What to expect on your first therapy session

What to expect in your first therapy session

by Maggie Jordan

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Seeing a therapist for the first time may be daunting if you don't know what to expect. While every therapist operates differently, hopefully this general outline will give you an idea of what you may experience the first time you walk into a therapist’s office and help calm some of the first-session jitters.

Walking in

Your first therapy session is typically not that different from what you might experience at an initial PCP visit. If you’re seeing a therapist within a group practice, there will likely be an administrative assistant to greet you and give you some basic paperwork to fill out. These will include questions to gather demographic and insurance information, questions about your medical and psychiatric history, and often a depression screening. You’ll also have to sign papers regarding patient privacy and confidentiality limitations. If you’re seeing a solo practitioner, you’ll typically be given the same paperwork at the beginning of the session, or perhaps the therapist will send it to you via email to complete before your first session.
 
Either way, arrive 10min before your scheduled appointment time and you’ll likely have a short wait in the waiting room. Your therapist will come get you when they’re ready and lead you to their office. Wondering what that staticky noise is? Many therapists use white noise machines so you can’t hear anything that’s said in the office from the outside in order to protect patient privacy. If you’re in a building with a lot of therapists, it can sound like the ocean waves as you walk down the hallway. 
 

Introductions

Your therapist will tell you where to sit, typically on a couch or comfy chair across from them. Then they may walk you through the paperwork you already filled out and ask follow up questions about anything that needs to be clarified. 
 
Many therapists also use the first session to ask history-gathering questions that will help them understand your past and what’s bringing you in. These might include questions about past events, your relationship with family members, and what your daily life is like. If you’re uncomfortable answering any of the questions up front, that is completely ok. Just let your therapist know you’d rather move on and revisit the topic later-- they won’t pressure you to share more than you’re comfortable with.
 

Assessing fit

Your therapist will likely ask if you’ve been in therapy before, what the experience was like, if there are any approaches or techniques that worked particularly well or didn’t work at all, and what you’d like to get out of your work in therapy. They will also probably tell you more about themselves and the approaches they use, as well as covering logistical details such as their cancellation policy. 
 
You’ll have the chance to ask them questions too-- don’t be afraid to say what you’re thinking! You might want to ask about how long clients typically see them for, what challenges they often help clients work through, and if they have experience working with clients from different backgrounds or identities and if not, if they’d be willing to learn.
 

Wrapping up

Therapists value the client-therapist fit, and ultimately they’re looking out for your best interests. If after the first session you don’t think they’re the one for you, you can tell them that. While “breaking up with a therapist” might seem awkward, they’ve been through it many times before and won’t take it personally. If you’re not comfortable or don’t know how you feel right away, when they ask if you’d like to schedule another appointment, you can just say you’ll call them after you’ve had time to think about it. But you should call and leave a voicemail, even if the answer is no.
 
Sessions typically last 45-50 minutes, although intakes can sometimes take longer; that’s a good question to establish before you come in. At the end, if you’re using insurance, you’ll be responsible for your copay; if you’re not using insurance or are using out-of-network benefits, you’ll be responsible for the full fee. Pay by card, cash, or check. Then take a deep breath. You’re on your way!


Maggie Jordan is Zencare's Therapist Success Manager. She is deeply committed to increasing access to care by streamlining the therapist search process, and particularly enjoys connecting LGBTQ+ folks with culturally competent therapists. She is a graduate of Brown University where she competed as a varsity swimmer.