What Actually Happens in a First Session? (And Why It’s Not as Scary as You Think)
If you have nerves surrounding coming into therapy for the first time (Or your first time with a new therapist) you’re not alone. I often hear from people that they had a difficult time sleeping the night before or felt a rush of anxiety before logging on to their video link or walking in my office.
It makes sense! In what other scenario in your life would you be alone with a stranger and start talking about things that feel really vulnerable - all before being completely sure if you trust the person sitting across from you?
If you’ve been wondering what actually happens in a first therapy session, let’s take a minute to de-mystify the process.
The First Few Minutes: Settling In, Not Diving Deep
Once, I was a client in my first session with a new therapist. I’ll never forget how she started it. “Hi, thanks for filling out all the paperwork. You mentioned a traumatic experience with so and so in your forms. Tell me about that.”
I froze. I felt caught off guard—and honestly, a little annoyed. These were literally her first words to me.
What I needed (and what I suspect a lot of people need) are a couple minutes to settle in, feel safe, and talk about things that feel nonthreatening and low-stakes. That’s why I start every first session with casual conversation to help my client feel a bit more at ease before we go anywhere vulnerable.
Housekeeping: Boundaries, Consent, and What to Expect
Before my client starts to share anything, I go over their Informed Consent. This includes:
What’s confidential (and what’s not)
My attendance and cancellation policy
Session length and structure
My therapeutic approach
An intro to Brainspotting, if they’re interested
Even though all of this is shared in writing beforehand, I’ve found that taking a few minutes to go over it verbally helps clients feel informed, respected, and empowered—no surprises.
The Heart of the Session: Your Story, at Your Pace
The bulk of the session focuses on two big things:
Why you came to therapy and what you’re hoping to get out of it
Your story—the life events (past and present) that are shaping how you show up today
I always give clients a choice: start with the present, or with their history—whatever feels safer. Everyone is different. Some people are ready to dive into childhood; others want to stay in the here-and-now. There’s no wrong place to begin.
While the client shares what they want to work on and some of their major life events, I am actively involved in the process by asking questions, providing empathy and attentive listening, and helping the client to already draw connections from their past to their present if that feels helpful.
By the end of our first session, we’ll start identifying what success in therapy looks like for you, so we can create a roadmap with specific and meaningful goals.
Wrapping Up: Scheduling and Feedback
At the end of the session, we discuss how often it’s helpful and feasible to meet, and I typically check in and ask what the session was like for them. It’s important that clients are able to share with their therapist their real time emotions of what they experienced in therapy, and I’m always open for feedback.
Ready to Get Started?
Hopefully after reading this you have a little more clarity and feel a little more courage to fill out that contact button on my website.
I’d love to hear from you and start your healing journey together!
