What Happens During Your First Therapy Session?
Booking your first therapy session can feel exciting, relieving… and slightly terrifying, all at the same time.
One of the questions I hear most often is:
"What actually happens in the first session?"
People often imagine they'll be expected to tell their entire life story in an hour, answer deeply personal questions or somehow know exactly what they want to work on.
The good news? None of that is expected. The first session is simply a conversation.
It's an opportunity for us to get to know one another and decide whether we feel like a good fit. Just as you're getting a sense of me, I'm also getting to understand you, your experiences and what brings you to therapy.
There's no pressure to have all the answers before you walk through the door.
You don't need to prepare
One of the biggest misconceptions about therapy is that you need to arrive with a clear explanation of what's wrong. You don't. Some people come to therapy because they're experiencing anxiety or burnout. Others because they're navigating a relationship, a career change or grief. And some simply say: "I don't really know why I'm here. I just know something doesn't feel right anymore." That's more than enough. You don't need to organise your thoughts beforehand or rehearse what you're going to say. You can simply arrive as you are.
We'll start by getting to know each other
Our first session is about understanding what has brought you here and what you're hoping might be different. I'll ask questions, but this isn't an interview or a checklist. Think of it as a conversation.
Some of the things we might explore include:
What's been happening recently?
How long have you been feeling this way?
Have you had therapy before?
What made you reach out now?
What would you like to work on as a first topic?
There aren't any right or wrong answers. Sometimes we'll spend most of the session talking about what's happening today. Sometimes we'll naturally begin exploring your past. It depends entirely on you.
You don't have to tell me everything
This is something I'd really like you to know. Trust isn't built in one hour. You don't need to tell me your deepest fears or most painful experiences during our first session. Therapy isn't about getting through your entire story as quickly as possible. It's about creating enough safety that, over time, those conversations become possible. We'll go at your pace. Always.
You can ask me questions too
People sometimes forget that therapy is a relationship. You're not just choosing therapy. You're choosing a therapist. That means you get to ask questions too.
You might want to know:
How do you usually work?
How often should we meet?
What happens if I don't know what to talk about?
How long does therapy usually last?
Have you worked with people experiencing something similar?
If something is important to you, ask.
The first session is just as much about helping you decide whether I'm the right therapist for you.
What my sessions are like
Every therapist works differently. My approach is collaborative. I don't believe therapy is about someone sitting opposite you with all the answers. Instead, I see therapy as something we build together. Sometimes we'll explore thoughts and emotions. Sometimes we'll notice what's happening in your body. Sometimes we'll sit quietly with something that doesn't yet have words.
I work integratively, which means I draw from different therapeutic approaches depending on what feels most helpful for you rather than following one rigid method. If you'd like to learn more about this, I've written more about my approach here:
What if I cry?
Then you cry. It's completely okay. Some people cry during their first session. Others don't cry for months. Some laugh. Some apologise. Some tell me they've been nervous all week. There is no "right" way to be in therapy. You don't need to hold everything together. In fact, therapy is one of the few places where you don't have to.
What if we don't click?
This is an important question. Sometimes people worry that if the first therapist they meet doesn't feel right, therapy simply isn't for them. That's not true. Finding the right therapist is a little like finding the right pair of shoes. You can appreciate that something is well made while also recognising it doesn't fit you. The therapeutic relationship is one of the biggest predictors of successful therapy. So if something doesn't feel right, it's okay to keep looking. Finding the right fit is worth it. I've written more about this here:
→ How to Choose the Right Therapist
What happens after the session?
Towards the end of our meeting, we'll spend a few minutes reflecting on how the session felt. We'll talk about whether it feels like a good fit and discuss possible next steps if you'd like to continue. There's no pressure to decide immediately. Some people know straight away. Others prefer to take a little time to think about it. Both are completely okay.
A final thought
I know how much courage it takes to book that first appointment. Often, the hardest part isn't therapy itself. It's reaching out. If you're reading this because you're wondering whether to book your first session, I'd like to reassure you of one thing:
You don't need to arrive with the perfect explanation.
You don't need to know exactly where to begin.
You simply need to be willing to begin somewhere.
Everything else, we'll figure out together.