What to Expect in Your First Therapy Session

American Psychiatric Association Foundation

Starting therapy is a great step forward in your mental health journey. You may feel anxious before your first session, but that’s completely normal. Learn what to expect in your first therapy session and find answers to common questions to help you feel prepared and at ease. 

Preparing For Your Session

    • Consider Why You’re There
      • Reflect on what brings you to therapy. Think about what you’ve been struggling with and what you’d like to work on. 
      • Whether your concerns are specific or less clear, any way you choose to share is welcome.
    • Set Expectations
      • During your first session, your therapist will get to know you, but not provide an immediate diagnosis or solution. Allow time for them to understand your case before suggesting a treatment plan. Trust the process and keep an open mind.
    • Choose the Right Time and Place
  • If your session is virtual, choose a time and place for the appointment where you can focus, clear your mind, and speak freely in a comfortable, distraction-free space.

During the Session

In your first session, the therapist will get to know you and set expectations for therapy. 

  • Introductions: Your therapist may explain their professional background, approach, and confidentiality policies.
  • Share Your Story: You’ll share what led you to therapy and what you hope to gain. If you are not sure, that’s okay too. It’s okay if you don’t feel like you got to everything right away. The trust and rapport are still building, and no one can tell their full life story in one session.
  • Talk Through What’s Going On: Expect to be asked about your symptoms, relationships, work or school life, and stressors. If you’re not ready to talk about certain things in your first session, that’s completely okay. Your therapist will help create a safe, supportive environment so you can share at your own pace.
  • Set Goals Together: You’ll begin outlining what progress might look like and how you’ll measure it.
  • Ask Questions Freely: Don’t be afraid to ask questions to help determine if this therapist is the right fit for you. You can ask questions like:
    • Have you dealt with similar cases before?
    • What types of treatment do you use?
    • Can you give me an idea of what to expect in our sessions?
    • How can I give you feedback if I ever feel uncomfortable or unsure during one of our sessions?

After the Session: Take time to reflect on what you talked about, and any insights gained.

Common Questions about Therapy

How long will my session last?

Most therapy sessions last about 45 to 60 minutes. Discuss session length with your provider to see what works best.

How long will I need to be in treatment?

Reaching your goals usually takes more than a few sessions, and ongoing therapy over several months or longer is common.

What if I feel like my provider is not the right fit or I don’t feel like therapy is working?

It’s normal for your first therapy session to feel uncomfortable. However, if it doesn’t feel like the right fit after giving them time to understand your case, it’s okay to look for someone whose approach better meets your needs. It’s important to find a therapist who makes you feel respected and heard during sessions and helps you notice progress or positive change over time. 

I am scared to bring up a topic because of what the therapist might think.

Therapists are trained to listen without judgment and create a safe space to talk about difficult subjects.

Will anyone find out what I talk about in therapy?

No. What you share in therapy is confidential except in specific safety-related situations which your therapist will disclose in your first session.

What if my therapist suggests that I should be evaluated by a psychiatrist in addition to therapy?

Your therapist may suggest an evaluation to see if medication could support your progress in therapy. If your psychiatrist recommends a medication plan, they’ll explain it thoroughly and answer any questions you have.

If you or someone you know is experiencing a crisis hotlines are available for 24/7 confidential support.

  • National Crisis Line – Call or text 988 or visit 988lifeline.org

This resource was review by Virginia Donovan, LGPC, NCC

For more information, and to learn about other types of mental health treatments visit mentalhealthcareworks.org.