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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. 

Your Therapist And Your Expectations

Your Therapist

Are you familiar with the type or types of therapy offered by your particular therapist? If you aren't or have questions about the method, your first appointment is the ideal time to get clarification. Which types of clients and issues do well with this method?


Are you a good candidate for this kind of therapy, or does your therapist believe that another type of therapy might better meet your needs?

Ask for an outline of the work generally done within the therapy method your therapist offers, and ask how many sessions clients generally have, and how often. Asking for book recommendations that tell you more about your particular kind of therapy is a good way to gain an insight into your therapist's personal therapy philosophy without spending valuable time on this discussion. 

It's comforting to know more about your therapist's professional background as well. Does he or she have experience in dealing with clients who have similar issues, and if so how much? Who are the therapist's professional role models? Where did your therapist study and for how long has he or she been practicing? What else do you need to know about working with this therapist?

Then, you'll want to know if the therapist is available for phone sessions or sessions set up at short notice if you are having some sort of mental health crisis. Some therapists are more flexible than others when it comes to this. 

People who are dealing with an issue they might need medication for — such as depression or ADHD — could ask if they need to see a different person to prescribe medication and if so, to what extent your therapist can coordinate the treatment with other healthcare providers. 

Don't Expect Too Much, Too Soon

Chances are that you have been struggling with the issues for which you decided to seek therapy for quite a while by the time you find yourself in your therapist's office for the first time. A first therapy session lays the foundation for your further work, but don't expect to feel better after that initial appointment — the sessions that come after will be much more productive. 

It's not uncommon to feel disappointed or unsure after a first session.

Remember that therapy takes time and that you need to get to know your therapist and build up a relationship of trust before you will feel able to share what you need to share, and get good advice. 

You might even find, after attending a few sessions, that this therapist is not the right one for you. If that happens, don't let the experience put you off therapy completely and just look for another therapist or another method. Hopefully, though, you'll find that one therapy session builds on another that that the at-home work you do between sessions has a continuous positive impact on your well-being. 

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