What Happens in Your First Therapy Session?

Your first therapy session is different from all the future sessions you will have. Despite popular belief, a therapist’s role is not to solve your problems for you. They aren’t there to tell you what to do or to point out how wrong people who have hurt you have been.

In fact, most therapists will avoid discussing the rights and wrongs of people in your life. Instead, they’ll focus on assisting you in shifting your focus to what you can and cannot change — ultimately, you, your choices, and your reactions to events. Depending on your reason for starting therapy, most therapists will spend time encouraging you to look inward.

Many people who have never attended a therapy session are curious about the experience. Will the therapist bombard you with questions about your emotions? Will they ask you to talk about your fears? Will you be forced to discuss your childhood?

The truth is that different therapists approach their first therapy sessions in different ways. They may even encourage you to ask them questions about their lives, training, or experiences during the first session.


Waiting: The initial moments of your arrival at a therapist’s office may be similar to any other type of health care appointment. You may check in with a receptionist, complete preliminary paperwork, and then wait for your therapist to call you back for your session.

Introductions: The first part of your therapy session will most likely be spent getting to know one another. Your relationship with your therapist is like any other—it may work best if you can connect on a personal level at first. You don’t have to jump right into your deepest darkest secrets—talk about your favorite book or the movie you saw last week to get a sense of how the two of you will communicate with one another.

Establishing Needs: Your therapist will require information about why you are seeking therapy. They may inquire about the kinds of needs or issues you’d like to address during your treatment, as well as what you’ve done in the past to manage your mental health. They’ll want to talk about what worked and what didn’t in order to figure out how to best help you.

Asking Questions: As a secondary part of understanding what you need from therapy, your therapist may ask some of the following questions:

  • Have you attended therapy in the past?
  • What are your symptoms?
  • Do you have any mental health issues in your family history?
  • How is your home life?
  • Do you have a history of suicidal ideation?
  • Do you have a history of self-harm?
  • What do you hope to get from therapy?
  • What do you want to accomplish in sessions?

More Questions: It can also be helpful to plan on asking questions of your therapist. Before your session, consider thinking over what worries or concerns you may have about treatment and then brainstorm some questions to ask your therapist. For example:

  • Is this confidential?
  • When would you need to break confidentiality?
  • How long have you been a therapist?
  • Do you have any experience with my specific type of mental health issues?
  • Have you ever been to therapy yourself?
  • What kind of things should I plan to do between our sessions?


No two therapists are the same. Asking the right questions will help you choose the best therapist for you. Questions to ask before you make an appointment:

Affiliations: What professional associations do you belong to?
Background: What is your academic background, and what has your training been to prepare you to practice as a therapist?
Cost: What are your fees? How will my insurance claim be handled?
Experience: What specialized training and/or experience have you had in working with the issue I am dealing with?
Rules: What are your office protocols? (e.g., booking appointments, payment for missed appointments, emergencies, building access after hours, etc.)
Specialties: What type of therapy do you do? (Does the therapist to mostly talk therapy or include opportunities for role-playing, visualizing, hypnosis, artwork, “bodywork”)


Therapy can last a few sessions, several weeks, or years, depending on your issue and therapy goals. While you may be wondering how long it will take to “feel better,” there is no simple answer. It is highly personalized.

In addition, for those that have the privilege of insurance coverage, some insurance plans only cover a set number of sessions in a given year, so you may need to factor in those limitations and/or work with your therapist to come up with a payment plan.


A big part of successful therapy is feeling comfortable with your therapist, which may come over time. However, if after a few meetings, you’re just not clicking, you do have the choice to seek out another therapist.

To determine if you’re receiving the best care from your therapist, we recommend asking yourself the following questions:

  • Do they challenge you?
  • Do they check-in with you?
  • Do they guide you to your goals?
  • Do they help you learn?
  • Do they show acceptance and compassion?
  • Do they treat you as an equal?

If your answer to any of these questions is “No,” then it’s likely time to consider changing therapists. At the end of your session, just tell your therapist that you will not be returning. Don’t be surprised if your therapist asks why.

You can answer honestly (you just feel like you’re not clicking) or just say that you prefer not to say. In most cases, your therapist will be professional and can recommend another therapist who will be a better fit. 


After your first therapy session, the most important thing you should do is check in with yourself. Consider how you felt about your first session and how you would feel about going to another one with this therapist. Remember that there is no such thing as a one-session cure, so while you may feel a little better or relieved, your symptoms will not go away immediately.

Think about how you felt about your therapist in particular. Did you feel at ease conversing with them? Did you think the two of you could collaborate for a long time? If your therapist tries to diagnose you in the first session or makes you feel uncomfortable for any reason, it may be time to look for another therapist. Because therapy is a highly personalized process, not every therapist will be a good fit for you. It’s fine to interview several people before finding the right one.

In addition, your therapist may assign you some “homework” before your next session. This can range from journaling throughout the week to doing some light reading to help provide context for your next session. Remember that the goal of any work you do between sessions is to make you feel healthier and happier, not to get a good grade.


Taking the first step on a new path to improved mental health can be scary. Getting through the first appointment may be one of the hardest parts of starting therapy. However, by taking everything one step at a time and communicating openly about your goals with your therapist, you can set yourself up for the best possible experience.

To talk to a therapist today, click here.

You May Also Like

More From Author