Navigating Your First Therapy Session What to Expect

Starting therapy can feel like a big step—and it is. Whether you're feeling anxious, curious, hopeful, or unsure, know that you're not alone. Many people find therapy to be a powerful, life-enhancing experience. Understanding what to expect in your first individual therapy session can help ease nerves and set the stage for a positive start.

What Is Therapy?

Therapy, or psychotherapy, is a professional relationship between a trained mental health provider and a client. Its goal is to help individuals explore thoughts, emotions, and behaviors, improve coping strategies, and enhance overall well-being. Therapy is an effective treatment for a wide range of concerns, including stress, anxiety, depression, trauma, relationship issues, and life transitions.

Your First Session: What Happens?

1. Brief Introduction to Therapy

Your therapist will begin by introducing themselves, explaining their approach, and giving you a general idea of what therapy looks like. They may share their specialties and how sessions are typically structured, as well as invite you to share any expectations or questions.

2. Review of Intake Forms

Before or during your first session, you'll likely review and sign several important documents:

• Clinical Intake History Form – gathers background on your mental, emotional, and physical health.

• Email/Text Consent – allows for communication outside of sessions.

• Informed Consent for Assessment and Treatment – outlines what therapy involves, including risks and benefits.

• Notice of Privacy Policies – explains how your information is protected under HIPAA.

• Telehealth Consent – if applicable, permits therapy to be conducted remotely.

• No-show / Cancellation Policy – details expectations for scheduling and missed sessions.

• Credit Card and Fee Agreement – explains billing procedures and associated fees.

These documents are important for transparency and ensure a shared understanding between you and your therapist.

3. Clinical Assessment

Your therapist may conduct a clinical assessment to create a baseline of your mental health. This can include structured questions, rating scales, or open-ended discussions. These tools help your therapist track progress and tailor treatment to your specific needs.

4. Information Gathering

During this initial conversation, your therapist will want to understand what brings you to therapy, your personal history, and your goals. While this may feel like a lot of sharing, remember: this isn’t about perfection—it's about honesty.

Tip: Be open and honest. Therapy is a safe space, and your therapist is there to support—not judge—you.

Also, your therapist is assessing whether their skills and experience align with your needs. If it turns out they aren’t the right fit, they may refer you to another provider who is better suited to help.

Be Yourself

There’s no need to present a polished version of yourself. Therapy works best when you're authentic. If you're nervous, say so. If you're unsure where to start, that's okay too.

It's Okay to Show Emotion

Your first session may stir emotions, and that’s perfectly normal. Tears, laughter, frustration, relief—whatever comes up is welcome. Expressing emotion is part of the healing process.

Ask Questions

Your therapist welcomes your questions. Here are a few you might consider asking:

• What is your approach to therapy?

• Have you worked with clients who have similar concerns?

• How long do you think therapy will take?

• How do you handle confidentiality?

• What should I do between sessions?

Keep Communication Transparent

Let your therapist know what communication methods you prefer (phone, email, portal messaging), and ask how they handle emergencies or after-hours concerns. Clear communication sets the tone for a respectful, supportive partnership.

Final Thoughts

Your first therapy session is the beginning of a journey toward greater self-awareness and emotional health. While it can feel vulnerable to open up, you’re taking an important and brave step. Trust the process, be patient with yourself, and remember that therapy is a collaborative space built on trust, respect, and hope.