
- These forms are important in helping your new therapist understand your specific concerns and prepare for later sessions.
Confidentiality and Informed Consent
At the start of therapy, your therapist will walk you through how privacy works and what your rights are, so you always know where you stand.
- Your experienced therapist will explain informed consent, a document that outlines your rights, the scope of therapy, and how your data is handled.
- Everything you share in therapy is confidential, including your innermost thoughts and feelings.
- Exceptions to confidentiality will also be explained (e.g., in cases of harm to self or others), in line with American Psychological Association guidelines.
- You'll learn about the therapist’s cancellation policy, communication boundaries, and how to reach out between sessions if needed.
Understanding the Therapy Process
Your first session is also about orientation. Your therapist will help you understand what to expect and begin shaping your therapy plan.
- You’ll be introduced to the various types of therapy offered, including talk therapy, couples therapy, and online therapy, to find a good fit for your needs.
- Your therapist may discuss how many sessions might be helpful, depending on your therapy goals and mental health conditions.
- If you're unsure about committing long term, that’s okay; this is just the first meeting to see if it’s a good match.
- Don’t hesitate to ask lots of questions about the process, especially if something feels unclear or if you're comparing a few potential therapists.
Not sure if therapy is right for you? Here’s how to know when it might help Explore who needs therapy and why it might be helpful.
How to Prepare for Your First Therapy Session?
Walking into your first therapy session can feel like a big step, and it is. Whether you're feeling nervous, hopeful, overwhelmed, or all of the above, it's completely normal. The good news? With a little preparation, you can reduce anxiety and get the most out of your first appointment.
Here’s a step-by-step guide on how to prepare for your first therapy session, emotionally and practically:
1. Reflect on Why You’re Seeking Therapy
Before your first session, take a few moments to consider what’s bringing you to therapy right now. You don’t need to have everything figured out—just a few honest thoughts can go a long way.
Start by asking yourself:
- What’s been bothering me lately?
- Are there specific areas I’d like support with?
- How do I hope therapy might help?
2. Write Down Questions or Topics You Want to Cover
It’s easy to forget things in the moment, especially when emotions run high. Writing down a few questions to ask during your first therapy session, such as “How does therapy work?” or “What type of therapy do you offer?”, can help you feel more confident and in control.
Common topics you might want to ask about include:
- Types of therapy offered (CBT, talk therapy, EMDR, etc.)
- Session structure and frequency
- Confidentiality rules and limits
- What progress in therapy might look like
Not sure how to choose the right therapist?
This video breaks it down, what to look for, what questions to ask, and how to tell if someone’s the right fit for your needs.
3. Gather Practical Information
Before your first therapy session, make sure you’ve completed any intake forms and understand key logistics like:
- The exact location or login link (for online therapy sessions)
- The therapist’s cancellation policy
- Session fees or insurance coverage
- What to bring, if anything
Being logistically prepared helps reduce unnecessary stress on the day of your appointment.
4. Set Realistic Expectations
Your first therapy appointment isn’t about solving everything in one go. It’s about starting a conversation and building trust with a new therapist. You may not feel better instantly, and that’s okay. Think of this as planting the first seed of growth, not harvesting the results.
5. Choose a Comfortable Time and Setting
If your session is online, find a private, quiet place where you won’t be interrupted. For in-person sessions, give yourself time to arrive early, breathe, and settle in. Avoid scheduling back-to-back work calls or errands if possible; having space before and after can make a big difference.
6. Bring Your Authentic Self
You don’t need to act a certain way or say the “right” things. Therapy works best when you show up as yourself, even if that means feeling confused, guarded, or emotional. Your therapist is there to meet you where you are.
7. Be Open, But Set Boundaries If You Need To
You’re never required to talk about something you’re not ready to discuss. If a topic feels too raw or overwhelming, let your therapist know. It’s completely acceptable to say, “I’m not ready to go there yet.”
8. Keep an Open Mind
Every therapist works a little differently, and the first session might not feel like a perfect match. That’s okay. Use it as an opportunity to explore whether this person feels like a good fit. Sometimes, it takes a few sessions, or even trying a different therapist, to find the right one.
If choosing a therapist feels overwhelming, here’s a simple guide to help you decide.
Therapy vs Assessment: What’s the Difference?
Are you unsure if you’re starting therapy or undergoing a psychological assessment? You’re not alone.” While they’re often part of the same process, it’s important to understand how therapy and assessments differ, and how they may work together as part of your mental health journey.
Licensed mental health professionals use both to understand your concerns, but their purposes and methods vary. Knowing the difference helps you set realistic expectations and feel more confident during your initial appointments.
What to Expect in Each?
| Feature | Therapy | Assessment |
|---|---|---|
| Purpose | To explore emotional well-being and create positive change over time | To identify specific conditions or issues (e.g. anxiety, ADHD, depression) |
| Setting | Weekly or biweekly sessions (in-person or online) | One-time or short-term testing sessions |
| Format | Talk-based, collaborative discussions | Structured tests, forms, and interviews |
| First Session | Focus on building rapport, discussing concerns, and setting goals | Focus on answering standardised questions and collecting clinical data |
| Outcome | Ongoing support, insight, and growth | Diagnostic clarity or treatment recommendations |
| Who It’s For | Anyone seeking help with emotions, stress, life changes, or relationships | Those seeking a diagnosis or clarification of symptoms |
Do You Need One, the Other, or Both?
In many cases, assessments are used before or during therapy to gain a deeper understanding of what you're experiencing. For example, suppose you're unsure whether your struggles are related to trauma, burnout, or a mood disorder. In that case, an assessment can help your therapist tailor the type of therapy that's most effective for you.
Some therapists offer both services, while others may refer you to a psychologist or specialist for the assessment component. Afterwards, you may continue with regular sessions to process what you've learned and begin your healing journey.
What Are the Risks of Therapy?
Therapy is a safe space—but that doesn’t mean it’s always easy.
- Difficult emotions may come up, especially in early sessions, as you talk about painful memories or current struggles.
- You might feel more vulnerable before you feel better, and that’s a normal part of healing.
- Your therapist will guide you through these waves, helping you feel supported even when things get heavy.
What Are the Benefits?
Despite the discomfort, therapy has powerful long-term rewards.
- Greater emotional awareness and tools to handle overwhelming feelings
- Improved communication and stronger relationships
- Reduced stress, anxiety, and internal conflict
- Clearer goals and a better understanding of your patterns and needs
You might be asked reflective questions like:
“What do you hope to gain from therapy?”
“What’s held you back from seeking support in the past?”
These aren’t tests—just invitations to think about your hopes and roadblocks.
Why This Conversation Matters
Talking openly about the risks and benefits helps build realistic expectations from the start. It also sets the tone for honest, collaborative work between you and your therapist.
Bottom line: Therapy can be uncomfortable, but also life-changing.
With the right support, you can navigate the hard parts and make real progress toward your goals.
How Can I Manage My Symptoms Between Therapy Sessions?
After your first therapy session, it’s normal to feel a mix of emotions, relief, exhaustion, or even doubt. That’s why most experienced therapists recommend building a toolkit of coping strategies to help you manage your mental health between appointments.
Here’s a list of coping techniques your therapist might introduce, depending on your specific concerns, symptoms, and therapy goals:
Mind-Body Techniques
- Deep breathing exercises (like box breathing or 4-7-8) to reduce anxiety or overwhelm.
- Progressive Muscle Relaxation (PMR) to release physical tension.
- Guided imagery or visualisation to create a calming mental escape.
- Yoga or stretching routines to reconnect with your body and reduce restlessness.
Cognitive Strategies
- Thought records to track and challenge negative thinking patterns (commonly used in CBT).
- Positive affirmations to shift your internal dialogue and boost your self-esteem.
- Reframing techniques to view stressful situations from a more empowering perspective.
- Creating a “Worry Time” window, where you give yourself 10–15 minutes to journal about your worries, then move on with your day.
Journaling & Self-Reflection
- Mood tracking apps or notebooks to observe patterns and triggers.
- Gratitude journaling focuses on small wins and positive aspects of each day.
- Stream-of-consciousness journaling to release racing thoughts and gain clarity.
Lifestyle Tweaks That Support Mental Health
- Setting a consistent sleep schedule to stabilise mood and energy.
- Limiting caffeine or sugar if you notice they worsen anxiety or restlessness.
- Scheduling regular movement (walks, workouts, dancing) to release endorphins.
- Establishing screen-free wind-down time before bed for deeper sleep and less overstimulation.
Connection-Based Coping
- Talking with a supportive friend or family member about your feelings.
- Joining a support group for shared experiences and mutual encouragement.
- Practising assertive communication in relationships to express needs more effectively.
- Setting healthy boundaries to reduce emotional burnout.
Creative & Expressive Outlets
- Art, music, or dance therapy exercises to express emotions without words.
- Crafting, painting, or photography to channel attention into something tactile and calming.
- Playing or listening to music that matches or shifts your emotional state.
Feeling Nervous About Your First Therapy Session? Let TherapyRoute Help You Find the Right Fit
It’s normal to feel nervous, unsure, or even overwhelmed when starting therapy, especially if it’s your first time. You might be wondering where to start, who to trust, or how to know if someone truly gets you.
That’s where TherapyRoute.com comes in.
We make it easier to find a licensed, experienced therapist who aligns with your needs, background, and preferences. Whether you're dealing with anxiety, relationship struggles, or just want space to grow, TherapyRoute helps you connect with professionals who offer compassionate, personalised care.
Start your therapy journey with confidence.
Because finding the right therapist makes all the difference.
Conclusion
Starting therapy can be a daunting experience, but it's important to remember that your therapist is there to help you. While every therapy session is unique, some common elements you can expect in your first session include questions about your personal history and experiences, exploration of your sense of self, and discussion of treatment goals and strategies. Knowing what to expect in your first therapy session allows you to mentally and emotionally prepare yourself, engage more effectively with your therapist, articulate your concerns and goals, and start working towards positive change.
Frequently Asked Questions
What is the first session with a therapist called?
The first session is typically referred to as an intake session or initial consultation. It focuses on understanding your background, current concerns, and therapy goals while building rapport with your therapist.
Is the first therapy session awkward?
It can feel a bit awkward at first, especially if you’re unsure what to expect. However, therapists are trained to ease you in gently, creating a space for you to feel safe and supported.
Will I cry in my first therapy session?
Possibly, and that’s perfectly okay. Many people feel emotional during their first session, especially when discussing sensitive topics. Crying is a natural response and a sign you’re beginning to release what matters.
What is the first goal of therapy?
The primary goal is to establish trust and build a therapeutic relationship. It also involves identifying your concerns, setting goals, and creating a safe, non-judgmental space for future sessions.
How did you feel after your first therapy session?
People often feel a mix of relief, vulnerability, and emotional exhaustion after their first therapy session. It’s completely normal to feel both lighter and a bit unsettled as you begin the healing process.
Important:
TherapyRoute does not provide medical advice. All content is for informational purposes and cannot replace consulting a healthcare professional. If you face an emergency, please contact a local emergency service. For immediate emotional support, consider contacting a local helpline.
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