A person taking notes with a pen in a notebook representing how preparing before your first therapy session can help with calming nerves and getting the most out of your appointment.

I’m a planner, and before I start something new, knowing what to expect can help calm a lot of my worries and anxieties. (I am always the person researching the parking situation!) If you are anything like me, and are getting ready for your first therapy session, you may be worried about what to expect. Although not every therapist is the same, here are 7 things you can expect to happen during your first therapy session, sometimes called an intake appointment:

1) Preparation Before the First Session

Okay, so one of the things on the list is before the first session, but your preparation will be very relevant to the rest of the session.

Paperwork: Before your first therapy session you will have paperwork to complete. Many times this paperwork will be sent to you via email or another online format prior to the session for you to complete. If you are attending sessions in person, you may be asked to arrive early to complete paperwork. The paperwork may vary, but will generally include information on your therapists’ policies and procedures, informed consent, and confidentiality. Additionally, you will be asked to complete some information about you, such as your demographics, mental health history, and current concerns and symptoms. Completing this paperwork will help your therapist have a better understanding of you and what you are looking for in therapy. I also think it gives you a chance to further reflect on what feels important for you to share with your therapist and what your goals are for therapy, both of which will be relevant in the first session.

Arriving at the Appointment: Make sure to ask any questions you have about how to get to the appointment. If you are meeting virtually, make sure you know how you will receive a link to your appointment, and if you are meeting in person, you know I will recommend asking about the parking situation!

2) Business and Logistics

An important aspect of your first session with your therapist is to also go over all of the logistics, policies, procedures, and informed consent prior to beginning treatment. This is the time for you to get all the information for what to expect while working with your therapist. You will likely go over logistical things such as how payment will be made, how scheduling will occur, expectations around contacting your therapist outside of session, cancellation policies, and other important policies your therapist may have. This is likely information that you reviewed in the paperwork you filled out, so your therapist may quickly cover this information and see if you have any questions from the paperwork you completed.

This can also be a time to ask any questions you may have had in reading the informed consent forms you reviewed prior to your session. An informed consent form will outline all of the information you may want to know about prior to beginning treatment, including things such as possible risks and benefits, limits to confidentiality, your therapists’ credentials, the nature of treatment, and your right to refuse treatment. If you are meeting virtually, this may also include risks and benefits to using technology for your appointments and the nature of telehealth therapy. In the world of scrolling past the terms and conditions to just click “accept” I know I’ve worked with a lot of people who just sign off on things like the informed consent form, but I’d really encourage you to read them thoroughly. They will give you a lot of information, and also maybe bring up questions you may have for your therapist.

3) Getting to Know You

Beyond the logistics, a large portion of your initial session with your therapist will be spent getting to know you. Your therapist will review the paperwork you completed prior to the session, and likely ask you to share more about certain aspects of the questions you answered. You can often expect questions about you to be around three main themes:

What you are experiencing currently that is bringing you to therapy, including your current symptoms.
Information about other areas of your life that are likely impacting or are impacted by your mental health concerns, such as, your relationships, your employment, your family, your cultural background and identities, and your history of mental health treatment and concerns. These questions will likely both get into the past and the present. In my experience, many people may come into therapy with certain things they feel they are not quite ready to talk about with a therapist they are just meeting. For example, if you’ve experienced a past traumatic event, it’s common to not go in depth into talking about that experience right away. I say this just to note that you don’t have to share everything right away. You can even tell your therapist that there is more you might want to talk about in a given area, but aren’t quite ready and you hope you can return to it in the future.
Your safety. It is common for therapists to ask about things like suicide, thoughts of hurting yourself, thoughts of hurting others, and self-harm behaviors. These are important topics for your therapist to know about for not only your safety, but so that they can also be goals to work on throughout your work together. Many clients will feel nervous sharing about things like suicidal thoughts because of a fear about being hospitalized. This topic is a little beyond this post (but I plan to write a post regarding this in the future, so keep your eyes open!), but this is a reason reviewing informed consent and policies is so important. Your therapist will share when they might share information with others regarding your safety without your consent when they overview their policies. Just talking about having suicidal thoughts is not an automatic hospitalization, a lot more goes into that decision.

4) Your Goals

You have come to therapy for a reason. You want your life to change and improve in some way. Part of your first session will talk about what you are hoping to see change in your life, and what your goals for therapy are. This discussion may extend into your second session too, time depending. You don’t have to have all of your goals clearly thought out at this point, but some idea of what you are hoping will be different is helpful. If you are feeling stuck, or just know that you don’t want to feel how you’ve been feeling anymore, that’s okay too. Your therapist will help explore and collaborate with you on goals that feel right for you. Goals in therapy are helpful to keep therapy on track and also as a way to determine if therapy is helping.

5) Learning About Your Therapist

Although a lot of the first session is spent on you, there will also be time for you to get to know your therapist as this is also important for knowing if they are a good fit for you. Your therapist will share about their credentials, and likely share some about their theoretical approach to therapy or what therapy with them tends to look like (they may have also shared some of this in an initial consultation call). They may not share in depth about themselves, but you should ask them questions that are important for you to know.

6) Space for Questions

You should absolutely ask any questions you have for your therapist, especially if they are questions that are important to you to determine if your therapist is a good fit (read more about finding out if your therapist is a good fit here). This is your treatment, so just like with any medical procedure, you deserve to understand what you can expect in therapy. A therapist will likely leave space for questions you may have in a first session, especially around reviewing logistics and consent forms, but also feel free to ask other questions that come up for you. A common question I ask when I am meeting with a new therapist is what I can expect future sessions to look like. I unfortunately can’t write a blog post on what the rest of sessions will look like with a therapist, because that can vary widely depending on the approach a therapist uses, so I definitely encourage you to ask this if it feels important for you to know!

7) Feedback

Finally, a therapist will likely end your initial session asking you about how you felt the session went. This can be a time to give your therapist feedback about what things seemed helpful and things they may be able to change to be more helpful. Remember, that an initial session likely feels different than a typical session, since it is much more focused on gathering information than a typical session will feel! Your therapist is asking you for feedback because they care about your experience of therapy, so share with them as honestly as you are able. A good therapist will likely check in with you towards the end of at least the first few sessions to see how things are going.

There you have it! You’ve finished your first session of therapy. This is a big step towards your goals! Although a quick list may make it seem easy, starting therapy can also be tiring and draining at times. You might be opening up about things or feeling emotions in ways you haven’t before. So be gentle with yourself after your first session. It might even be a perfect time for a small treat, or watching your favorite comfort show. There will be more work to be done in therapy, but you’ve just made a huge first step and that is something to be rewarded and celebrated!

If you are interested in having a first session with me, you can email me at carolyn@carolynmeillerphd.com or request an appointment here. If you are still in the process of finding a therapist and wanting to learn more about how to find and get started with a therapist, check out the rest of my Beginning Therapy Series.

Dr. Carolyn Meiller is a queer psychologist in Lexington KY. She is a White, ciswoman, with a larger body and curly brown hair. She is wearing a grey quarter zip sweater outside with a trail behind her and some green bushed and trees to her left. — About the Author:

Carolyn Meiller, PhD is a licensed psychologist in Lexington, Kentucky. At her virtual private practice she works with adults navigating interpersonal trauma, relationship concerns, anxiety, and LGBTQ+ and identity concerns. Carolyn has worked with many people coming to therapy for the first time, and having been nervous before attending therapy the first time herself, she is passionate about helping people understand and navigate the world of therapy.

Seven Things To Expect During Your First Therapy Session