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What To Expect During Your First Therapy Session


You've made the difficult decision to start going to therapy. Kudos to you! In my many years of therapy, I have heard over and over again that the most challenging aspect of therapy is the vision or anticipation of what the first appointment will be like. Many of my first sessions end with clients saying some version of that wasn’t so bad, that went way better than I imagined, I should have done this sooner or that wasn’t so scary once I started.


These common responses remind me that the anxiety around a first therapy session is normal. Truth be told, when we really think about it, the idea of going to therapy and exposing thoughts, feelings and emotions we’ve never explored before is a tall order. When we couple that with the fact that we are hearing the innermost part of ourselves with a virtual stranger, that undoubtedly adds to the anxiety. We are socialized to reserve intimate details for people who know us well. However, the concept of therapy violates this social norm. Hence the fear and anxiety. Additionally, you might have never processed or articulated many of these feelings. The idea of coming up with words to describe such complex, nuanced emotions that you feel can be daunting and terrifying. Suffice it to say, it can be challenging to get started.


Although the fear and anxiety are natural and expected emotions, there are a few things that can be done to ease the tension and make your first therapy session a more comfortable and productive experience.


Tips for Your First Therapy Session

  1. Therapists are Experienced Professional


This might go without saying but certainly worth mentioning. The therapeutic relationship is not like speaking with a friend, spouse or family member. Psychotherapists are competent, trained, experienced professionals that work collaboratively with you to positive change (thoughts, feelinging, emotions, behaviors) in your day-to-day life. Additionally, we are bound by established professional standards and ethics. You can take comfort in knowing that unlike a conversation with a friend or family member, we are mandated to practice in an ethical, competent manner that protects you and your confidentiality.


However, in addition to our ethical obligations, most psychotherapists are guided by an internal sense of passion, empathy and a deep desire to support clients’ overall well-being.

Resort assured, your’re in good hands.


  1. Do what makes your feel prepared


Some clients find it helpful to make a list of topics you’d life to discuss.

One of the first questions you might hear from a therapist during a first appointment is some variation of what brings you in today”. I usually ask something like, “when you made the decision to start or resume therapy, did you a specific issue on your mind?” Your therapist is skilled at asking questions and reflecting responses that will help you articulate what brought you in. Despite this, some clients find that feeling prepared and knowing what they want to talk about can reduce their anxiety and make the prospect of attending therapy much greater.


Writing a list of issues you’d like to discussed prior to your first appointment can help you to you to feel more grounded, in control and focused.


Here a few topics to consider as you begin exploring what to cover:

  1. Current life challenges and changes (e.g. interpersonal challenges, family problems, career transitions, health concerns, change in family configuration, patterns of behavior etc.)

  2. Previous experience with therapy

  3. Concerns expressed by family, partner or friends including: habits, moods or behaviors

  4. Past or present life events, traumas or losses

  5. Difficult emotions have been hard to cope with (e.g., anxiety, depression, difficulty regulating emotions etc.)

  6. Are your concerns new or have their been with you for sometime?

Although, you might not reference the list during the appointment, any activity that you can do to increase your sense of agency/control, might help you to reduce your anxiety. If the options are to go to therapy with a list or not go to therapy; I say, go to therapy with a list.


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