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What to expect from your first therapy session

Written by Sarah Norman

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    Oct 21, 2021, 5 min read

    If you’ve decided to start therapy, congratulations on making such a fantastic first step! If you’re still thinking about it, that’s good too. Starting therapy for the first time can be pretty nerve-wracking, especially as you might have no idea what to expect.

    What to expect from your first therapy session

    Attending your first therapy appointment can be a significant step towards better mental health, and knowing what to expect can help alleviate some of the anxiety surrounding it. Initially, your therapist will likely focus on building rapport, creating a safe and welcoming environment where you feel comfortable discussing your feelings and experiences. The objective is to establish trust, as this foundational relationship is crucial for effective therapy.

    During an initial session, often referred to as an assessment, the therapist will ask questions about your life, emotions, relationships, and the issues that brought you to therapy. This is not only to gain insight into your situation but also to formulate a treatment plan tailored to your needs. It's important to be as open and honest as possible to make sure you get all the the benefits therapy can offer.

    Remember that confidentiality is a key aspect of any kind of mental health support, meaning that what you discuss remains private (although there are a few legal exceptions, which you should ask about if you're concerned). Understanding the boundaries of this confidentiality can provide reassurance and help you to be more open. Therapists might also explain their approach and what you can expect from the sessions moving forward. Feel free to ask questions at any point - you might want to know more about how often you'll have sessions, what kind of treatment the therapist uses, or how your progress will be measured.

    For more detailed insights, resources like the NHS guide to psychological therapies and Mind's tips for your first appointment offer valuable information on navigating therapy effectively. Here's exactly what to expect from your first therapy session in detail, so you can be more confident in what sort of conversations will happen and what you'll be asked:

    Your therapist will start with some admin

    Therapists might send you their paperwork to fill out in advance, but some will ask you to complete it during the session.

    Personal details

    Your therapist needs to know information such as your address, your GP, and your next of kin. This information is kept strictly private, and is covered under all relevant data protection laws.


    Many therapists use questionnaires to try to understand your current mental state. Some will ask you to complete these in advance, while others prefer to talk them through with you. These are standardised questionnaires, so some questions might not apply to you.

    Plus, questionnaires can be useful for you to see how your feelings have changed following therapy too.


    Some therapists call this their ‘contract’. Your therapist will talk you through the agreement you make to each other about your sessions, for example how long the sessions are, how often you will meet and their cancellation policies.

    They will also explain that your sessions are fully confidential, but that they might have to break that confidentiality if you report a serious risk of harm to yourself or others. It’s important that you understand the limits of confidentiality, but try not to dwell on it too much. It’s extremely rare for most therapists to need to break confidentiality, and they’ll usually try to speak to you beforehand if it does become necessary.

    Getting to know each other

    Once you’ve sorted any outstanding admin, your therapist will typically want to talk about what you want to achieve from therapy. They may explain that therapy is an ongoing process and that you might feel worse for a while before things start to get better.

    If you’re not really sure what you want from therapy, or even what is possible, be honest about that.

    Questions you may be asked

    The exact questions your therapist asks will depend on lots of factors, like your current circumstances or why you reached out in the first place. Here are some common questions that you might be asked:

    • Have you had therapy before?
    • How did it work for you?
    • What is your home life like?
    • Who is your support network?
    • How do you look after yourself (self-care)?
    • Do you have a history of self-harm?
    • Have you ever thought about taking your own life?

    The more open you are with your therapist, the more they’ll be able to help you.

    Remember that you can ask questions too

    Therapy isn’t like going to a doctor, where you’re given a specific treatment. Therapy is about building a trusting relationship between you and your therapist that teaches you to help yourself. Your questions are just as important as your therapists’.

    Your therapist will usually ask whether you have any questions, but you should feel free to ask them at any point. Questions you might like to ask include:

    • How long have you been working as a therapist?
    • Do you have much experience with this kind of problem?
    • How will I know that I’ve had “enough” therapy?
    • Will you expect me to do anything specific between sessions?
    • What would mean that you had to break confidentiality?

    You might feel nervous about asking questions, but your therapist wants you to feel comfortable. They’ll happily answer any questions you have, no matter how silly you might feel asking.

    You might get emotional (and that’s perfectly normal)

    Therapy is a really unusual experience. It might be the first time you’ve been able to talk about certain things that have been bothering you. Even if you don’t get to the root of your problem (and you probably won’t during your first session), you can find that having someone listen to you for that long can feel quite emotional.

    Your therapist is there to help you deal with those feelings.

    There might be silences

    People who are new to therapy often find silence difficult. It’s normal for there to be silences during a therapy session where your therapist is giving you space to understand and explore your feelings.

    You’ll talk about how to move forward

    Towards the end of the session, your therapist will talk about the next steps. No one is expecting you to trust your therapist implicitly from the very start, but being able to learn to trust your therapist is the most important factor in how successful therapy is for you.

    If you think they’re a bad fit, it’s ok to say that. Many therapists will be able to suggest someone else who might suit you better. It's all a very personal and gut feeling type of thing, so a good therapist will never be offended if you don't think they're the right person for you!

    If you have a question about mental health, like if reflexology for depression really works, we’re here to assist on your journey. Our free 15 minute consultation can guide you to the most relevant specialists to answer your questions and discuss next steps.

    Whether you’re feeling off-kilter or want to shake up your routine, our state-of-the-art mental wellbeing platform gives you quick and seamless access to world-class support on your terms, from private psychiatric assessments to helping you find a therapist near you for support on your journey.

    Not sure where to start?

    We offer a free 15 minute consultation so that we can guide you to the most relevant professionals