Four Things to Expect In Your First Therapy Appointment

To begin, I want to say that whether you already have an appointment scheduled with a therapist, or you are just beginning to research the process of starting therapy – Congratulations! You are taking an important step in attending to your mental and emotional healthcare, which isn’t always easy. Deciding to take action in seeking to heal and be supported in your life and relationships is an important investment in your short and long-term wellness.

Seeing a therapist for the first time, or meeting a new therapist if you have been to therapy or counseling before and are returning, can be a daunting and even anxiety-provoking task. Many new clients are turning over big questions in their minds, such as:

Is therapy going to work?

Can I trust this therapist?

Will this therapist truly understand me?

Can this therapist help me?

And so I decided to sit down and write about typical first therapy appointments, to help potential clients get a sense of what the process often looks like before walking into an unfamiliar situation. Keep in mind that every therapist has their own unique style, and I am writing based on my experience with folks who have been trained in marriage and family therapy.

1) Paperwork

First thing’s first, you will be handed a clipboard with a small stack of papers to fill out, much like you would at any doctor’s office. These documents will contain information about client-therapist confidentiality, the risks and potential benefits of therapy, cancellation policies, etc. You will also fill out a basic demographic form, and potentially a short assessment questionnaire to get an introductory sense of what you are hoping to work on in therapy. Don’t worry, there will be plenty of time in session to discuss the items on a questionnaire like this, and you are of course free to fill out this form only within your comfort level.

2) Sharing What Brought You In

Your therapist might begin a first session by making space for you to share about how you are feeling right now, in this moment, as you enter the therapy space for the first time. Usually this leads to a discussion of how come you decided it was time to begin or restart therapy. Sometimes, something specific has happened in someone’s life that puts them “over the edge,” and this is where the therapist would start exploring what that has been like. Or, sometimes folks have more general goals that they hope to work on, or even need some help figuring out where they would like to go in therapy. No matter how you step into the room, your therapist will be there to meet you exactly where you are.

3) Telling Your Story

Do you enjoy sharing about your life story? Your family, your past relationships, your high school or college years, your jobs? If you do, you might enjoy this part of the session when your therapist wants to simply learn all about you and where you come from. If you don’t enjoy this as much, don’t worry – your therapist will take the lead and ask some gentle questions to start to paint a fuller picture of who you are. Also, it is 100% normal and expected that it will take time to build trust in the therapeutic relationship, and that you might be keeping some things close to your chest (or not yet realize that they are important to share). Getting to know “Your Story” is an ongoing process, and most often it takes time for folks to feel safe sharing some of their deeper hurts that they may not want to or be ready to share with us.

4) Something to Take With You

Hopefully by the end of the first session, you and your therapist will have identified some clear, primary goals for your work together. Your therapist will most likely explore with you some ideas for what you can be doing before your second session to either a) reflect on an important topic, such as through journal writing or simply introspection or b) address a behavioral or self-care goal, such as increasing time spent with friends or practicing an anxiety management skill. This will largely depend on the therapist’s style and the feedback you give them about what you are hoping for in a therapeutic relationship. Some folks love therapy homework, others are more keen to delve into existential questions each week without any pen and paper prompts (or some prefer a blend of both styles). After every session, you should have something to take with you: a question to reflect on, a worksheet to fill out, or even a recommendation for a song or movie to watch if that’s what you and your therapist decide might be helpful.

Your therapist is here to create a safe space to explore what’s hurting in your life and to help you create an action plan for reaching your goals. Don’t be afraid to ask for exactly what you are looking for out of your own therapy, and together you and your therapist will co-create an environment that works for you and best supports your healing and growth. The important thing to remember is: this is your hour.

~ Nicole Brown,

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