The First Therapy Session: What to Expect and Why It Matters
Many people experience anxiety when they think about starting therapy because there may be uncertainty about the process, fear of being judged, or worries about being vulnerable. Navigating what to expect can feel stressful at times; you may have thoughts like “I won’t know what to say, so maybe I shouldn’t go.” These concerns are not only valid, but they are also normal. We want to help you understand what the first therapy appointment will look like, so you feel less anxious, less stressed, and reassured as you enter the therapeutic space.
The first therapy session, often referred to as the intake session, typically begins with a greeting in which the therapist introduces themselves and explains their role. The therapist will then review informed consent, including the purpose of therapy and discuss confidentiality.
Then the therapist will ask you about background information, your current concerns, any previous therapy experiences, and any questions you have about the process of therapy. The therapist’s main goal is to get to know you as a person and understand what brings you to therapy. After gathering some background information, the therapist will ask you about your goals and what you hope to achieve in therapy to ensure you both work collaboratively towards those goals. According to Spencer et al. (2019), a collaborative relationship is “a relationship in which the client and therapist actively work together to fulfill treatment goals”. It is important that mutual involvement and participation occur. You can be assured that you will never be forced to share anything you are not ready to discuss.
The therapist’s focus is on building rapport and creating a safe, supportive space. This means the therapist wants to ensure that “there is trust, warmth, respect, and care exuded between the parties involved” (Pashak & Heron, 2022). During the first session, there is typically less focus on problem-solving. An intake session does not typically involve deep exploration of the past or begin trauma work.
To conclude the session, you will be asked questions to help you process how you’re feeling and schedule the next appointment. After the first session, it is important to reflect on how the session went. You might ask yourself, “Do I feel a little bit relieved?” and “Was I comfortable talking to this person?” This reflection can help you determine whether the therapist feels like a good fit for you. Not every therapist will be the right match for everyone, so taking time to reflect can help you set the foundation for future sessions.
Remember, improving mental health is a journey that unfolds gradually, and starting the journey begins with a simple, but meaningful conversation.
For more information you can contact info@williamspsychological.org.
References:
(Includes peer-reviewed research and clinician-authored educational resources)
Lmft, R. M. M. (2025, September 24). What actually happens in your first therapy session and how to prepare? — Raincross Family Counseling. Raincross Family Counseling. https://www.raincrosstherapy.com/blog/what-to-expect-in-your-first-therapy-session
GoodTherapy. (2024, January 10). What will happen in my first therapy session? - GoodTherapy blog. GoodTherapy Blog. https://www.goodtherapy.org/blog/faq/what-will-happen-in-my-first-therapy-session
Pashak, T.J., Heron, M.R. Build rapport and collect data: A teaching resource on the clinical interviewing intake. Discov Psychol2, 20 (2022). https://doi.org/10.1007/s44202-022-00019-5
Spencer, J., Goode, J., Penix, E. A., Trusty, W., & Swift, J. K. (2019). Developing a collaborative relationship with clients during the initial sessions of psychotherapy. Psychotherapy, 56(1), 7–10. https://doi.org/10.1037/pst0000208
Denaiya Pendleton, Intern at Williams Psychological Services
Cedric Williams, Ph.D.
Licensed Clinical Psychologist