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A first therapy session can be scary as well as exciting. How can you get through it in one piece, and what can you expect from that first time?

People decide to take the courageous step of engaging in therapy for a wide variety of reasons. You might be contemplating therapy because you need help dealing with the loss of a loved one, past trauma, depression, your relationship, or any number of other issues. 

One thing is common to all "therapy virgins" — that first appointment is a little scary, because you are about to share your deepest thoughts with a stranger and have no idea what to expect. So, you've been assigned a therapist or have chosen one yourself? Here's how to go into your first session feeling a little easier. 

Your Therapy Goals

Your first session will, by definition, center on your therapist getting to know you and the issues you are struggling with. What is most pressing for you right now? To avoid awkward silences and discussions about things that are not all that helpful to you, it is a good idea to write your goals down or at least to think about them in detail. 

Sit down and take your time to think about the questions your therapist will inevitably ask you during that first session:

  • For what issue(s) are you seeking therapy right now, and how long have you been struggling?
  • What are you hoping to achieve in therapy?
  • What is your end goal? How do you want therapy to change you?
  • What are you feeling right now?

These four questions will give you plenty of material to discuss during your first session, but make sure you play an active role in the session by asking questions of your own as well as beginning to talk about the problems you want to deal with in therapy. 

It is normal to feel anxious and awkward about your first session. You are talking about things that are difficult to discuss, with a person you have probably never met before.

Feel free to tell your therapist that you are not quite sure how "this all works", and don't feel pressured to tell more than you feel comfortable with for now.

It is usually a good idea to arrive at your first session a little early. In most places, you will have forms to fill out. They will typically cover your personal history, and insurance if your therapy is covered by your insurance policy. Your therapist will also need to discuss the privacy policy that is in place, and you can ask questions about that. Under what circumstances is what you say in therapy not confidential? If your therapist has concerns about any suicidal feelings you might have, he or she is required to report those, for instance. While that is clearly in your interest, you will want to know about it in advance. 

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