Starting therapy can be daunting, even when you’re confident in your decision to attend. Knowing what to expect can make a big difference as you embark on this journey. In this article, I’m going to walk you through your first therapy session and share some tips to help you prepare.
5 Things to Expect at Your First Therapy Session
1. First Appointment = Assessment session
Your first appointment with me will be an assessment session. It should feel fairly informal. People are often anxious about coming, but they tend to find things flow much more naturally than they expect.
Your assessment session isn’t about fixing anything. Instead, we’ll focus on getting to know each other. You’ll be assessing me too, so this is where you’ll start to get a sense of who I am and whether I can help. It is important to notice how you feel with the therapist and whether you feel safe enough to be honest.
2. I’ll Guide and Prompt Things as We Go
I’ll ask you what’s bringing you to therapy right now. What made you finally pick up the phone or reach out. This might be a current stressor, but it often gives clues about the deeper issues at play.
I will also ask about different influences in your life, relationships, family and history. I don’t need an exhaustive biography, but I will be listening for patterns and themes that give clues about your inner experience.
Finally, I’ll want to get an initial sense of what you’re hoping for from therapy. Don’t worry if your answer feels vague. Things like ‘I just want to feel less like there’s something wrong with me’ or ‘I want to stop overthinking everything’ are enough.
3. First Sessions Can Feel a Bit Messy
Many of my clients aren’t sure why they feel the way they do, why they keep having bouts of depression, or find themselves being triggered by certain situations or people. You don’t need to have a dramatic reason or obvious trauma you can link things back to. It’s okay for things to messy and all over the place at first. This is what I’m here to help with, and we’ll start putting things together in subsequent sessions. Therapy brings clarity so you don’t need to have it figured out.
4. It’s Okay to Feel Guarded
Depending on people’s experiences, opening up can be tricky and trust may not come easily. This isn’t a problem you need to solve before you start. It’s something therapy helps with. You also don’t need to say everything in the first session. We can take things at whatever pace feels comfortable to you.
5. It’s Hard to Predict How You’ll Feel After Your First Session
Although we’re not yet in the treatment phase, many people find the assessment session really helpful. Speaking openly and honestly about things represents a turning point, and you may well gain important insights.
For some people things can feel a lot clearer and lighter after their first session. For others, they may feel a bit raw, especially for the 24hours following. This is actually a good sign. It shows you’ve gone where you needed to go, and although it’s not easy, it will be worthwhile. If this is the case, I try to encourage people to prioritise doing gentle activities afterwards.
An Approach Based on Personal Experience
I went to see a therapist myself for the first time over 20 years ago. At my first session, I didn’t really know what to say, so I just shared everything I thought was relevant. The therapist gave little back in terms of warmth, guidance or encouragement. At the end, I said I was worried I’d just bored her for an hour, and she didn’t do much to allay that fear! It was awful.
I did go back, but only for one further session before bailing. Although that experience wasn’t what I needed at the time, it has been helpful for my professional work. I will never forget how vulnerable and rubbish I felt leaving that first session. If a client ever expressed something like that to me, I wouldn’t let them leave until I was absolutely sure I’d reassured them completely! And for the record, I have never ever been bored when someone has shared their story with me!
My Tips to Help You Prepare for Your First Therapy Session
Remember, you don’t need a neat story or a clear place to start. Many clients worry their problems aren’t big enough to warrant therapy, or that they should be able to get over certain things on their own. Don’t let thoughts like this get in the way. Bring your ‘presenting problem’, however small it seems. Some people find it helpful to jot down a few things that have been weighing on them, but this is by no means essential.
Reflect on what you’re hoping for. It might be something specific or it might be a feeling. For example, ‘I want to feel more like myself’. There are no wrong answers, and having a loose sense of what you want to be different will give us some direction without being restrictive.
Give yourself a buffer. Try not to rush to therapy straight from something busy or stressful. I’d also encourage you to allow for some downtime after the session too.
Be kind to yourself. First sessions can stir things up – memories, emotions, thoughts you’ve sat on for a while – and leave you feeling vulnerable. As I said above, this is often a good sign, but you do need to be gentle with yourself afterwards. I’d recommend having some quiet time or making a point to do something nourishing.
Therapy to Help You Heal
With more than 18 years’ experience in the field of mental health, I help clients understand the patterns of thinking and behaving that have been driving their actions for decades. By connecting past experiences to your present struggles, we create lasting transformation.
I regularly support people experiencing specific psychological difficulties such as PTSD, OCD, panic attacks, and depression. I also help clients struggling with low confidence, excessive worry, burnout, and the sense that the same painful patterns keep repeating. If these things sound familiar, please get in touch. I also share mental health education via Instagram.
