A Guide To Your First Therapy Session: What To Expect

Updated January 22nd, 2025 by BetterHelp Editorial Team

A first therapy session can be exciting yet daunting. Clients may be eager to get help from a mental health professional yet not know what to expect from the first session. Some people might not know what to say or how to express what they are experiencing. Below, explore what to expect from your first therapy session, how to prepare for the first session, and strategies to ease anxiety related to starting therapy. 

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Are you nervous about your first therapy session?

What do you talk about in your first session?

Therapists often seek to get to know the client during the first therapy session. They may ask about their background, career, family, and hobbies. As part of the intake process, they may also ask if a person has a family history of mental illness. At some point, the therapist may ask why the person is seeking therapy. Clients can feel free to discuss as much or as little as they want at this time. They can also ask therapists any questions that arise about their practice and the therapeutic process. 

How to prepare for your first therapy session

Therapists often don’t require much preparation by clients prior to the first session. However, given that the first appointment typically involves intake, you might try to prepare to answer questions about personal or family history related to mental health. Also, if you take any medications for mental health conditions or medications that affect mental health, you might write them down or take a picture of them prior to your first appointment. 

Given that the first session also allows you to ask questions of your therapist, you might consider writing down questions you’re curious about. For example, you might ask about your therapist’s credentials, what they studied, how long therapy takes, and how they believe they can help you meet your therapy goals. 

Is it normal to cry during your first therapy session?

Much of the first session tends to involve the intake process. For this reason, there may be less time for extensive discussion of mental health challenges or relationship difficulties. However, if you do cry, know that this response is perfectly normal, and therapists often keep tissues on hand to support their clients. They are often accustomed to observing strong emotional reactions as clients discuss the challenges that brought them to therapy. 

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How to ease anxiety before your first therapy session

If you’re feeling anxious prior to your first session, you might consider a few strategies that may ease your nerves, such as the following: 

  • Write down any questions about therapy and take them to your first appointment.
  • Read success stories about your therapists’ previous clients, if available.
  • If you have a friend who has been to therapy, ask if you can talk to them about the therapeutic process.
  • Remember that therapists typically receive therapy themselves as part of their training during graduate school or to support them in daily life. 

What to do after your first session

After your first session, you may note how you felt during the session. You’re also allowed to take notes during the session, so you might do so if it makes you feel comfortable. Writing may give you something to do with your hands during the session if it would ease your nerves. 

Whether you take notes during or after the session, you might go over them once or twice. If you know that you want to continue with the same therapist, you can write down any further questions you have based on your first session. If you know that you’d like to try another therapist, know that this is perfectly normal. Many people change therapists at some point. You can send your therapist a message via email or any other means of contact they provided. Most therapists are used to having clients switch therapists, as choosing the right therapist is a personal decision. 

How to find a therapist 

You might find a local therapist by using an online directory. Some therapists might offer you a free initial call so that you can ask questions and get to know them. If you can’t find a therapist in your community, you might consider online therapy. 

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Are you nervous about your first therapy session?

Online mental health care

Online therapy platforms typically have a large network of therapists. For example, platforms like BetterHelp offer a network of more than 30,000 licensed mental health professionals. Because of the options, finding a therapist you’re comfortable with may be easier, as you can be matched with a therapist with experience in your specific areas of concern. You can also decide whether to attend therapy by audio, videoconferencing, or live chat, and the online method may be more affordable. 

Online talk therapy has also been shown to be effective for several mental health conditions. One systemic review and meta-analysis from 2017 examined the effectiveness of internet-based cognitive-behavioral therapy (CBT), an evidence-based practice. They found that it was effective for generalized anxiety disorder, social anxiety, depression, phobias, and obsessive-compulsive disorder (OCD). 

Takeaway

Experiencing nervousness before beginning therapy for the first time can be a normal reaction to opening up to someone about personal challenges. You may prepare for the first session by writing down any questions you have for the therapist. Doing so may help you feel less nervous as you ease into the therapy process. If you haven’t found a therapist yet, you might consider online therapy. 

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