What to Expect from Your First Therapy Session

Jul 27

Start therapy with a new therapist can be daunting. It’s normal to feel anxious about your first session, especially if you’ve never been to therapy before. Here’s a breakdown of what you can expect from your first session with a therapist.

Not a ‘normal’ session

The first session is different from a standard therapy session. It’s all about getting to know each other. Your therapist wants to know more about you, but you also want to get to know your therapist better so that you can decide if they’re the right fit for you.

In general, the first session focuses on your background and history. It’s common for your therapist to ask a lot of questions and talk more than they would during a standard session. They’re trying to get all the relevant information so that they can get a clearer picture of what is going on for you and how they can support you.

Paperwork and formalities

Your therapist will discuss any paperwork that you’ve completed or still need to complete (intake forms, consent forms, …). They will discuss confidentiality and how it applies to your sessions and you as a client. Some therapists might also cover their cancellation policy, payment policy, and other formalities.

Your story

The main goal of the first session is for your therapist to get a better understanding of you and your story. As we mentioned, this usually means that they will ask quite a few questions that are very specific. Getting a better understanding of your life, your family, your relationships, and your history helps your therapist to deeply understand your current situation. And ultimately, this will help them to support you in a way that’s helpful to you.

If you’re seeing your therapist for issues relating to body image and your relationship to food, eating, dieting, or exercise, they will probably be interested in the following things:

What is your current relationship with food or your body like?
Has it always been like this or has anything changed or happened recently?
Are there any events or people that have shaped your relationship with food or your body?
Which beliefs to you have about your body and about food?
What is your history with dieting and exercise like?
Are there any medical events or conditions that contribute to your relationship with your body or food?
Which therapies, strategies, or coping skills have you tried?
What is your goal when it comes to your body and food?

Previous experiences with therapy

Most therapists are interested in your past experiences with therapy. If you’ve previously been in therapy, your therapist might ask you questions about this. This information can help your therapist to better support you. They might ask questions like:

Have you previously had therapy from a counsellor, psychotherapist, psychologist, or psychiatrist?
What is the reason that you’re no longer seeing them? Did treatment come to a natural end? Was their style not a good fit for you? Did they not specialise in what you need support with? Did they do something that made you lose confidence in them?
Are there things your previous therapist did that you really liked?
Are there things your previous therapy did that you really did not like?

Expectations and goals

When you start therapy, your therapist will discuss with you what your goals are. Goal-setting is one of the important parts of therapy, and it has different purposes:

Goals can make you feel more empowered. As the client, you decide what your goals are, and for some people this feels like taking back control of their life.
Goals give your sessions a direction and purpose. Knowing what goals you’re working towards will help your therapist to determine how they can support you.
Goals can make you feel more motivated and committed to the therapy process. If they are made specific and achievable, they can also make you feel less overwhelmed. Knowing what you’re working towards can make you feel more committed to the process and motivate you to implement new coping skills and emotional regulation techniques outside of therapy.
Goals help you and your therapist to track your progress in therapy.

Most therapists will end the first session with one or several clearly defined goals. But it’s important to know that goals can change along the way — sometimes you achieve a goal quicker than you expected or you learn during your sessions that there’s actually a different goal that feels more important to you. It’s all about collaboration and open communication with your therapist.

Exploring if you’re a good match

The first session is often a good indicator whether the therapist is a good match for you. Not every therapist is right for every client, and the first session is a good opportunity to explore this.

During the session, you can try to observe the following things:

How do you feel while talking to this therapist? Relaxed, comforted, anxious, stressed?
Does the therapist make you feel understood?
Is the therapist doing anything that makes you feel at ease?
Has the therapist done or said anything that made you feel angry, upset, misunderstood, or any other negative emotion?
Do you feel comfortable with their style of communication, the language they use, and their body language?
Do you believe that the therapist understands what you want out of therapy?
Do you believe that you can trust this therapist?
Does the therapist give you time and space to tell your story or do you feel rushed?

All of these can be indicators of whether this is the right therapist for you. If you have any doubts about the therapist being a good fit for you, it’s always a good idea to discuss this during the session.

Deciding to book a next session (or not)

At the end of the session, your therapist will likely ask you if you’re interested in booking a next session. It’s important to know that the decision is entirely your own, and it’s okay if you don’t know the answer right away.

Often, one of the two following scenarios happen:

You’re ready to immediately book a next session. You feel good about the therapist and their approach. They make you feel safe and understood, and you believe that you can work well together. You book in a time and date for the next session at the end of your first session.
You’re not sure if you want to book a next session. Maybe you’re not sure if this therapist is the right one for you. Or maybe you’re just not sure if you’re ready to start therapy. Or perhaps you’re worried about money, or you don’t know when you might be able to take time off work to book a session. These scenarios are normal and happen often. It’s okay to ask your therapist if you can get back to them in a few days.

Looking for More Support?

I work with clients to help them recover from diet culture, improve their body image, and reduce shame and restriction in their lives. If it sounds like we’d be a good match, you can book a free 15-minute call or book a session with me. Please don’t hesitate to reach out via yasmine@outofthewoodscounselling.net if you have any questions.