What to Expect in Your First Therapy Session (And Other FAQs)

Many people contemplate starting therapy but often hesitate several times before making the decision. Several clients have asked me about what to expect from therapy and whether there's anything they should do or bring to their session.

For many people, therapy is very abstract, and it's often a bit daunting treading towards an unknown. There is sometimes the fear of being judged, not knowing where to begin, wondering whether your problems are “serious enough,” and whether therapy can do anything for them at all.

That's why I have decided to share a few helpful information to ease you a bit, especially because the first session is actually very different from other therapy sessions moving forward.

Click here for a bulleted summary of the whole thing.

1. Is there anything I need to do or bring to my first therapy session?

There can be a strange pressure to arrive at therapy already knowing how to explain yourself. You may feel like you need to organize years of experiences into one clear story, identify exactly what is wrong, and know what you want to change. Most people cannot do that. And you are not expected to.

You may walk in knowing only that something feels heavy, that a pattern keeps repeating, or that you no longer want to manage everything alone. That is enough for you to start this journey.

But if you're one of those people who feels overwhelmed by your thoughts and are looking for something to ground you a bit, you can think briefly about what made you book the appointment now. Things may have been bothering you for months or years, but something usually brings a person to the point of finally reaching out. Even if you cannot fully explain it, that can be a helpful place to begin.

P.S: You'd be surprised how helpful it is to put it in writing somewhere, even if in just one bullet point. It's not as easy to remember as you think!

2. What will we talk about?

The first session is called the "intake." You're expected to share an overarching summary or story of what brought you to therapy, and a short assessment of how you're doing in terms of mood, sleep, and other aspects of wellbeing. But that's not the time when we dig deep into what's going on.

It really is about your therapist "taking in" as much information about your background and where you come from as a person. For example, you can expect questions about your educational and professional background; the structure of your family now and growing up; the kind of social support you have; and a general overview of your lifestyle. You can also expect questions about your medical or psychiatric history (like previous experiences with therapy) if there is any.

While this may not be the core of your present concerns and may initially feel unrelated to what's bringing you to therapy, it is still crucial information for your therapist. The reason is that difficulties rarely exist in isolation. Anxiety can be affected by exhaustion. Relationship conflict can be connected to family history, cultural expectations, stress, or previous experiences of emotional safety. The intake helps us get a "snippet" of what's been going on in your life and how it looks like and helps me, or your therapist, understand the larger context rather than reducing you to one symptom or one difficult moment.

3. I don't open up easily. I don't know what to talk about.

These are probably the most common things I hear as a therapist. The good news is that it's not your responsibility to make yourself talk. That's not on you. As your therapist, it is my job to ask you the right questions, and most importantly, it is my responsibility to help you feel safe and comfortable enough to share. And you don't have to share everything from the get-go. We can take our time for you to build enough trust or until you're ready to share those challenging pieces of your story.

4. What if I don't feel comfortable with my therapist?

Let's take a tiny step backwards on picking the right counsellor. You obviously want to start with finding a counsellor who specializes in the area you need help with, but it can be helpful to look at their website and/or their social media profiles (if they have one) to see if you can sense some comfort from reading or knowing about them, or from what they're telling you through their page.

Your relationship with your counselor is the most important thing about therapy. You do need to feel good chemistry between the two of you. Sometimes you "click" from the first meeting, and sometimes it takes a couple more sessions to start feeling a positive connection between the two of you.

But here's something to keep in mind:

Feeling comfortable does not necessarily mean the therapist agrees with everything you say or that every session feels easy. A good therapeutic relationship can include challenge, discomfort, and conversations you would rather avoid. The difference is that you should still feel respected, emotionally safe, and able to ask questions or disagree. You should not feel shamed, pressured, dismissed, or as though you need to perform a version of yourself that your therapist will approve of.

One really important thing to remember: If you still don't feel comfortable with your therapist, don't give up on therapy! You will find your match, but only if you keep looking.

5. How do I tell my therapist that I don't wish to continue?

Therapists know that they can't expect to be everyone's match - or at least, they should. A good therapist will want what's best for you, and being comfortable with your therapist is on top of the list! You can simply tell them, "I don't feel this is the best fit for me." This should be enough to kindly communicate that you'd rather continue with someone else. They may even offer you a few suggestions of other counsellors you can work with, so it's worth letting them know what you're looking for.

Conclusion

Starting therapy often feels like the hardest step. Ironically, it's also the step that many people later wish they had taken sooner. You don't need to feel "ready." You only need to be willing to begin.

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In a nutshell, what should I expect from my first therapy session?

1. You're expected to share only a brief summary of what's going on.

2. You will give a historical summary of who you are and your lived experience so far.

3. You don't need to worry about forcing yourself to open up. It's your therapist's responsibility to make you feel safe and comfortable enough to share.

4. You don't have to share EVERYTHING from day 1. You can take your time.

5. It's important to feel good chemistry and a sense of comfort with your therapist. If you don't after 2 or 3 sessions, don't give up on therapy. Find another therapist.

6. If you wish to discontinue, you can simply say, "I don't feel this is the best fit for me."

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Let me know what other questions you have about starting therapy. Share your thoughts in the comments and what topics you'd like addressed!

And as always, if you need someone to talk to, you can always reach out to info@tomoumcounselling.com, call/text 604-800-5154, or book a free consultation.