What to Expect from Your First Therapy Session

Before I became a therapist, I had a lot of assumptions about what therapy would be like—and let’s just say, reality didn’t exactly match the fantasy. Now that I’m a therapist myself, I want to share what you can actually expect from your first therapy session.

Whether you’re feeling nervous, curious, or somewhere in between, this guide will help ease the uncertainty and give you a better idea of what to anticipate.

The Practical Stuff: Finding a Therapist

First and foremost, the not-so-exciting part: Finding a therapist. It can be difficult finding a therapist that takes your insurance. When looking for a therapist, I personally used PsychologyToday.com which is a great resource to find demographics that you enjoy, if they take your insurance, and you may also see a quick blurb of who you are about to spill your guts to!

After reaching out to your preferred match via whatever communication method they prefer, they will most likely reach back out and gather your insurance information and card information if necessary. From there, you will schedule a date and time that works best for the both of you.

Ready to begin your therapy journey? Get started below to be matched with the right therapist for your unique needs.

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How to Know if Your Therapist is the Right Fit?

Finding a therapist is like online dating… kind of. You might read a profile and think, “This is the one!” but then meet them and… the vibe just isn’t there. That’s okay.

Sometimes, people worry that switching therapists means they’re being “difficult,” but trust me, it’s normal. In fact, it’s a healthy part of the process. You’re allowed to seek out someone you feel safe and comfortable with. Therapy only works if you feel seen and understood.

How will you know if your therapist is the right fit? Think about what’s important to you. Do you want them to be similar in age, older, or younger? Do you want them to specialize in a certain diagnosis? Here are some things to keep in mind:

Trust your gut: If it feels comfortable and like you can be open with them, that’s key. It might take a few sessions to feel this out, and that’s ok!
Type of therapy: There are tons of different therapy modalities and approaches. Ask them (or read their bios online) about what types of therapy they specialize in. it’s important that their approach fits your needs and goals!
Availability and accessibility: Make it easier on yourself. If the therapist has spotty availability, is located far away, or doesn’t take your insurance, it might mean they are not the right fit.
Communication style: If you feel listened to and appreciate their feedback, that’s a good sign. Do you want them to laugh at your awkward coping jokes, or do you want them to call you out? It all comes down to communication styles.

You might ask yourself:

Do I feel comfortable opening up to this person?
Do they respond in a way that feels supportive?
Do I want someone who laughs at my awkward jokes or calls me out (or both)?

Even if your therapist checks all the boxes, you may not have that comfort level immediately, but you should feel like you could get there. Therapy should feel like a space where you can be your full self.

Before Your First Session: Checking In With Yourself

It’s totally natural to feel nervous before your first appointment. You might wonder:

What if I don’t know what to say?
Is it okay if I cry? What if I don’t?
What if I forget something important?

Take a deep breath. Your therapist has likely heard it all, and nothing you say will be too “weird” or too small.

To ease your anxiety of your first therapy session, you could jot down some things either on paper or in your notes tab on your phone some important things from your past. Is there any trauma? Did anything happen in your childhood that is significant? Is there anything that you were already diagnosed with? Even if it seems unrelated, jot it down just in case. You will feel more prepared

Here are some other questions that you might expect your therapist to ask in your first session:

Are there any mental health concerns in your family?
What is your relationship like with your family? Who are other important people in your life? Who is in your support system?
What are your current stressors? What are you doing to cope with your stressors?
Have you been the therapy before? What was helpful or not helpful about that experience?
What are your personal goals? Why did you decide to seek out therapy now?
How long have you been dealing with these symptoms? How often do you experience these symptoms? Have you noticed any patterns?

Remember that the initial session is an opportunity for both you and your therapist to get to know one another and determine if it’s a good fit therapeutically.

**What the First Session Is Actually Like**

Your first therapy session, usually called an “intake”, is usually focused on gathering information. Your therapist will want to understand your presenting concerns, your strengths, your personal history, and your goals for therapy. They’ll probably ask about your relationships, family background, work or school, and overall mental health.

Your first therapy session will be a lot about your background for your therapist to get a snapshot of what’s happening in your life right now. Even if some of these topics seem to have nothing to do with what you are coming in for, it can be beneficial for the therapist to hear about your life to analyze what could be leading to your mental health concerns or symptoms. They’ll also give you different assessments to better understand the symptoms that seem to be bothering you, how often you’re experiencing the symptoms, and when they started.

Some people cry during the first session; others don’t. Both are totally normal. Crying might be a release after holding something in for a long time, while others may not feel ready to get emotional in front of someone new—and that’s okay too.

You may also notice that you feel physically tired or sore afterward. This can happen because your body’s been holding tension without realizing it. If possible, schedule your first session on a day when you can take it easy afterward. Some rest, hydration, and self-care can go a long way.

Common Therapy Myths (and What’s Actually True)

“Therapy is just laying on a couch while someone silently nods.”

Sure, you can lay on the couch if you want to—but therapy can be so much more interactive and personalized. Some people like to sit on the floor, kick off their shoes, or bring a cozy blanket. Others find comfort in doing something creative, like drawing or playing games. Therapy doesn’t always have to be serious or structured.

“Therapy has to be sad and intense every time.”

Not true! Some of my favorite moments in sessions are the ones filled with laughter. Therapy can be joyful, silly, celebratory, and playful—and it can be hard, emotional, and messy. There’s room for it all.

You don’t need to wait for a crisis to go to therapy. Even during calm weeks, therapy can be a space to reflect on growth or explore what’s working in your life.

“What I say in therapy might get out.”

Confidentiality is a cornerstone of therapy. Your therapist is legally and ethically bound to keep what you share private, with a few exceptions:

If you’re planning to hurt yourself or someone else
If there’s abuse of a child or vulnerable adult
If your records are subpoenaed by a court

Outside of those rare circumstances, your therapist won’t repeat what you say to anyone. It’s a judgment-free space—yes, even when you’re venting about your friends.

After the Intake: What Comes Next?

After that first session, you and your therapist will start discussing your goals. One question I often ask clients is: “Where do you see yourself in a year or two? What do you hope will be different?”

Some other goal setting questions might be:

How would you like to feel differently?
What areas of life do you feel are more important to focus on right now?
What obstacles do you anticipate encountering as you work towards these goals?
What specific changes would you like to see in your life?

Based on your goals, your therapist will collaborate with you to decide how often you’ll meet and what your sessions might look like. Most people start with weekly 60-minute sessions, because this is helpful for building rapport and starting to make progress. Others prefer 30- or 45-minute sessions or every other week. If you’re finding the time too short (or too long) you can always adjust.

Therapy is flexible. It should fit into your life, not the other way around.

Next Steps

Starting therapy can be a big (and brave) step. It’s okay to feel unsure, excited, or even a little skeptical. The most important thing is finding a therapist who feels like the right fit for you and giving yourself permission to take up space in that room.

Whether you cry, laugh, vent, or sit in silence, therapy is yours to shape.

Ready to start your therapy journey? Explore our clinician profiles and find someone who feels like a good fit for you.