What to Expect During Your First Therapy Session

Realizing it’s time to ask for help is no small thing. Mental illness is still stigmatized in our culture, so it can be really hard to admit that you need support. If you’re reading this because you’ve decided that therapy might be the right choice for you, take a minute to pat yourself on the back. Asking for help is difficult, and you should be proud of yourself for seeking help. People are sometimes intimidated by starting therapy. It’s emotional and intimate, and it costs money and time! It can also be scary to realize you have no idea what you’re getting into. Some people have bad experiences with therapy that leaves them feeling like they can never try again. Some people grew up thinking asking for help is a sign of weakness. The more you learn about what actually happens in therapy, the less scary it will be. 

Finding a therapist is a process that depends on your health insurance and finances, your particular mental health needs, and your location. It can sometimes be a long time before you find a therapist who is a good fit for you, which can leave you all the more frustrated and eager for help. Finding a therapist who is a good fit for your needs can help you experience how transformative therapy can be. If you’re nervous before your first therapy session, you’re not alone. Sometimes the worst part is making the call or filling out the forms to begin, and sometimes it’s the waiting for the unknown that can freak people out. You might even feel like you want to cancel your appointment or not show up. That’s normal! Any therapist worth their salt will be happy to tell you how therapy works, because their goal is to help you feel better. If you’re looking for what to expect during your first therapy session, here are some common themes: 


You’ll have to fill out paperwork to get started. This varies from practice to practice, but some offices send paperwork ahead of time for you to fill out and some have you do it in your first session. Some of the forms you might see are informed consent, where you can learn about + opt-in to treatment; HIPAA forms and release of information to protect your privacy and allow your therapist to confer with your other healthcare providers; medical history forms so your therapist can get an idea of why you’re coming in; and insurance forms (if you’re at a practice that accepts your insurance). It might seem overwhelming to fill out a bunch of paperwork right off the bat, but it makes sure all your ducks are in a row so you can proceed with treatment without any snags.  At Andover Family Counseling, all of the paperwork will come straight to your email and can be filled out in the comfort of your home.

Sign in

You’ll probably be asked to sign in in some way. Some practices have a check in tablet, some have a receptionist, some have a button system, and some have you text your therapist when you get there. If you’re concerned about not knowing what to do when you arrive, you can ask in advance! There’s no shame in being prepared. Feel free to ask where to park, how to get into the building, and where to wait. With covid protocols, some offices may be entirely online right now, so you may be meeting via video chat. It’s also completely fine to ask questions about the software that you’ll be using to meet with your therapist virtually. If you think you may need help using the software, you can always talk that through with your therapist so you have a plan including what you’ll do if you get disconnected.  At Andover Family Counseling, if you are coming into the office, you will just take a seat in the lobby and your therapist will come on out and greet you at your appointment time. 

Intake chat

When you meet with your therapist for the first time, you’ll spend some of the first session talking about your history and why you’re there. They will want to know what made you decide to come to therapy in the first place. Are you experiencing symptoms? Is there a situation you need support with? Your therapist will ask you questions about your personal history and your family history, as well as assess how you’re doing at the moment. They may ask about your job, your relationships, or your childhood to get a clearer idea of the big picture. This first visit is often called an intake visit, where your therapist will discuss your needs and talk about the treatment process. They may also talk to you about your rights of confidentiality, the treatment methods they would like to use, and the length they think that treatment will last. 

Now that you know what to expect from the visit itself, here are some ways to make the most of your first therapy session: 

Be honest

You probably won’t feel completely comfortable in your first session, but that’s okay. You’re going to be chatting 1:1 with a total stranger, so it stands to reason that you won’t be ready to bare your soul in your first session. However it’s important to remember that your therapist can only do so much if you’re not being honest with them. They’re not here to judge or belittle you, they’re here to help, and they can’t help unless they get the whole picture. It may take time to build up that trust so you feel comfortable sharing more intimate things. If you have any strong feelings about the therapeutic process, it’s okay to talk them out with your therapist! 

Ask questions

Remember, therapy is a service that you are paying for and you are allowed to ask questions to make sure it’s the right fit for you. If you haven’t chatted with your therapist before your appointment, you can ask questions in the session. You can keep a note on your phone of things you want to ask your therapist before you get into things. Here are some questions you may want to ask:

  • How long have you been practicing?
  • What are your specialties? 
  • How long do you expect treatment to take? 
  • When can I expect to feel better? 
  • Are there any rules or policies I should know about the practice? 
  • What therapy methods do you typically use? 
  • Do you take my insurance? How does payment work? 

Come prepared

Taking some time before your appointment to get your thoughts and materials organized can make a huge difference. It will leave you feeling calmer and more in control. Your therapist will likely spend this first session asking questions about you + your life, so make note of anything important you want to bring up in case you draw a blank. You can also keep track of symptoms you’ve experienced or things you want to discuss in therapy so you don’t stress about what to talk about each time. It may also help to write down a list of questions you want to ask your therapist to see if they’ll be a good fit for you.  

Minimize distractions

Try to start off on the best possible foot by giving your attention fully to your appointment. Turn off your phone if hearing it buzz will bother you (unless you have something on your phone that you need for your session). Make sure you’ve used the bathroom beforehand and aren’t’ hungry or thirsty – those needs can get distracting fast. 

Starting therapy can be intimidating, but it doesn’t have to be. Remember that your therapist is a part of your team, and you’re allowed to shop around until you find someone who is the perfect fit for you. Remember to ask questions and be honest, even if something isn’t working for you. If you feel really nervous or uncomfortable beforehand, you’re not alone! Therapy is an intimate experience, and that can bring up a lot of feelings. You’ve got this. If you’re looking to get started with a therapist today, our clinicians are here to help! Contact us today to learn more about our specialties. 

-Lindsay N Sanner, LSCSW, RPT