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3 Minutes Read

What should I expect from my first therapy session?

Going to therapy for the first time can be intimidating. 

Many clients conjure up the stereotypical, old school image of being in a clinician’s office – laying down awkwardly on a chaise lounge while an unsmiling professional in tweed business wear quietly stares at you. 

However, most therapists today take a more dynamic approach, and tend to follow a general structure to the first therapy session which can help put you at ease.

Initial forms and consents

Before your first session, your therapist will ask you to complete some initial paperwork, including informed consent forms and often some demographic and health data. 

These might be completed electronically, especially if you are meeting with your therapist virtually, or you might fill them out physically in the waiting room prior to the session. 

The paperwork is pretty similar to what you are presented with when going to a doctor for the first time (but with a stronger mental health emphasis), and will help your therapist get a sense of your overall situation as you start working together. 

If there are any forms or consents you find confusing or feel uncomfortable completing, don’t hesitate to ask your therapist clarifying questions.  

Learning about confidentiality

An important aspect your therapist will bring to your attention, either written in the paperwork or verbally at the beginning of the first session, is the limits of client/therapist confidentiality. 

Like any other health professional, your therapist is obligated to keep information about what you disclose in sessions private, except for in limited specific situations. These include if your therapist has credible reason to believe the following:

  • You are in imminent danger of harming yourself
  • You plan to imminently harm a specific person
  • There is a possibility that a child, elderly person, or other vulnerable person is being abused

It’s a good idea to ask your therapist anything about confidentiality rules that you don’t understand – this will help you feel comfortable sharing what’s on your mind moving forward without inaccurately believing your therapist may disclose it.

Going over your history and what brings you to therapy

To begin your session in earnest, your therapist will typically ask you if there is a specific problem or concern bringing you to therapy, and explore things like:

  • How long this has been bothering you
  • Impact on your day-to-day life
  • Ways you have tried to cope with it so far
  • How you envision this matter being resolved 

A significant portion of the first session will also be dedicated to your general life history, including topics like:

  • Details about your childhood and family
  • Your relationship history
  • Your career and interests
  • Any especially difficult life events you have gone through

Although this is part of your therapist getting to know you, going over your whole life story in under an hour can feel overwhelming. If the pace feels like too much or there are specific questions you don’t yet feel comfortable answering, it’s OK to tell your therapist that you’re not ready.

A check in at the end of your session

At the end of the session, your therapist will check in with you about how you’re feeling. 

You might feel exhilarated and excited to start connecting, drained and overwhelmed by reflecting on what you’re facing, a combination, or anything in between. 

If you felt like your therapist did more talking and inquiring than you expected, don’t worry. As your work progresses your therapist’s role will be more guiding and prompting your exploration, and your voice will be predominantly what’s heard in the session.

Whether this is your first time in therapy or you’re returning after a break, I can help guide you through the process of getting started. When you’re ready, click the button below to book a free phone consultation, and we can go over the next steps.


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