Counseling Awareness Month

What to Expect at Your First Therapy Appointment

Trying anything for the first time can be intimidating. Like going off to college or taking up a new hobby, it’s both easy and common to get nervous when we don’t know what to expect.

These feelings can be especially present when starting therapy. So, if you’re a little overwhelmed, you’re not alone, and this guide is for you.

First things first: it’s a big deal to recognize that you may benefit from talking to a professional counselor. Kudos for taking the first steps toward developing skills to become the healthiest version of you!

Seeing a therapist is a way of confiding in someone outside of your immediate friend or family circle, talking through life stressors and challenges, discovering coping tools for self-improvement, understanding our emotions better, and having a space to be heard without judgment.

For whatever reason you’ve chosen for yourself, your wellbeing, and your life, taking care of your mental wellness is a brave thing to do, and an accomplishment itself.

Navigating Pre-Appointment Worries

Now, back to those pre-session jitters. Just know that it is entirely normal (and OK!) to feel anxious or uncertain before your first appointment. Beyond the newness of the experience (whether you’ve previously seen a counselor or not), opening up to a stranger can feel vulnerable.

On top of this, the idea of therapy can evoke a certain image.

Historically, the media has shown therapy to be an impersonal and clinically rigid encounter. These scenes would typically feature a person lying down on a couch in a stuffy room while someone in thick-rimmed glasses comes in, holding a clipboard, asking a checklist of questions while avoiding eye contact.

This doesn’t inspire ease or comfort.

However, therapy is about fostering a supportive human connection through a conversation that aims to create a safe, welcoming, and comforting environment for clients. The therapist works with you to promote self-exploration, understanding, healing, acceptance, and validation.

The right therapist will be genuine, present, compassionate, caring, and inquisitive. They are real people with their own lived experiences, who want to be a trusting resource you feel you can openly talk to. They may even understand where you’re coming from given those lived experiences. It just happens that therapists have the training and education to help you dig deeper.

Ways to Prepare

To ease that anxiety, it might help to approach your first session with a general idea of what you might like to get out of therapy or are seeking help with, and if there are any goals you’d like to achieve or specific challenges that you would like to talk through.

However, it’s totally okay if you can’t fully identify those ideas or goals yet—and maybe that is what you end up sharing, that you’re still figuring it out (because, let’s be honest, most of us still are).

It also might help to tell your therapist if you’re feeling particularly nervous. This can break some of the tension you (and many new clients) tend to feel, but also help inform your therapist on how to flow through the session.

Perhaps that means that they do less talking and more listening. Perhaps it means they take more of the lead and guide you. It might mean taking a break and doing a few breathing and grounding exercises, or it might mean giving you a fidget toy or piece of paper and coloring pencils to draw on throughout the appointment.

More than anything, the best preparation for the process is to come in with an open mind and know that your therapist is there to listen and help you learn, heal, and grow.

The Anatomy of Your First Therapy Appointment

Whether over Zoom or in an office setting, your first session will likely be a kind of “intake” or assessment visit — similar to how it is when initially visiting a doctor for a medical issue, like a sudden cough or bodily injury.

A physician asks you to give a snapshot idea of what’s going on (or what you think is going on). They’ll ask about the history of your symptoms — such as when they started or if there was a notable event, like an accident, that may have led to the issue. You’ll likely fill out informational forms or surveys on prior diagnoses as well as family/relationship dynamics and work/education history.

Therapists follow a similar route of getting to know you and your background during the first session. It likely won’t be a sudden deep dive into your life, but instead about getting a ‘feel’ for each other, helping them understand what brings you in, and assessing whether a meaningful counseling relationship could be forged through further sessions.

Often, they’ll tell you about their training and therapy style or approaches to therapy so that you yourself gain a snapshot into them and how they might be able to collaboratively help you.

During this session, you and your therapist will develop a plan together around what care could look like for you. Feel free to ask any and all questions you need to during the session. It’s important for you to feel comfortable with your therapist moving forward.

What you get out of therapy often comes down to what you put into it, taking the skills you learn and using them in real life.

Checking in With Yourself and Moving Forward

By the end of your initial session with a therapist, you’ll have the freedom to decide whether you want to proceed with working with this therapist and make another appointment. It’s entirely your choice.

It can help to “check in with yourself” after your appointment. These first visits are for you to explore that authentic connection and partnership. Ultimately, it might take a few sessions to really get a feel for that.

Sometimes, we get lucky and click right away with a new therapist—like a weight is lifted off our shoulders and we can finally speak what is on our minds. Other times, it just isn’t the right fit or the connection feels off for any number of reasons. For example, you might prefer someone who has a specific specialization in something like complex trauma, military families, or LGBTQIA+ issues.

There are no hard feelings if you think exploring other options would be beneficial. Sometimes the therapist can even refer you to someone else who would be better suited to your needs.

Be sure to give yourself time and space to take care of yourself after a therapy appointment. Maybe that looks like doing something fun or doing absolutely nothing. But it can help to give your mind, body, and spirit a break from any heavy thinking after.

Talking about problems and personal experiences can be cathartic but also a bit draining — even in those first sessions where you maybe haven’t done a ton of unpacking yet.

On the other hand, you may feel as if nothing much has changed after this first session, which is also a very normal thing to experience.

Stick with it and try not to give up, because mental health is health. You don’t have to go through it alone. Talking helps, and there is hope for a brighter, better tomorrow.