First Therapy Session Anxiety: A Guide For Starters
Therapy can make a significant difference in many life challenges, including relationship concerns and mental health conditions. However, some people who have never been to therapy might not know what to expect from the therapeutic process. Attending therapy for the first time can make people feel nervous, which is a normal and valid reaction. Below, explore first therapy session anxiety symptoms and what to expect during your first session.
Do I need to prepare before starting therapy?
Typically, clients don’t have to prepare for their first therapy session. If you prefer, you can write down topics you’d like to discuss beforehand. As part of the intake process, you may be asked about any medications you take and the doses. Write down your medical history to have the information ready.
What to expect during your first therapy session
During the first therapy session, therapists typically explain their approach to therapy. They may explain that you are always in control of what you’d like to discuss and that you can pause at any time. The rest of the first session often involves you and the therapist getting to know each other. The therapist may ask about the concerns that brought you to therapy and whether you have any experience with mental health support. This session typically doesn’t involve conversations about deep trauma, but feel free to discuss any concerns and ask questions.
What if I cry during the first session with my therapist?
While each person is unique, the first appointment often doesn’t get into deep traumatic memories. However, if you have an urge to cry, crying is a valid emotional response and has proven beneficial for mental wellness. Therapists are typically used to seeing people cry as they discuss challenging emotions. If you see a therapist in person, they may have tissues nearby, as crying tends to be a natural response during therapy. If you see a therapist online, it’s still okay to cry and express your emotions.
Feel free to ask your mental health professional questions
Although you may be asked several questions during your first session, you can also ask the therapist questions. You might ask about treatment goals, frequency of appointments, and any other topic that comes to mind. If you think you might forget your questions, write them down before your first appointment. You may also try to remind yourself that therapists are typically used to being asked about their credentials and therapy practice, so don’t be afraid to clarify any doubts.
What can you do about first therapy session anxiety?
Many people feel anxious during their first therapy session. They may be afraid that they won’t know what to say or that they will shock their therapist. In these cases, remind yourself that most therapists have seen hundreds of patients with diverse challenges. Although the exact details of the challenges one faces may be unique, the themes may be similar across different people.
To ease any nervousness you experience, you might consider looking up your therapist’s credentials and areas of experience. Some therapists may also publish information about papers they have written or conferences they have attended. This information may help ease your nerves and assure you that you are seeing a qualified, licensed professional. In addition, if you have a friend who has seen a therapist, you might ask them what their first therapy session was like. By learning about their therapy experience, you might feel more comfortable going into your first session.
What to do after the first session and subsequent therapy sessions
After the first session, consider writing down your first impressions. Given that the first session often doesn’t involve lengthy discussions about deep concerns, you might not have much insight or advice to write down. However, you may at least have enough information to decide if you’d like to continue with the therapist. If you don’t want to continue, know that it is totally normal to change therapists. Most therapists are used to having clients who decide to work with another licensed mental health professional.
If you decide to continue with your therapist, taking notes after each session may be helpful. Subsequent sessions may offer more insight into what you’re experiencing. If your therapist offers coping strategies, consider writing these down to reinforce them.
Online therapy for your first session
If you’re nervous about meeting with a therapist in person, you might consider trying your first therapy session online through a platform like BetterHelp. With online therapy, you may feel more at ease, as you can connect with the therapist from home or anywhere you have an internet connection. You can communicate with the therapist via video chat or by phone or live chat if you aren’t uncomfortable with being on camera. In recent years, many researchers have studied online therapy and found it to be effective for several mental health conditions. One systemic review and meta-analysis published in 2020 concluded that online therapy was as effective as in-person therapy for depression symptoms.
Takeaway
Many people experience nervousness before their first therapy session. However, the first session tends to be about you and the therapist getting to know each other. You can feel free to discuss anything you want, with no obligation to reveal any topic you don’t want to discuss. Finally, you might consider online therapy if you aren’t comfortable with an office setting for your first time in therapy. Online therapy allows you to communicate with your therapist from home or anywhere you feel comfortable.
Frequently asked questions
Below are some common questions related to starting therapy.
What will the therapist ask during your first therapy session in person or via online therapy?
During your first therapy session, mental health professionals might ask some basic questions about your life, including your work, your family, and your background. Your therapist might also ask what brought you to therapy. This question serves as an opportunity to openly discuss your concerns in a safe environment.
Is it normal to have first-therapy session anxiety, and how can you reduce it when starting therapy?
Feeling somewhat anxious about starting therapy is expected. Before your first session, it may help to research your therapist and prepare some questions for them. You might also try to remember that many mental health professionals have gone through therapy themselves as part of their training. Many therapists also have a therapist of their own, as they are human, too.
Can a therapist diagnose a mental health disorder during the first session?
The first session typically involves both you and the therapist asking questions and getting to know each other. The therapist may ask about the reason for seeking therapy. Doing so may serve as an opportunity to discuss any emotional challenges or symptoms you’ve been experiencing. Whether a therapist can diagnose a mental illness may depend on how much has been discussed during the session. Mental health professionals typically have to determine if a person’s symptoms meet sufficient criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The first session may not be sufficient to diagnose a disorder.
Is it normal to change therapists?
Many people change therapists if they don’t experience a strong rapport with their therapist. However, sometimes it may take a few sessions to determine if you can develop a therapeutic relationship.
How many therapy sessions are necessary?
The American Psychological Association states, "on average, 15 to 20 sessions are required for 50% of patients to recover as indicated by self-reported symptom measures.” However, this number can vary depending on each person’s needs. Some people may benefit from fewer sessions. Successful therapy may depend on a person being comfortable enough to openly discuss what they’re experiencing.
Why is therapy so hard at first?
Therapy services can bring up negative emotions and topics that one might be first uncomfortable discussing in such a vulnerable way. When clients begin therapy, they might not feel comfortable immediately with a particular therapist or feel apprehensive about the process. Although the first few therapy sessions are usually meant to do the intake process, set realistic expectations, and develop a treatment plan, it can take time to bond with a new therapist enough to talk openly and be comfortable in sessions.
Is it okay to cry in your first therapy session?
Crying during your initial sessions is normal. Difficult emotions can arise during this time, and those not used to talking about these challenges might cry or have other emotional responses, which can be normal. Regardless of your past experience with therapy or vulnerability, crying is not bad, and studies show that openly crying may actually benefit your mental well-being.
How can you make therapy not awkward?
If your first counseling session seems awkward to you, you might be having an emotional response to vulnerability. Talking about emotions, managing anxiety, and exploring your past can be uncomfortable if you’re not accustomed to doing so or if you tend to avoid emotions. The therapy room may be quiet, and talking about these topics can be scary when sitting face-to-face with a stranger. To make future sessions less awkward, talk to your therapist about your hesitation and explore these feelings together. The right therapist can offer helpful tips and insight to guide you through the counseling session and make future sessions more comfortable as you get to know each other.
Why do I feel anxious about therapy?
You might feel some anxiety about therapy if you’re not used to discussing sensitive topics in a quiet environment with someone new. Some people may be uncomfortable with receiving advice or might not believe in the effectiveness of therapy. If you’re receiving inappropriate treatment or don’t connect with your therapist’s counseling style, you may also start to experience anxiety. The relationship between client and therapist can be one of the most important aspects of mental health care, so talk to your therapist about your feelings and thoughts. You can also decide to switch therapists for any reason, regardless of how many sessions you’ve had in the past.
How do you calm your nerves before therapy?
One way to calm your nerves before therapy is to talk to a close family member or friend about how you feel about starting therapy. You can also try a guided meditation or breathing exercise. Let your therapist know if you still feel anxious when you start the session. It’s okay to ask your therapist to lead the session with questions if you’re not sure what to talk about or have social anxiety regarding therapy.
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