It takes a lot of strength to make that first therapy appointment, but now that you have, you might be wondering what it will involve.
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Scheduling your first therapy session requires resolve — to admit you may need some help or that you have a condition, symptoms, or challenges to work through — and self-awareness to recognize you need a little help.
So if you’ve made your first counseling session already, you should know just how much strength you truly have.
And if you haven’t picked up the phone quite yet, there’s nothing to fear in doing so — and everything to gain.
But if you’re new to therapy, you might be wondering exactly what to expect when meeting with a therapist or counselor for the first time.
What to expect from your therapist
Despite some misconceptions, a therapist’s job isn’t to solve your problems for you.
They aren’t there to tell you what to do, or to tell the people who’ve hurt you just how wrong they were.
In fact, most therapists won’t bother touching on the rights and wrongs of people in your life. Instead, they’ll focus on helping you turn your focus to what you can and can’t change — ultimately: you, your choices, and your responses to events.
Depending on your reason for starting therapy, most therapists will spend time encouraging you to look inward.
This might mean talking through past trauma and developing strategies to help you cope.
Looking inward might require you to explore any phobias you have, and then work with your therapist to overcome them.
Or you may dive deep into your interpersonal relationships — not to examine the faults of others, but to help you better understand your role in making relationships better or setting boundaries in order to protect yourself.
Whatever your case may be, you’ll find that therapists can be great sounding boards and provide excellent resources when needed. But their main goal is to help you learn how to better help yourself.
What to expect from yourself
Your first session will probably involve your therapist asking you a lot of questions about you, how you cope, and your symptoms (it’s basically an interview). You may also chat about goals for therapy, expectations, and more.
Your first therapy session can be emotionally draining, even if you don’t initially expect it to be.
Therapy can involve unearthing many things your brain has worked hard to bury — the painful memories and feelings you may not have been up to exploring on your own. And as you sit down for first-time therapy, you may find the floodgates opening… whether you mean them to or not.
This is pretty much to be expected. Still, it can feel surprising, especially if you find yourself opening up to a stranger in ways you haven’t been able to open up to others in your life.
Don’t let it scare you. Being open and candid with your therapist is one of the best things you can do for yourself.
And, you should know that not every session will be so intense. It often happens that initially starting therapy can take a lot out of you. That’s OK.
Do’s and don’ts
Now that you’re aware of what to expect from your therapist and yourself, we’ve put together a few quick pointers to help you maximize your time in therapy.
Do
- Be kind to yourself. Therapy can be emotional; you’re allowed to have big feelings.
- Tell your therapist why you’re there. There’s no reason to be vague.
- Be willing to reflect on your own thoughts and behaviors. A good therapist will challenge you to look inward.
- Close your session with a plan. Do you have homework before your next session? Some new behavior to try? When will that session be? You may want to write it down or throw a reminder on your phone so you don’t forget.
- Give therapy at least a few tries. It does get easier, and the first session is often just about providing background info, which means it may not be as helpful as you would have hoped.
Don’t
- Put up a wall. Therapy only works if you commit to leaning in with your therapist.
- Ask personal questions about your therapist. Healthy professional boundaries mean your sessions should be focused on you.
- Lie. Therapy won’t do you any good if you aren’t willing to tell the truth. And it’s a waste of a good copay!
- Drop a bomb on your way out the door. While some sessions may be packed with things to talk about, try to prioritize the big things at the beginning. When you reveal big topics as your session is ending, you’re doing both yourself and your therapist a disservice. Share while there’s still plenty of time to discuss! Bookmark the bombshells if you don’t get to them before you touch that doorknob.
- Stick with a therapist you don’t feel a connection with. Just as in life, you won’t always mesh with everyone you meet. You’re allowed to search for a new therapist you feel comfortable with, rather than sticking with one you don’t.
So, now what?
Therapy can be extremely beneficial — but it won’t heal you overnight.
The American Psychological Association says that half of folks with mental health symptoms need between 15 and 20 sessions. So if you’re being treated for a mental health condition, you’ll need to be prepared to commit to several months of treatment if you hope to see the improvement you deserve.
But don’t let that overwhelm you. Take your sessions one at a time, and assess how you feel about the value of therapy after each one.
There are a wide variety of therapeutic options available — and countless therapists who work with different approaches.
If you find you aren’t getting much from therapy, you may just need to try a different therapist or approach.
But you don’t need to figure all that out in the immediate aftermath of your first session. Instead, give yourself some space and time to process.
Don’t be surprised if you’re especially tired following that first session. You’ve started some important work, but it’s still definitely work — it’s normal to feel the weight of that initially.
So go home, try to relax, and consider the fact that your emotions might need time to recover in the same way your muscles do after a strenuous workout. You’ve earned the breather, and by allowing yourself that opportunity, you’ll be better prepared to dive even deeper at your next session.
If you have an appointment with a counselor for your first therapy session, you might not know what to expect. Or perhaps you’re considering starting therapy but don’t know where to begin. Knowing where to start and what to expect during your first session can help you feel more comfortable and informed.
Learn more about the different types of therapy, what to expect from your first appointment, what questions to ask your therapist, and more.
How to Choose a Therapist
No two therapists are the same. Asking the right questions will help you choose the best therapist for you. Questions to ask before you make an appointment:
- Affiliations: “What professional associations do you belong to?” Knowing more about a therapist’s professional affiliations can give you a better idea of their credentials, background, and current focus.
- Background: “What is your academic background, and what has your training been to prepare you to practice as a therapist?” Making sure your a potential therapist has training and experience in treating your condition or concerns means you will be more likely to get the appropriate treatment you need.
- Cost: “What are your fees? How will my insurance claim be handled?” Not all therapists accept insurance, so it is important to consider the cost and payment before starting treatment. Rates may also vary considerably.
- Experience: “What specialized training and/or experience have you had working with the issue I am dealing with?” An experienced therapist can recognize the problems you are facing, which can give them greater insight into the treatments and techniques that can most help you.
- Rules: “What are your office protocols?” (e.g., booking appointments, payment for missed appointments, emergencies, building access after hours, etc.) Understanding how such situations or handled can help protect your working relationship and ensure that your sessions proceed with fewer issues.
- Specialties: “What type of therapy do you do?” It can be helpful to know whether the therapist does mostly talk therapy or if they include opportunities for role-playing, visualizing, hypnosis, artwork, ‘bodywork,’ and other techniques. You may prefer a specific approach, but some techniques may be more helpful for certain types of problems.
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Before Your First Therapy Session
When you get to the therapist’s office, expect your initial experience to be similar to a doctor’s appointment. You will sign in when you get there, sit in the waiting room, and wait for someone to call your name. If your therapist has a home practice, the scene might be a bit more casual.
While waiting, you will likely fill out some paperwork, including:
- HIPPA forms
- Insurance information
- Medical history, including your current medications
- A questionnaire about your symptoms
- Record release form
- Therapist-patient services agreement
If you feel uncomfortable answering any of the questions on paper, you can wait until you are with the therapist and answer the questions orally. You might also have the option to complete this paperwork at home prior to your first visit.
Your First Therapy Session
Your first session with the therapist will be different from future visits. The initial visit is a period for you and your therapist to get to know each other and get an idea of how to proceed. Future visits will be more therapeutic in nature. For example, in your second session, you may explore a specific symptom, problem, or past trauma you mentioned in the first session.
Keep in mind that psychotherapy usually requires multiple visits, so don’t expect any instant solutions to your problems the first day. Therapy is about equipping you with life-long solutions and not a quick fix.
During the first session, your therapist may ask you:
- What are your symptoms?
- What brought you to therapy?
- What do you feel is wrong in your life?
- Some questions about your history, including your childhood, education, relationships (family, romantic, friends), your current living situation, and your career
You and your therapist should also come to an agreement about the length of your treatment, methods to be employed, and ins and outs of patient confidentiality.
Length of Treatment
Depending on your issue and therapy goals, therapy can last a few sessions or several weeks or years. While you likely want to know how long it’s going to take to “feel better,” there’s no simple answer. It’s very individualized.
In addition, some insurance plans only cover a set number of sessions in a given year, so you may need to factor in those limitations and/or work with your therapist to come up with a payment plan.
Therapy Methods
Therapists have training in a variety of techniques that can help you better cope with mental illness, resolve personal issues, and create personal changes in your life. Finding out what technique or combination of techniques your therapist will use can give you a better idea of what will happen during your sessions. Some common types of therapy include:
- Client-centered therapy (person-centered therapy): A non-directive form of talk therapy that emphasizes positive unconditional regard
- Cognitive or cognitive-behavioral therapy: Focuses on making connections between thoughts, behavior, and feelings
- Existential therapy: Focuses on you (free will, self-determination) rather than the symptom
- Gestalt therapy: Focuses on the “here and now” experience of the client
- Psychoanalytic or psychodynamic therapy: Focuses on getting in touch with and working through painful feelings in the unconscious mind
Patient Confidentiality
In most cases, a therapist is required to keep information discussed during therapy private. However, according to the American Psychological Association’s “Ethical Principles of Psychologists and Code of Conduct,” confidential information can be disclosed with the permission of the individual or as permitted by the law.
While the specifics of a legal duty to warn vary by state, in most cases, a therapist is required to breach confidentiality if a client poses an imminent threat to themselves, the therapist, or a third party. The information must be divulged to a person capable of taking action to reduce the threat, for example, a police officer.
What to Ask Your Therapist
When the therapist finishes, they should ask you if you have any questions. You can use this opportunity to get to know your therapist a little better by asking more about their training, experience, approaches, and goals for therapy.
Questions to Ask During Your First Therapy Session
- How can you assure my confidentiality?
- How long will each session last?
- How many sessions will it take to resolve my issue?
- Will you briefly explain what I can expect to happen in my sessions?
Is Your Therapist Right for You?
A big part of successful therapy is feeling comfortable with your therapist, which may come over time. However, if after a few meetings, you’re just not clicking, you do have the choice to seek out another therapist.
To determine if you’re receiving the best care from your therapist, the National Alliance on Mental Illnesses recommends asking yourself the following questions:
- Do they challenge you?
- Do they check-in with you?
- Do they guide you to your goals?
- Do they help you learn?
- Do they show acceptance and compassion?
- Do they treat you as an equal?
If your answer to any of these questions is “No,” then it’s likely time to consider changing therapists. At the end of your session, just tell your therapist that you will not be returning. Don’t be surprised if your therapist asks why.
You can answer honestly (you just feel like you’re not clicking) or just say that you prefer not to say. In most cases, your therapist will be professional and can recommend another therapist who will be a better fit.
A Word From Verywell
Knowing what to expect during your first therapy session can help you feel more prepared. Your first session is often about you and your therapist getting to know one another, determining if the therapist is a good fit for your needs, and going over what you want to accomplish in therapy.
