What to Expect at Your First Therapy Session
Starting therapy can feel scary, especially if you have never met with a therapist before. Your first appointment is designed to help you and your clinician begin getting to know one another, understand what brought you to therapy, and start identifying what you would like to work toward together.
What Happens During the First Therapy Session?
Your first appointment is considered an initial diagnostic assessment.
It is typically more structured and interview-style than an ongoing therapy session. Your therapist will ask questions about what has been happening in your life, what prompted you to seek therapy, your current symptoms or concerns, relevant history, relationships, stressors, and other factors that may help provide a fuller picture of what you are experiencing.
The goal of the first session is to begin understanding you as a person, what is bringing you to therapy now, and what kind of support may be most helpful.
What Will My Therapist Ask Me?
Every first session is somewhat different, but your clinician may ask about:
- What brought you to therapy
- Symptoms or concerns you have been experiencing
- How those concerns are affecting your daily life
- Important relationships and family history
- Previous therapy or mental health treatment
- Medical or medication history when relevant
- Current stressors
- Significant past experiences
- Your strengths and support system
- What you hope may be different as a result of therapy
These questions help your therapist understand the context around what you are experiencing rather than focusing only on individual symptoms.
Do I Need to Prepare Anything?
You do not need to prepare a detailed history or know exactly what you want to say. It's okay to show up a little messy!
It can be helpful to think about:
- What made you decide to schedule therapy now
- What has been most difficult lately
- What you would like help understanding or changing
- Any questions you have about therapy
If you are unsure where to begin, your therapist will help guide the conversation.
Do I Have to Talk About Difficult Experiences Right Away?
No.
The first appointment is about beginning to understand your concerns and establishing a working relationship with your therapist.
You may discuss difficult experiences when they are relevant, but you should not feel pressured to describe traumatic events or deeply personal experiences in detail before you feel ready.
Therapy is a process, and you and your clinician can determine an appropriate pace based on your needs, goals, and comfort level.
How Are Treatment Goals Developed?
Your first appointment begins the process of identifying what you would like to work on in therapy.
Treatment goals are developed collaboratively between you and your therapist rather than being decided for you.
Your clinician may help you translate concerns such as:
into specific areas of focus for your work together.
These goals may change over time as you gain insight, circumstances change, or new priorities become more important.
What Happens After the First Appointment?
After the initial assessment, you and your clinician can begin discussing the next steps for therapy.
Ongoing sessions generally become less interview-style and more focused on the concerns, patterns, skills, experiences, and goals that are most relevant to you.
Your therapist may also discuss what treatment approaches could be helpful based on what you identified together during the assessment.
What If I'm Nervous About My First Session?
Lots of people feel nervous about the first session.
You are not expected to know how therapy works or to arrive with an organized explanation of what you are experiencing.
Your clinician's role is to help guide the conversation, ask questions, and create enough structure for the two of you to begin making sense of what has been difficult.
Insurance & Fees
The first appointment is billed as a diagnostic assessment.
Insurance coverage and out-of-pocket costs vary by clinician and insurance plan.
Ready to Get Started?
If you are considering therapy, the first session is simply the beginning of a conversation about what has been happening, what you need, and what you would like to work toward.