Many people who have never participated in a therapy session wonder what it will be like. Will the therapist ask you a lot of questions about your feelings? Will they ask you to discuss your fears? Will you have to talk about your childhood?
The truth is that different therapists handle their first therapy sessions differently. They may even encourage you to ask them questions about their lives, training, or experiences in the first session.
A Timeline of Your First Therapy Session
Waiting: The first moments of your arrival to a therapist’s office may be very similar to waiting for any other kind of health care appointment. You might check in with a receptionist, fill out initial paperwork, and then wait for your therapist to bring you back for your session.
Introductions: You’ll most likely spend the first part of your therapy session getting to know one another. Your relationship with your therapist is just any other—it may work best if you’re able to connect with one another on a personal level initially. You don’t have to leap into your deepest darkest secrets immediately—feel free to talk through your favorite book or the movie you saw last week as a way to get a sense of how the two of you will communicate with one another.
Establishing Needs: Your therapist will need to know why you’re seeking therapy. They may ask what kinds of needs or issues you’d like to address in your treatment together as well as what you’ve done to manage your mental health in the past. They’ll want to talk through what worked and what didn’t to get an understanding of how best to 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?
What Should I Do After My First Therapy Session?
The most important thing to do after your first therapy session is check in with yourself. Ask yourself how you felt your first session went, and see how you would feel about going to another one with this therapist. Remember: there’s no such thing as a one-session cure, so you may feel a little better or relieved, but your symptoms won’t immediately disappear.
Consider how you felt about your therapist specifically. Did you feel comfortable talking with them? Did you feel like the two of you could work together over a long-term time frame? If your therapist tries to give you a diagnosis in the first session or makes you feel uncomfortable for any reason, it might be a good idea to find someone else. Therapy is an incredibly individualized process, so not every therapist is going to be the right fit for you. It’s okay to interview a few before you find the right person.
Additionally, you may have some “homework” from your therapist before your next session. This could be anything from journaling throughout the week to doing a little reading that may help provide context for your next session. Remember: whatever work you do between sessions is about making you feel healthier and happier, not about getting a good grade.
What Therapists Have to Say About Attending Your First Therapy Session
Several therapists explain what goes on in their first sessions with people new to their practices:
Damon Constantinides, PhD, LCSW: I think of the first three times that I meet with someone as a trial run. I encourage people that come to me to pay attention to how they feel both while we’re meeting and afterwards. My style is not going to work for everyone, and what’s most important to me is that you find someone who feels like a good fit.
I like to use my first session with someone in two ways, and I ask you which direction you’d like to go in first. I want to begin to get to know you, and I want the session to be useful. Getting to know each other includes providing time for you to ask me any logistical questions about working together, as well as questions about my experience and therapy style. It’s also a time for me to learn a little bit about you generally and to begin to get an idea of your expectations of therapy. What do I need to know about you to understand where you’re coming from? How you had any experience with therapy before? If so, what was good about it? What wasn’t so good? These questions help me to understand what you’re looking for and if I think we’ll be able to work well together. With some people, this takes our entire first session. For others, they want to get started with the problem they’re coming to therapy to solve.
It’s important to me that therapy feels useful to you. For people who are ready to get started right away, we begin with what’s been going on recently and what’s on their mind in that moment. At the end of the first session I check in with people to see how it felt during the session and if they have any other questions about me or my work. For therapy to be useful, we need to build trust together. This trust building happens over several sessions. Our first session is an introduction, which is the beginning of forming a trusting relationship together.
Marla B. Cohen, PsyD: In your first session, your therapist will spend some time getting to know you and the issues that brought you into treatment. He or she may use a formal, structured interview, or it may just feel like a more free-flowing conversation. The therapist will ask questions about your presenting concerns, as well as your history and background. Most likely, you’ll find yourself talking about your current symptoms or struggles, as well saying a bit about your relationships, your interests, your strengths, and your goals.
Most importantly, in that first session, you will begin making a connection with your therapist. You should feel safe, accepted, respected, and relatively comfortable. Not all therapists are right for every person, so use your first session to assess whether or not the therapist you chose feels like a good match for your personality.
Lynn Somerstein, PhD, E-RYT: Usually, in your first session you will be invited to be seated comfortably. The therapist will usually begin with some initial small talk to help you feel at ease. I usually make reference to the scariness of starting therapy, since I like to honor the feelings that are present. That’s a feature of therapy: find out where the person is and start there.
Sometimes people have lots to say and start talking right away, pouring out their thoughts and feelings, and sometimes their fears and tears, too.
Other people find it very hard to speak, so I’ll ask questions about how they decided to come to therapy, why therapy with me and not somebody else, whether they have been in treatment before, and whether there is something in particular troubling them. Each statement the person in therapy makes leads to many other questions.
I say what my expectations are: that people come on time, that they pay on time, that they say what is on their minds—even if it sounds silly to them. In fact, especially if it sounds silly; those silly ideas are frequently the best things to talk about because they often lead to issues that need to be explored.
Toward the end of the first session I also always thank the person for coming, say that I’ve asked a lot of questions (if indeed I have) and invite the person in therapy to ask me questions. Sometimes people feel it’s not polite, and they are afraid. So, then I say not to worry about courtesy, that I’ll probably feel comfortable answering, but that if for some reason I don’t want to answer something I’ll say so and we’ll move on.
Then we discuss whether we’d like to meet again and, if so, when. I’ll say how often I think we should meet, and we’ll talk about that too.
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.
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- Kuzma, C. (2018, September 27). What to expect from your first therapy appointment. Retrieved from https://tonic.vice.com/en_us/article/d3jyv7/what-to-expect-from-your-first-therapy-appointment
- Schimelpfening, N. (2018, December 10). What to expect during your first therapy session. Retrieved from https://www.verywellmind.com/psychotherapy-101-p2-1067403
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