What to Expect From Your First Therapy Session: A Guide to Help You Feel Prepared
It’s completely normal to feel nervous before your first therapy session—whether it’s your very first time in therapy or your first appointment with a new therapist. Taking that first step is a sign of strength. Here’s what you can expect from your initial session and how to feel more confident walking through the door (or logging in online!).
Paperwork
Before your first therapy session, you’ll be asked to complete intake paperwork—similar to what you’d fill out at a medical provider’s office. This will typically include:
Personal and medical history
Work and school background
Significant relationships
Current symptoms or challenges
Insurance and payment information (if applicable)
You’ll also be asked to review and sign informed consent documents, which outline your rights as a client, your therapist’s responsibilities, and important office policies like cancellation fees and confidentiality. This document may be several pages long, but it’s important to read it thoroughly before your session begins.
Some therapists offer paperwork in person, while others (like me) provide secure online forms to be completed within 48 hours of scheduling your first appointment. If you’re asked to arrive early to complete paperwork, it’s highly recommended—otherwise, your session time may be reduced.
Getting to Know You: The Initial Assessment
Your first therapy session is focused on building rapport and understanding your background. Your therapist may ask questions about:
Family and relationship history
Career and education
Alcohol or substance use
Gender identity, sexual orientation, and cultural background
Spiritual or religious beliefs
Medical or mental health diagnoses
Any past trauma or major life stressors
This is often called a clinical intake or assessment, and it helps your therapist get a holistic view of who you are and what you’ve been through.
Current Concerns
Expect to talk about what brought you to therapy. You may be asked questions such as:
“What are you currently struggling with?”
“How are these issues impacting your daily life?”
“Are you experiencing symptoms like anxiety, depression, or difficulty sleeping?”
Sometimes therapists use standardized assessments or questionnaires during the intake process to gather additional insight.
Setting Therapy Goals
One of the most important parts of your first therapy session is discussing what you want to get out of the process. Your therapist may ask:
“What are your goals for therapy?”
“What would a successful outcome look like for you?”
“What changes would help improve your quality of life?”
Coming in with a general idea of your goals can help you get more out of your first session and start therapy with intention and clarity.
Other Tips for Your First Counseling Session
Therapy is a process – You probably won’t walk away with all the answers after one session, and that’s okay! Effective therapy takes time, consistency, and collaboration.
Finding the right therapist may take time – It’s okay if your first therapist isn’t the perfect fit. Building a strong therapeutic relationship is essential for your progress, and it’s worth the effort to find someone you connect with.
Check your insurance coverage – Even if your therapist offers to verify your benefits, it’s important to personally confirm your mental health coverage. Check for copays, deductibles, prior authorizations, and whether a referral is needed.
Ask questions – Don’t be afraid to ask your therapist about the therapy process, what to expect in future sessions, or how progress is typically tracked. Your therapist is there to support and guide you.
Final Thoughts
Starting therapy is a brave and empowering decision. Knowing what to expect from your first session can ease some of the uncertainty and help you feel more in control. Remember—this is a step toward greater self-awareness, healing, and personal growth. You've got this! If you’re interested in starting therapy, feel free to reach out today.
Related Article: 7 Ways to Know If Your Therapist Is A Good Fit
