Starting therapy brings up common questions: What happens in the first therapy session? What will my therapist ask me? Will I feel uncomfortable? These concerns are valid, especially if you’ve never been to therapy before.
Your first therapy session is designed to help you feel oriented and supported, not to push you into vulnerability before you’re ready. Understanding what typically happens can make that initial appointment feel less intimidating.
What Happens in Your First Therapy Session?
Introductions and Informed Consent
Once you join the session, your therapist will introduce themselves and explain how therapy works. This includes reviewing informed consent and confidentiality, ensuring you understand how your privacy is protected and what boundaries exist in the therapeutic relationship. While this may sound formal, its purpose is reassurance.
Your therapist will explain their general approach in accessible language. You’ll learn what to expect from your sessions together without overwhelming clinical terminology.
Understanding Why You’re Here
The conversation then shifts to understanding why you decided to start therapy now. Your therapist will gather context about your concerns, current stressors, and what you hope might change.
You’re not expected to provide a complete life history or arrive with perfectly formed goals. Many people simply start with what feels most present—a specific situation that’s been difficult, a pattern they’ve noticed, or a general sense that something needs to shift.
Common First Therapy Session Questions
Your therapist will ask questions to guide their understanding, not to interrogate you. Expect questions about:
- What brought you to therapy at this time
- How you’ve been feeling emotionally and physically
- Whether you’ve had therapy before and what that experience was like
- Your current support system and living situation
- Major life transitions or challenges you’re facing
- Your mental health history and any previous diagnoses
Some therapists use brief screening questionnaires to assess depression, anxiety, or stress levels. These aren’t tests you can pass or fail—they’re frameworks to understand what you’re experiencing and track progress over time.
Setting Goals for Therapy
Goal-setting often begins in the first session, though it doesn’t need to be finalized. Your therapist might ask what you’d like to be different three months from now or what would make therapy feel worthwhile. Goals can be broad like “feeling less overwhelmed” or specific like “setting boundaries at work.” They can also evolve as therapy progresses.
How to Prepare for Your First Online Therapy Session
Practical Preparation
Choose a private space where you feel comfortable and won’t be interrupted. Test your internet connection if attending virtually, and log in a few minutes early. Consider using headphones for added privacy.
You might want to have water or tissues nearby. Some people find it helpful to jot down a few notes beforehand about what they want to mention, especially if they tend to forget things when nervous.
Emotional Preparation
Release the idea that you need everything figured out or articulated perfectly. Therapists are trained to help you make sense of confusing or overwhelming feelings.
Give yourself permission to rest after the session and process at your own pace. Therapy can stir things up, and that doesn’t mean something went wrong.
What to Ask Your Therapist
Your first therapy session is also your opportunity to interview your therapist. Consider asking:
- What is your experience with issues like mine?
- What approach or therapy modality do you typically use?
- How long do you typically expect therapy to last?
- How do you measure progress?
- What should I do if I need support between sessions?
- What is your cancellation policy?
Not every therapist is the right fit, and asking questions helps you determine if this working relationship feels right for you.
After Your First Therapy Session: What’s Next?
At the end of your first session, your therapist will discuss next steps, including scheduling future appointments and outlining a general treatment plan. They’ll explain session frequency and logistics like cancellation policies and crisis support.
Your therapist may also check in about how the session felt. If something didn’t sit right or you have concerns about the fit, this is the time to mention it. Finding the right therapist is important, and it’s okay to acknowledge if the match doesn’t feel quite right.
Finding the Right Fit
A strong therapeutic relationship is key to successful therapy. After your first session, ask yourself:
- Did I feel comfortable speaking with this therapist?
- Did they seem attentive and focused on what I was saying?
- Did I feel respected and heard?
- Can I imagine working with them over time?
If the answers are mostly yes, you’ve likely found a good match. If not, it’s okay to keep looking. Finding the right therapist may take time, but it’s worth the effort.
Take the First Step With Insight Therapy Solutions
At Insight Therapy Solutions, our licensed therapists specialize in helping clients feel comfortable during their first therapy session. We focus on thoughtful pacing, clear communication, and matching you with a therapist who understands your unique goals and concerns.
If you’re considering online therapy but still feel unsure where to begin, we can help. Book your 15-minute free Therapist Matchmaking Session today and let us help you find the right therapist who understands your needs.
Starting therapy doesn’t require certainty or readiness—it just requires a place to begin.
Frequently Asked Questions About First Session Therapy
Is It Normal to Be Nervous About Your First Therapy Session?
Is It Okay to Cry During Your First Therapy Session?
Will I Feel Better After One Therapy Session?
How Long Does a First Therapy Session Last?
What If I Don’t Know What to Say in My First Therapy Session?
Additional Resources
Getting Mental Health Support Virtually – Official NIMH guide explaining what virtual mental health care includes, how it works, the benefits and things to consider when looking for teletherapy or telehealth services. This is a great resource for understanding online therapy in a clinical context.
“Online therapy is here to stay” – An APA article discussing trends in online therapy and telepsychology, including benefits, challenges, and evolving practice standards. This helps explain teletherapy from the perspective of psychological professionals.
NAMI mental health support and education – While not exclusively about teletherapy, NAMI provides extensive support, education, and virtual groups that complement online therapy by offering peer support and community resources.
