What to Expect in Your First Therapy Session

I remember when I went to my first therapy session. This was before I became a therapist. I had no idea what to expect. TV and Movies make therapists look like some weirdos that make you lay on a couch.

While the therapist sits in a chair with a pen and paper in hand taking notes on everything you say and making very few comments. TV and Movies also make it seem like you have to be losing your mind to go to therapy. I can personally attest to the fact that all of the examples that TV and Movies give are wrong.

So let me help you better understand what a first therapy appointment can look like. One thing you will want to be aware of is that each therapist will approach the first session a little different depending on their style and where they work.

For example, when I am working with clients, I am looking at the therapy relationship from the perspective that my client and I are on the same level. I see myself this way because, while I come with the education, we are discussing my client’s life experiences.

In my opinion there is no way I could be the expert in the room because they aren’t my life experiences. In saying that, there are other clinicians that take a more clinical approach to how they do therapy.

They do create a hierarchy between themselves and the client. When I say hierarchy, I do not mean that the therapist is looking down on the client.

I simply mean that the therapist has the mindset that because of their education and training, they are the expert in the room. This is just one example of the nuances that can occur in the first session.

In saying all of this, there are three items that are consistent in every therapy session. These items include the collection of intake paperwork, the clinician getting to know you, and goal setting.  

1.      Intake Paperwork

Before coming to your first session your therapist will send you their intake paperwork. Depending on where your therapist works depends on how many documents you will need to complete, if they are offered to be returned electronically, and the length of all of the documents.

For example, my best friend used to work for an eating disorder clinic where their paperwork was much more extensive due to taking insurance and getting government funding.

Some of the documents found in any therapy office, no matter where you go, include: consent to be seen, demographic/background information, legal/ethical requirements of the therapist, and office policies.

One thing to be aware of is that some clinicians will put a completion date on returning the documents. In my practice, I require clients to return their documents to me 12 hours before their first session. No matter where you go to be seen know that these documents aren’t difficult to fill out but can be time consuming.

2.      Getting to Know the Client

One of the biggest purposes of the first therapy session is getting to know you. Along with, building comfortability and report with your therapist. With this intent in mind it means that there are going to be a lot of questions asked in the first few sessions.

There are two important components of the first session I want you to understand. First, you are ALWAYS allowed to tell the clinician you aren’t ready to answer a question or go into great detail. Second, it is common that the session might end up going deeper than you thought or you end up having more emotionality than you intended.

I cannot tell you how many times I get a new client, we have our intake session, and they end up getting very emotional. It also never fails that the client will start apologizing for getting that emotional. You do not have to feel uncomfortable or apologize for getting emotional.

That is the entire point of therapy. We want our clients to process their emotions. If you don’t then it is really hard for healing and change to happen. Think of therapy as your 50-60 minute time period to talk about whatever you want and experience all the emotions you want.

In saying this, it is not lost on any therapist that what we do is weird. My best friend who is also a clinician, and I always laugh about how weird of a profession we are in.

We always talk about if we went back in time to the days of the pioneers and we explained what we did they would be looking at us like we are crazy. My job is asking complete strangers to trust me with their trauma and by the way, you don’t get to know much about me.

I tell you this because you are allowed to take as much time as you need to build trust with your clinician. Remember this is your therapy not ours and you get to dictate the pace to which we move.

3.      Setting Goals

In the midst of the varying different questions your new clinician will ask you, one of the questions will be about setting goals. The purpose of setting goals for therapy is so you and the therapist have an understanding of what you want to focus on.

This does not mean that you can’t change your goals. I tell all of my clients that they can set as many goals as they want, at any time they can change their goals, and they tell me when they feel their goals are completed. Setting goals for therapy is important for a few reasons.

First, goals help the clinician gain a trajectory for the client’s therapy. Second, it helps the client identify the places or situations that are most pressing to focus on.

Third, the goals help to ensure that each session has purpose. It is ok if you come to your first session and only give one goal, to then come in the next week and add five more. Again, this is your therapy and the therapist is there to help you with as much or as little as you want.

I hope this takes some of the anxiety or fear out of having your first session! Like I mentioned above, clinicians understand how weird and uncomfortable the first session can be. So don’t feel like you have to come a specific way. The sessions our yours and the intent for all of us therapists is to help our clients heal.

I would love to help you on your road to healing. Please take a look at my about me page if you are interested in getting to know me better.

If you are in need of more information about the services I offer please click one of these links to learn more: couples counseling, family counseling, premarital counseling, and women’s counseling.

Otherwise, if you are ready to take the leap in starting therapy and would like to work with me, feel free to call me at (702) 356-6631 or email me at amanda@setapartcounseling.net.