What to Expect in Your First Therapy Session
It’s Normal to Feel Nervous
Starting therapy is a big step, and it’s completely normal to feel unsure about what it will be like. Some people worry they won’t know what to say. Others worry they will cry, get judged, or have to talk about things they are not ready to share.
Here’s the good news: your first session is not a test. It’s a starting point.
The Purpose of the First Session
Think of the first session as a chance to:
Get to know your therapist
Share what brings you in (at a pace that feels safe)
Talk about what you want help with
Ask questions
Decide whether it feels like a good fit
A strong therapy relationship is built on trust, and trust takes time. The first session is simply the beginning.
What You’ll Talk About
Every therapist’s style is a little different, but most first sessions cover a few core areas.
1) What brought you in
You might share:
What’s been feeling hard lately
What you’ve tried so far
What you’d like to feel different
You do not need a perfect summary. Even “I’m not sure where to start” is a valid starting point.
2) Your current life and support system
You may talk about:
Relationships and family
Work and daily stress
What support you have (and what you wish you had)
3) A bit of background
Some therapists will ask about:
Important life experiences
Past therapy experiences (if any)
Big stressors or losses
Anything you want them to understand about you
You’re always allowed to say, “I’m not ready to go into that yet.”
4) Goals, hopes, and what you want from therapy
You might explore:
What you want to work on
How you want life to feel in a few months
What would make therapy feel worthwhile to you
Goals can be concrete or simple, like “I want to stop feeling so on edge” or “I want to feel like myself again.”
Common Questions People Ask in the First Session
If it helps, here are a few questions you can bring to your first appointment:
What is your approach or style in therapy?
What might sessions look like over time?
How will we know if progress is happening?
How do you handle situations when I feel overwhelmed?
What can I do between sessions to support myself?
If you’re doing telehealth, you can also ask:
What should I do if my connection drops?
How do you recommend creating privacy at home?
Do You Have to Talk About Trauma Right Away?
No.
You can share as much or as little as you want in the beginning. Many people start by focusing on what is happening now: stress, anxiety, relationships, sleep, or feeling stuck. Deeper topics can be approached later, when you feel safe and supported.
A good first session should feel like you are building a foundation, not being pushed into anything.
How to Prepare for Your First Session
You do not need to do a lot, but these simple steps can help:
Write down a few notes
If your mind goes blank under pressure, jot down:
What’s been hardest lately
One or two moments that made you think “I need help”
What you want to be different
Decide what pace feels right
You can set a boundary from the start, like:
“I’m nervous and need to go slowly.”
“I want to focus on coping tools first.”
If it’s telehealth, set up your space
Choose a quiet place where you can speak freely
Use headphones if you want more privacy
Have water nearby
Give yourself a few minutes after the session before jumping back into your day
What You Should Leave the First Session With
By the end of the first session, you do not have to feel “fixed.” But you should have more clarity.
Many people leave with:
A sense of being heard
A clearer understanding of what therapy could help with
A next step, like a focus area for upcoming sessions
A feeling of whether the therapist is a good fit
If it does not feel like a fit, that does not mean therapy will not work. It might simply mean you need a different therapist or style. That’s allowed.
A Supportive Next Step
If you’re considering therapy and feeling nervous, you’re not alone. Taking the first step is often the hardest part, and you do not have to do it perfectly.
When you’re ready, The Healing Quest is here to support you.
