What to Expect During Your First Therapy Session

What to Expect During Your First Therapy Session
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Embarking on the journey to address your mental health issues can be a daunting task, especially when you're not sure what to expect.

Today, more than ever, we're seeing a significant rise in mental health issues worldwide. With increasing awareness and advancements in mental health services, more individuals are recognizing the need for help and reaching out to professionals like me, a psychologist and psychoanalyst. However, this step, while courageous, can also be intimidating.

The fear of the unknown can often be overwhelming, particularly when it comes to your first therapy session.

In today's blog post, I aim to alleviate some of these concerns. Drawing from my extensive experience in providing online therapy and counselling, I'll guide you through what to expect during your first therapy session.

Together, we'll explore the process of psychotherapy, my role as a counselling psychologist, and how I can help you navigate challenging situations using evidence based psychotherapy. I also acknowledge the unique challenges faced by the LGBTQ community and will shed light on how as an LGBTQ therapist, I can offer specialized support.

So, whether you're seeking therapy for the first time or transitioning to online therapy, this post will equip you with knowledge, preparing you for the journey ahead. Let's demystify the therapy process together, making mental health services more accessible and less intimidating for all.

What is Therapy?

One of the first and most important things we need to understand is the true meaning of therapy. Although therapy has become very popular in the last few years, there is still widespread confusion about its true essence and potential.

In simple terms, therapy, also known as psychotherapy or counseling, is a process where an individual works with a therapist to address their mental health concerns. These can range from emotional distress, problematic behaviors and thoughts, to specific mental health conditions.

The ultimate goal of therapy is to improve the individual's well-being and mental health, resolve or mitigate troublesome behaviors, beliefs, compulsions, thoughts, or emotions, and to improve relationships and social skills. There are several types of therapy such as cognitive-behavioral, interpersonal, and other kinds of talk therapy that help individuals work through their problems.

Psychotherapy or therapy as it is more commonly known is a collaborative treatment based on the relationship between an individual and a psychologist. Grounded in dialogue, it provides a supportive environment that allows you to talk openly with someone who’s objective, neutral and non-judgmental.

Studies have demonstrated the effectiveness of therapy. For example, a study published in the Journal of Affective Disorders found that cognitive-behavioral therapy significantly reduces symptoms of various disorders such as depression and anxiety. Another research highlighted the effectiveness of psychotherapy in reducing suicidal thoughts among adults who had recently considered or attempted suicide.

Types of Therapy

Over the years researchers across the world have pioneered a wide catalogue of therapies to be used in holistic treatment. Although all of them share commonalities, each one is designed to meet the needs of a particular set of indivuduals, for example Cognitive Behavorial Therapy (CBT) for those suffering from depression and anxiety and Behavorial Therapy (BT) for those suffering from maladaptive behaviour.

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Shared below is a comprehensive list of the most common therapies used by counselling psychologists and psychotherapists around the world.

  1. Cognitive Behavioral Therapy (CBT): This type of therapy is commonly used because it helps individuals identify and change dysfunctional thought patterns that lead to maladaptive behaviors.
  2. Psychoanalysis and Psychodynamic Therapies: These approaches focus on changing problematic behaviors, feelings, and thoughts by discovering their unconscious meanings and motivations.
  3. Behavioral Therapy: This therapy focuses on changing unwanted behaviors through conditioning processes like reward systems or desensitization.
  4. Humanistic Therapy: This approach emphasizes people's capacity to make rational choices and develop their maximum potential.
  5. Dialectical Behavior Therapy: This type of cognitive-behavioral treatment aims to recognize, and help people manage negative thought patterns and destructive behaviors.

What to Expect From Your First Therapy Session?

Your first therapy session is a significant step towards better mental health, and it's entirely natural to feel a mix of emotions. You might feel anxious, hopeful, scared, or even relieved. Each of these feelings is valid and expected.

Upon arriving at the therapist's office, you'll typically check in at the reception. Similar to other healthcare appointments, you'll be asked to fill out some paperwork. This usually includes basic personal information, your medical history, and possibly some questionnaires related to your mental health.

Once you're called into the therapy room, the format of the session can vary based on the therapist's approach. Some therapists conduct the first session like a structured interview. They may ask you about your current life situation, what brought you to therapy, your past experiences, relationships, family background, and other relevant aspects of your life. This process gives the therapist a comprehensive picture of your life and helps them understand the issues you're dealing with.

In contrast, other therapists might make the first session more like an open-ended conversation. Rather than asking direct questions, they might invite you to share what's currently on your mind or what concerns brought you to therapy. This approach can often make the session feel more relaxed and less like an interview.

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Regardless of the format, it's not uncommon for the first session to feel emotionally intense. As you start discussing your experiences, especially those you haven't shared before, you might find a wave of emotions washing over you. It could feel like an emotional rollercoaster, but many people also describe a sense of relief as they get things off their chest.

One critical aspect to remember is that it's important to be as open and honest as possible during therapy. It might feel strange at first to share your deepest thoughts and feelings with a stranger. However, remember that therapists are professionals who are there to help, not judge. The more candid you are, the better they can assist you.

So, as you navigate this new experience, remember to take a deep breath, know that it's okay to feel vulnerable, and take this first step at your own pace. With time, and through the therapeutic process, you'll begin to develop positive coping mechanisms and strategies to navigate past traumas and manage your mental health effectively.

What to Expect From Yourself?

Indeed, therapy is a journey of self-discovery and healing. The role of a therapist, whether they are a psychologist, psychotherapist, or psychoanalyst, is not to hand you a quick solution but to guide you through your mental and emotional landscape. They are there to help you navigate your thoughts and feelings, offering a safe space for you to express your worries and fears.

During the first session, you might discuss your current situation, your history, and what brought you to therapy. This is an opportunity for you to get a feel for the therapist and for them to understand your needs better. It's also a time when you can set expectations and talk about your goals for therapy.

Some therapists might delve into your past, helping you to process traumas and experiences that could be influencing your present. Others might focus more on the present and future, helping you to change your perspective from what you can't control to what you can. This could involve cognitive behavioral techniques or mindfulness exercises, for instance.

No matter the approach, a good therapist will make you feel heard. They will validate your feelings and help you to see things from different perspectives. You might leave the first session feeling a sense of relief, as if a burden has been lifted. You've taken the first step in addressing your mental health, and that in itself is a significant achievement.

Remember, therapy is not a one-size-fits-all solution, and it's okay if it takes a few sessions to feel comfortable or to find the right therapist for you. The important thing is that you're taking steps towards better mental health, and that's something to be proud of.

Length of Therapy

The journey of therapy is an incredibly individualized process, and its length can vary greatly from one person to another. There's no one-size-fits-all approach in mental health services, and this is especially true when it comes to the duration of therapy.

The time you spend with a psychologist, psychotherapist, or psychoanalyst can be influenced by a myriad of factors. For instance, the type of mental illness you're grappling with can play a significant role. Conditions like depression, anxiety, or trauma-related disorders might require different lengths of therapy. Moreover, the approach and type of therapy your therapist offers, whether it's cognitive behavioral therapy, psychodynamic therapy, or any other form, can also impact the duration.

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Some approaches may necessitate more extended engagement, while others might facilitate progress in a relatively shorter span. It's crucial to remember that therapy is not a race, but a personal journey towards better mental health, and each individual's pace will differ based on their unique circumstances and needs.

Ensuring Your Confidentiality

Ensuring the confidentiality of your information is a pivotal step in your first therapy session, whether it's with a psychologist, psychotherapist, or any other mental health professional.

It's crucial to understand how your therapist records and stores your personal and sensitive information. You have every right to ask about their data handling practices and the security measures they have in place to protect your privacy.

Therapists are bound by stringent ethical guidelines and laws that prevent them from sharing confidential information without your consent. However, there are certain scenarios where they might be required to breach confidentiality, such as when there's a serious risk to yourself, the therapist, or others. In such cases, they may need to share information to ensure safety. Remember, your trust and comfort are paramount in therapy, and understanding these aspects can help build a strong therapeutic alliance.

Questions to Ask Your Therapist

Your first therapy session is a vital opportunity to establish a dialogue with your therapist and understand their professional background, educational qualifications, experience, affiliations with professional associations, and their therapeutic methods.

Asking the right questions can help you determine if they're the right fit for you. You might consider asking about their specialization and how it relates to your concerns. Inquire about their experience in dealing with issues similar to yours and their approach to therapy. Understanding their perspective on medication, their views on the client-therapist relationship, and their thoughts on setting goals can also be illuminating. Here are some questions you can keep handy for your first session:

  1. What is your educational background and training in psychotherapy?
  2. How long have you been practicing, and what is your area of expertise?
  3. What professional associations are you affiliated with?
  4. What is your approach or orientation in therapy? Can you explain it a bit?
  5. Have you treated individuals with similar issues as mine?
  6. What is your perspective on involving medication in treatment?
  7. How do you view the role of the client in the therapy process?
  8. How do you approach goal setting in therapy?

Remember, the goal of these questions is to ensure that you feel comfortable and confident in your therapist's capabilities and approach.

How to Find the Right Therapist for Your Needs?

Finding the right therapist for your unique needs can be a journey of its own. Each therapist has their own distinct approach, and it's important to understand that not every method will align with your needs, and that's perfectly okay. Therapy is a highly personalized process, and sometimes, you might need to try out several therapists before finding the one who resonates with your concerns and preferences.

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When searching for a therapist, it's crucial to consider various factors which might influence your decision. The most significant of these are as shared below.

  1. Therapist's Affiliations: Therapists associated with professional bodies are bound by a code of ethics and standards of practice that ensure they offer high-quality care. These affiliations can also be indicative of their commitment to ongoing learning and staying updated with advancements in the field.
  2. Background: A therapist's educational background and training can assure you of their competence. Therapists with diverse backgrounds bring different perspectives and approaches to therapy which can be beneficial depending on your unique needs.
  3. Costs and Mode of Payment: Therapy is a commitment, both emotionally and financially. Understanding the costs upfront helps you plan better. The mode of payment (cash, card, insurance) can also influence your decision based on what is most convenient for you.
  4. Type of Therapies: Therapists use different therapeutic approaches (like cognitive-behavioral therapy, psychodynamic therapy, etc.) based on their training and philosophy. Knowing the type of therapies a therapist offers can help you choose one whose approach aligns with your preferences.
  5. Session Approach (In-Person or Online): The format of therapy sessions depends on your comfort and convenience. While in-person sessions may offer a more personal connection, online therapy provides flexibility and accessibility, especially in the current pandemic scenario.
  6. Experience: A therapist's experience in dealing with issues similar to yours can provide you with confidence in their ability to understand and help you navigate your concerns effectively.
  7. Rules: Each therapist has their own set of rules regarding cancellation policies, session timings, etc. Knowing these rules beforehand helps set clear expectations and ensures a smooth therapeutic process.
  8. Specialities: If you're dealing with specific issues (like anxiety, depression, trauma), finding a therapist who specializes in that area can be particularly beneficial.

Remember, the goal is to find a therapist with whom you feel comfortable and safe, enabling you to embark on your healing journey with trust and confidence.

Tips to Ensure a Great First Therapy Session

Embarking on the journey of therapy can be an empowering step towards self-improvement and wellness. However, it's equally important that your first session aligns with your expectations to lay a solid foundation for the subsequent therapeutic process. Here, are six key tips that can help ensure that your initial therapy session goes well and caters to your unique needs.

  1. Set Clear Goals: This implies defining what you hope to achieve from therapy. Perhaps you're looking to manage stress better, improve your relationships, or cope with a significant life change. By having a clear understanding of your objectives, you can guide the course of the therapy and enable your therapist to tailor their approach to your specific needs. It also provides a roadmap that can help track your progress over time.
  2. Be Open and Honest: Therapy is a safe space where you can share your thoughts, feelings, and experiences without judgment. The more open and honest you are, the more effectively your therapist can understand and assist you. It might feel difficult initially, but remember that this honesty forms the bedrock of successful therapy.
  3. Prepare Mentally: It's natural to feel a mix of emotions before your first therapy session - curiosity, apprehension, hope. Preparing yourself mentally can help navigate these feelings. Reassure yourself that it's okay to feel vulnerable, and remember that therapy is about your growth and well-being.
  4. Ask Questions: Your first session is the best time to ask any questions you might have about the therapeutic process, your therapist's approach, the confidentiality protocol, and more. Getting answers can help you feel more comfortable and engaged in the therapy.
  5. Practice Mindfulness: Entering your session with a calm and focused mind can enhance the therapeutic experience. Simple mindfulness exercises, such as deep breathing or progressive muscle relaxation, can help reduce anxiety and promote clarity of thought.
  6. Remember It's a Process: Change doesn't happen overnight, especially when it comes to mental health. Be patient with yourself and the process. Each session contributes to your journey, even if the progress may not always be immediately visible. Remember, therapy is not a race, but a journey towards better mental health.

Do’s and Dont’s for Your First Therapy Session

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As you prepare for your first therapy session, it's crucial to understand the etiquette that can make the process smoother and more beneficial for you. Here is a list of do's and don'ts that can guide your behavior during your initial therapy session. These pointers aim to help you engage more effectively in the therapeutic process, ensuring that you get the most out of your sessions.


  1. Be Open: Therapy is a safe space. Your therapist is there to help you, not judge you. Being open about your thoughts and feelings can make the process more effective.
  2. Ask Questions: If you're unsure about anything, don't hesitate to ask. Whether it's about the therapy process, confidentiality, or your therapist's approach, getting clarity is crucial.
  3. Set Goals: Think about what you want to achieve from therapy. Clearly communicating these goals to your therapist can help guide your sessions.
  4. Be Patient: Change takes time. It's okay if you don't see immediate results. Every step you take in therapy is progress.


  1. Don't Expect Instant Results: Therapy is a process. It takes time to unpack feelings and develop coping strategies. Be patient with yourself.
  2. Don't Hold Back: It might be tempting to hide painful or embarrassing details, but remember that your therapist is there to help. The more honest you are, the more they can assist you.
  3. Don't Hesitate To Express Discomfort: If something doesn't feel right during the session, voice it. A good therapist will appreciate your feedback and adjust their approach accordingly.
  4. Don't Forget Self-Care: Therapy can sometimes be emotionally draining. Remember to take care of yourself outside the therapy sessions. This could mean engaging in relaxing activities, eating nutritious food, getting enough sleep, or whatever else makes you feel good.


Taking the first step towards acknowledging your mental health issues is an act of immense courage. It's a significant stride towards a healthier, brighter future. It's perfectly normal if your first therapy session feels overwhelming. Remember, healing isn't a race—it's a journey, one that involves gradual steps and a lot of patience.

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Each session, each revelation, each moment of understanding brings you closer to a healthier state of mind. If you or someone you know is suffering from any mental health illness, don't hesitate to reach out. You can schedule an online appointment with me today. Take that all-important first step towards better mental health—I promise to be there with you, guiding and supporting you at every stage of this journey.

Here's to a healthier, happier you.

With Love,

Arpan ❤️

Arpan Sarma

Arpan Sarma

Counselling psychologist and psychotherapist helping you navigate life's challenges with evidence based therapeutic techniques. Available for online, in-person and home visit sessions.
Calcutta, India