What to Expect During Your First Appointment With a Therapist

Starting therapy for the first time can feel a bit uncertain or uneasy, but knowing what usually happens can make it a lot easier. The first appointment is mostly about getting to know you and setting the foundation.

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1. Introductions
Your therapist will usually start with introducing themselves, explain their approach, and go over confidentiality (what stays private and the few exceptions). You’ll typically start talking about some basic things about yourself like your background, medical and mental history, and what brought you in. 

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2. Talking about why you’re there
When discussing what brought you to therapy, you don’t need to have everything figured out or explain it perfectly. Just sharing what you can is enough and your therapist will guide you through the rest. Common topics that a new patient may discuss include stress, anxiety, relationships, or major life changes.

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3. Questions about your life
Expect some broader questions from your therapist to help them understand you as a whole person, such as:

• Family relationships and friendships

• Work or school

• Mental and physical health history

• Sleep hygiene 

• Substance use 

• Coping habits

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You’re always allowed to say “I’m not ready to talk about that yet.”

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4. Setting goals (loosely)
If time allows, you might discuss what you hope to get out of therapy. For example, you might say you want to work on feeling less anxious, improving relationships, understanding yourself better, etc. These goals can evolve over time. A therapist may also provide feedback about what they may see as contributing factors to those symptoms or concerns. 

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5. Explaining the process
Your therapist may explain:

• How often you’ll meet

• What types of therapy they use

• What sessions might look like going forward

• Logistics: scheduling, payment, insurance claims/forms 

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6. A chance for you to ask questions
Take the time to ask questions so that you can determine if this therapist is a good fit for your needs. You can ask things like:

• “What’s your experience with issues like mine?”

• “What does progress usually look like?”

• “What should I do between sessions?”

Some people feel relieved after the first session; others feel awkward or emotional. Those responses are all completely normal. It’s also okay if you’re not sure yet whether the therapist is the right fit or not after the first session. That may take a few sessions to figure out.