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What to Expect in Your First Therapy Session

TherapistScore Team · February 14, 2026

Booking your first therapy session is a brave and important step. But it's completely normal to feel nervous about it. What will the therapist ask? Will you have to talk about everything right away? What if you cry?

Take a deep breath. This guide will walk you through exactly what to expect so you can go in feeling prepared and confident.

Before Your First Session

Paperwork

Most therapists will ask you to fill out intake paperwork before or at the beginning of your first appointment. This typically includes:

  • Personal information (name, contact, emergency contact)
  • Insurance details (if applicable)
  • Medical history and current medications
  • A brief questionnaire about your mental health history
  • Consent forms explaining confidentiality and your rights

If paperwork is sent in advance, fill it out ahead of time so you can use your full session for talking.

What to Bring

  • Your insurance card (if using insurance)
  • A form of payment for your copay or session fee
  • A list of current medications
  • Any specific topics or questions you want to discuss (optional, but helpful)

What Happens During the First Session

Your first therapy session is primarily about getting to know each other. Think of it as a conversation, not an interrogation. Here's the typical flow:

1. Introductions and Rapport Building (5–10 minutes)

Your therapist will greet you, introduce themselves, and try to help you feel comfortable. They might make small talk or explain how the session will work. This is intentional — building rapport is an essential part of therapy.

2. What Brings You Here? (15–20 minutes)

Your therapist will ask an open-ended question like "What brings you to therapy?" or "What's been going on?" You don't need a perfect answer. Just share what's on your mind in your own words.

You don't have to share everything in the first session. Share what feels comfortable, and know that trust builds over time.

3. Background and History (10–15 minutes)

The therapist may ask about:

  • Your family background and relationships
  • Previous therapy experience
  • Significant life events
  • Current stressors, sleep, appetite, and daily functioning
  • Any mental health diagnoses or medications

Again, this is a conversation, not a checklist. A good therapist will pace these questions naturally and follow your lead.

4. Goals and Expectations (5–10 minutes)

Toward the end, your therapist may ask what you hope to get out of therapy. It's okay if you're not sure yet — "I just want to feel better" or "I want to understand why I feel this way" are perfectly valid answers.

5. Wrapping Up and Next Steps (5 minutes)

Your therapist will likely:

  • Summarize what you discussed
  • Share initial thoughts on how they can help
  • Explain their therapeutic approach
  • Schedule your next appointment
  • Answer any questions you have

Common Worries (and Why They're Normal)

"What if I cry?"

Therapists are trained to hold space for tears. Crying in therapy is not just normal — it's healthy. Your therapist won't judge you. There will be tissues available.

"What if I don't know what to say?"

Your therapist will guide the conversation. You don't need to have a script prepared. Even "I'm not sure where to start" is a great place to begin.

"What if I don't like my therapist?"

That happens, and it's okay. Not every therapist is the right fit for every person. Give it 2–3 sessions unless something feels clearly wrong. If it's not working, try someone else. The process of finding the right therapist sometimes takes a few tries.

"Will my therapist share what I say?"

Therapy is confidential. Your therapist is legally and ethically bound to keep what you share private, with very limited exceptions (imminent danger to yourself or others, or mandatory reporting of abuse). They'll explain confidentiality during your first session.

Tips for Getting the Most Out of Your First Session

  • Be honest. The more open you are, the more your therapist can help. But go at your own pace.
  • Ask questions. What's their approach? How long do they typically work with clients? What should you expect?
  • Notice how you feel. Do you feel heard? Comfortable? Safe? The therapeutic relationship matters more than any specific technique.
  • Don't expect instant results. The first session is about laying groundwork. Change takes time.
  • Be kind to yourself. Showing up is the hardest part, and you're already doing it.

After Your First Session

You might feel a range of emotions after your first session — relief, exhaustion, hope, sadness, or a mix of everything. This is all normal. Processing emotions is part of the healing journey.

Give yourself some time afterward. Take a walk, journal, or just rest. And remember: you took an important step.

Ready to Book Your First Session?

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