What to Expect at Your First Therapy Appointment (and How to Prepare for It)

You’ve taken the leap and scheduled a first appointment with a therapist. Maybe it’s your first-ever session with anyone, or your last session was years ago, or you’re nervous about switching to a new therapist. Whatever your exact circumstances, you have a calendar appointment to physically (or virtually) sit on a stranger’s couch while they — presumably — ask you to talk about all your deepest feelings.

In the waiting period before your session begins, pre-therapy nerves build up: Are they going to analyse the way you sit in the chair? Do you need to brush up on your own mental health history? Will you have to talk about your childhood? It’s anxiety-inducing for anyone, even if anxiety isn’t the reason you booked the session in the first place.

Every therapist is different, as is every therapy session. Still, there are certain elements that you can anticipate in just about any appointment. After scheduling your first appointment with a therapist, here’s how you can mentally prepare for the session.

Tackle all the paperwork

Whether you’re scribbling on a clipboard in a waiting room, or have a separate tab open for filling out PDFs, your first therapy appointment comes with some necessary paperwork. Be ready to fill out the following:

• Medical history, including your current medications
• A questionnaire about your symptoms
• Record release form
• Therapist-patient services agreement

In addition to paperwork, there will be some other logistics to discuss with your therapist. Rather than diving into your childhood trauma, the first appointment will likely include discussions about their professional approach to therapy, the ins and outs of patient confidentiality, and other details about their practice. On this note…

Manage your expectations

Your first appointment with a new therapist is not enough time to get as deep as you might be hoping (or fearing). Still, they’ll ask bigger picture questions about your mental health in order to get to know you as a client. Manage your expectations for what you’ll get out of your first appointment. It’s likely far more introductory and far less probing that you might be thinking.

Mentally walk through the session

Uncertainty is likely the root cause of your anxiety right now. By mentally walking through your upcoming appointment, you can ease some of those nerves. Take comfort in the fact that most of the first session will be spent on more immediate, surface-level subjects.

The session will likely kick off with small talk. This is not a “trap.” It’s because your therapist is another human being, and your relationship will work best if you two have a rapport and base level of connection.

Then, your therapist might directly ask you what brought you to their office on this day. Prepare yourself to answer the question of why you’re seeking therapy. There’s no wrong answer here; try to respond as honestly as possible about what kinds of needs or issues you’d like to address in your treatment together.

Questions you can expect a therapist to ask

Here are some common questions that the therapists at GoodTherapy say you can expect in your initial meeting.

• Have you attended therapy in the past?
• What are your symptoms?
• What brought you to therapy?
• Do you have any mental health issues in your family history?
• How is your living situation/home life?
• Do you have a history of suicidal ideation?
• Do you have a history of self-harm?
• What do you hope to get from therapy?

If it helps to put you at ease, you can prepare your answers to these questions ahead of your appointment.

Prepare your own questions for your therapist

Therapy is not a one-way interrogation. If it helps you, consider asking your new therapist the following questions:

• How does patient confidentiality work? When would you need to break it?
• How long have you been a therapist?
• Do you specialise in certain mental health issues?
• What kind of things should I plan to do between our sessions?
• What advice do you have to help me get the most out of our time together?

If you have want to ask these questions before the appointment rolls around, ask if this therapist offers a free phone consultation before committing to a paid session. This is a common practice and could save you time, money, and mental anguish.

Check in with yourself before scheduling a second session

A good therapist uses the first session to begin making a connection and putting you at ease. If something feels off, listen to that feeling. Therapy is a highly individualized practice, and not every pairing is going to work out. If you can’t imagine the two working together long-term, it’s OK not to book a second session.

One of the hardest parts of therapy is showing up to this appointment in the first place. Don’t sweat if the first appointment was a no-go. Check out our guide to selecting the right therapist for you, and keep shopping around until you find the right fit.