What to Expect During Your First Therapy Session

Knowing what to expect during your first therapy appointment can help you show up to your session feeling confident and ready to heal. If you’re going to therapy (or teletherapy) for the first time, here’s what it will probably look like.

Main Topics You’ll Likely Cover 

Some therapists have a structured intake process that involves filling out forms and paperwork in-session. Others may take a more free-form approach to gathering the same information. Here’s what you’ll go over if you haven’t already:

• Confirming any information you provided when you scheduled your appointment
• Billing and payment information
• Insurance information (if applicable)
• How to handle scheduling – do you contact the therapist directly, schedule online, or go through a receptionist?
• Cancellation policy
• Emergency contact policy – if you have a mental health emergency outside of a therapy session that requires immediate attention, the therapist might tell you to call 911 or to go to the nearest emergency room. Some therapists have on-call hours, so they might tell you to contact them directly.
• The therapist’s legal and ethical obligations to you – therapists working with minors or families will explain what information can be kept confidential between the client and the therapist, vs. what the therapist is obligated to disclose to family members or authorities (such as if the client is threatening to harm themselves or someone else).

Questions They’re Likely to Ask You

Your Background

This can include your job, living situation, main relationships and support system, relationships with your family, and your current lifestyle.

Your Mental Health, Past and Present

They’re especially likely to ask about any main coping mechanisms you’re relying on and how well they’re working.

Any Traumatic or Formative Experiences 

You may not feel ready to fully open up about difficult experiences you’ve had. You should feel empowered to set the pace of disclosing these kinds of hard topics. If they ask you anything you don’t feel ready to talk about, it’s okay to tell them that. They can often still treat you with an incomplete account of events.

Your Current Medications

This includes over-the-counter drugs and supplements that you take for your physical or mental health. If you’re able to provide the frequency and dosage of each medication, even better. These may be relevant to your mental health.

Questions You Might Want to Ask Them

The therapist will often go over their background, credentials, and therapy style. This will help you know that you’re in good hands and give you a better sense of who the therapist is as a person.

Here are a few questions you might consider asking:

• How much experience do you have with my issue?
• What is your area of expertise?
• How would you describe your therapeutic approach/process?
• How do you normally treat your clients with similar issues to mine?

Keep in mind your therapist will likely not give you a ton of information about their personal life. Some therapists choose not to disclose any personal information, while some have a little more give-and-take. Remember, therapy is about meeting your needs, so don’t be offended or put off by that.

Don’t be surprised or embarrassed if you get emotional during the appointment. It’s totally normal and even common. Sharing your struggles can be emotionally exhausting and vulnerable. Any standard therapist’s office will have a box of tissues; don’t hesitate to use them. 

Don’t expect to have all your questions answered at the end of your first therapy session. Therapy and mental health are complicated, so treatment is complicated, too. The ideal first therapy session will leave you feeling optimistic and ready for the possibilities that treatment offers.