Mind | Written by: Jeana Marie

What to Expect in Your First Therapy Session

Whatever your reason for reaching out to a therapist, the idea of sharing your deepest secrets with a complete stranger is understandably frightening.

Even if you know that therapy can help you reach your goals and live a more positive life, the first appointment can be intimidating, especially if you have no idea what to expect during the process.

I felt the same way when I saw my first therapist. I knew that I needed outside help from someone who was trained in dealing with depression and anxiety, so I made an appointment with a practitioner in my area. 

When I showed up at her office, I felt a strong sense of trepidation and doubt. My mind raced with questions like - What is she going to ask me? Do I have to tell her everything? What if there is something wrong with me? What if therapy doesn’t work? 

If you find your mind echoing these same thoughts as you prepare for your first therapy session, you’re not alone. Some of the main reasons that people avoid going to therapy include feeling ashamed and wondering if it will work for them. 

These fears can be dispelled when you know what to expect in your first therapy session. Knowing what to expect helps you calm your fears and gain a sense of control in a vulnerable situation. You can also more easily spot therapist red flags and make efficient use of your first visit.

What to Expect Before Your First Therapy Session

Before you even schedule your first visit, expect to put time and effort into finding a good local therapist. The best strategy is to make a checklist of what you’re looking for in a potential counselor and refer to it as you research therapists online. Look for a therapist who:

  • Has a valid license
  • Takes your health insurance
  • Is located near you or is part of an online therapy group
  • Offers a free phone or virtual consultation
  • Is experienced in the field you are seeking treatment for
  • Uses a therapeutic approach that resonates with you 
  • Presents their fees and policies upfront

Taking the time to sus out these elements before your first session works to alleviate the nervousness that comes with visiting for the first time.

If you’ve already “met'' your therapist on the phone, you’re likely to feel comfortable during the first full session.

What to Expect During Your First Therapy Session

Based on my personal experiences, you can reasonably expect the following steps to take place when you arrive at your therapist’s office.


Much like any other professional you visit, you’ll fill out paperwork when you arrive. You’ll put down the usual information like your name, contact info, and address, but you’ll also be asked questions about your mental health and the reason you’re seeking therapy. 

The paperwork is meant to give the therapist an overview of why you’re there and what you’re hoping to get out of therapy before you start the session. 

Discussion of Your Goals

A good therapist will ask you to talk about your therapy goals during the first session. This isn’t a goal-setting session where you’re expected to come up with concrete SMART goals related to your anxiety or relationship issues; instead, you and your therapist will discuss what “getting better” looks like to you.

Do you want to lessen your anxiety overall? Learn coping skills? Have a better relationship with your mother? Change compulsive eating patterns? 

When you discuss these overarching goals, you can both get a sense of the overall reason you are seeking help and narrow down what you would like to see shift during the course of treatment. 

When I met my current therapist for the first time, she asked me what I’d like to accomplish in coming to see her. I was in a really dark place at the time and honestly, my only goal was to claw my way out of the depression I felt and experience positive emotions again.

In discussing my goal with her, we touched on some of the issues that I believed were causing my feelings and she was able to get a sense of what I was struggling with. This helped us develop a treatment approach that was tailored to my needs. 

It may be helpful to know that this conversation doesn’t usually feel invasive - you aren’t expected to talk about all of your problems up front -  but it does break the ice and allow you to speak about your most pressing issues in a way that gives both you and the therapist insight into your purposes for therapy. 

Explanation of Treatment Approaches

Your therapist may or may not talk about their treatment approach during your first session. Sometimes this conversation is left for another time; however, expect to touch on this topic towards the beginning of your treatment process. 

Your therapist will discuss the therapeutic approaches that they use in their practice. One popular approach is Cognitive Behavioral Therapy (CBT), which focuses on the connection between your thoughts, behaviors, and actions. 

Many therapists use an integrated, holistic treatment approach, which combines therapeutic approaches and uses them to help you make progress in different ways. 

Your therapist will explain how they typically approach therapy with their clients and give you an opportunity to ask questions about how this factors into your individual treatment.

Outline of Treatment Plan

After your conversation about therapeutic approach options, you may discuss an overarching treatment plan for your therapy sessions. This plan serves as a roadmap for treatment so that you are able to focus on the issues that need improvement. 

A treatment plan might include talk therapy in combination with therapy tools that are designed to help you process trauma, like EMDR. Eye Movement Desensitization and Reprocessing (EMDR) is a fairly new therapeutic tool that your therapist might use as part of your treatment plan. This is a complex process that uses touch or sight to help you reprocess traumatic memories.

During your first or second session, your therapist will likely discuss which approach they think will benefit you the most. You and your therapist may explore CBT, art therapy, EMDR, or a number of other methods to help you progress in your goals. 

My therapist and I decided that a holistic approach that incorporated CBT and EMDR would work well for me. Being part of the discussion and being given a choice in which “treatment plan” my therapist used made a big difference in my progress and level of trust during our sessions.

Opportunity for Questions

A good therapist will give you an opportunity to ask questions or share concerns during your first session. 

You should be able to voice your worries about therapy and receive a thorough response from your therapist. You should feel free to do this during any session, but it is especially important to expect this during your first visit when you are figuring out how your particular patient-therapist dynamic flows. 


Unless the therapist specified that your first visit is free, expect to pay for your first full session. Many therapists own their own practice and take credit card payments in the office.

If your session is covered by your insurance, make sure to double-check that the therapist takes your insurance and how many sessions your insurance covers. Either way, be prepared with the funds to cover your session. 

What to Expect After Your First Therapy Session

When you have experienced trauma, seeking professional help is an important step in the healing process, so when your first session concludes, expect to feel a little bit dazed. 

Even if you didn’t touch on anything traumatic or “big” during your first session, you may feel exposed and experience a sense of shock when it’s over.

You’ve just taken a big step that requires courage and vulnerability. Expect to experience any number of the emotions below. They are normal and will subside as your therapy sessions continue.

  • Emotional numbness
  • Elation
  • Fear
  • Anxiousness
  • Anger
  • Confusion
  • Regret
  • Vulnerability
  • Shame
  • shock

Red Flags to Look Out For in Your First Therapy Session

Knowing what to expect in your first therapy session can help you more easily spot red flags that indicate that a therapist is not right for you, or worse, an unqualified practitioner. 

While it is normal to feel out of your comfort zone during your first session, you should never feel unsafe or physically uncomfortable. 

Watch out for these red flags during your first session. If you start to feel unsafe or uneasy, remove yourself from the situation and find a different practitioner.  

  • They use shaming language or make you feel judged
  • They talk about their own problems
  • You feel you have to “prove” what you’re saying
  • They touch you inappropriately or make inappropriate comments
  • They try to convince or force you to use their approach 
  • You feel forced to discuss something you aren’t ready to talk about 
  • They ask for more money than was previously discussed
  • They cannot produce proof of licensure
  • Any other behavior that sets off your inner alarm that you are not safe

Make the Most of Your First Session

When you know what to expect during your first therapy session, you can start your journey towards better mental health with a sense of confidence and control. Make the most of your first session by speaking with the therapist ahead of time to get an idea of how they work and what you should expect from their approach.

Go into the session with an open mind and play an active role in your treatment plan by asking questions and narrowing down what you want to achieve in therapy. Allow your new therapist to help you choose an approach that you are both confident with. 

Finally, take it easy after your first session. It is a big step towards bettering yourself and you may feel strange emotions after your first visit. Allow the feelings to be what they are and know that it’s just part of the process.

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