If you are nervous about how your first therapy session will go – you are not alone. Feeling worried about what to say in the first therapy session is more common than you think. Therapy is a highly vulnerable space where you are invited to disclose issues you perhaps never mentioned to anyone or even articulated out loud. Knowing this, it’s normal that your mind feels somehow terrified by the uncertainty around your first therapy session.
To help you feel more confident about your upcoming therapy journey and inform you on what to expect in the first therapy session, this article includes key information about what to expect from your first therapy session. Besides that, it will help you uncover information about setting therapeutic goals, communicating with your therapist, and differentiating between various therapeutic approaches.
Remember that, at the end of the day, therapy is one of the safest spaces out there – so all you need to do is settle your mind and trust the journey.
Working With Your Thoughts and Fears
Let’s imagine this scenario. You are waiting outside a therapist’s office (or in the Zoom/Skype meeting room if you opted for online therapy), and millions of thoughts run through your mind. You create scenario after scenario, make up some things to say in order to mask the initial awkwardness, or worry about your voice shaking.
Maybe you are scared of the prospect of crying in front of a therapist you just met.
Or maybe you suddenly wonder if someone you know has worked with your new therapist and told them about you.
No matter how exaggerated or valid your worries about your first therapy session might seem, there is nothing wrong with you. When we do something we’ve never done before – especially a vulnerable endeavor like therapy – it is absolutely normal to feel anxious, worried, or downright frightened. This is the way in which our brain tries to protect us – by devising multiple scenarios that reduce the uncertainty and give us the illusion of control.
Once you meet your new therapist, you can expect a warm and welcoming person who is there to listen to you and help you work through any worries you may have. In some cases, the first therapy session feels like an introductory session. You might find that your therapist will ask you some questions about you and your background. This is nothing to be worried about – all the information you provide is just so that your therapist better understands how they can support you.
You will also find that during the first therapy session, your therapist will place a greater emphasis on building rapport with you. This is because the therapeutic alliance is one of the most important factors for the successful outcomes of therapy. Building rapport might be done through your therapist's attempt to mirror your body language, reflecting your personality traits, showing empathy, and asking questions to delve deeper into the issues you are describing.
Why Are You Here?
Everyone who seeks therapy should know one important thing. Contrary to popular expectations, therapists are not mind readers. While they do have the training and knowledge to work with the emotions and information available to them, they are not able to gauge what happens with you unless you honestly disclose this in your therapy session.
This is why it’s highly important to do some reflection work on what you’d like to get out of your therapeutic process and communicate that to your therapist during your first therapy session. It would also be immensely helpful to communicate to your therapist all relevant details about your mental health, social life, and reasons for seeking therapy. By doing this, you provide your therapist with crucial information to include in your treatment approach.
Similarly, in your first therapy session, you may also want to ask your therapist some questions (as opposed to just them asking you). These questions might be related to their training background, confidentiality of your data, or practical matters such as the cost of the therapy sessions or the recurrent date you are available to meet with them).
During your first therapy session, you can also set therapeutic goals and directions you would like to work on. If you cannot define those prior to meeting your therapist, this is absolutely fine, as they might get defined at a later stage.
Your goals are unique to you and depend on which areas of yourself and your life you intend to work on. For this reason, your therapist will never approach your sessions with predefined goals without consulting with you first. Once you state your reasons for seeking therapy, your therapist will help you articulate some relevant goals to improve during your therapy sessions. Some common examples of therapeutic goals are:
- Improving relationships (with romantic partners, family members, friends, or co-workers)
- Working with an addiction disorder
- Decreasing mental health pathology (i.e., anxiety, depression, phobias, etc.)
- Improving self-esteem and self-acceptance
- Healing past traumas
- Forgiving other people or releasing challenging emotions such as anger, disappointment, etc.
While you can prepare with goals and questions to discuss with your therapist prior to your first therapy session, it is almost impossible to know exactly how a session will proceed. For this reason, the best thing you can do is trust the process and work on building a strong therapeutic alliance with your therapist. Planning out an entire therapy session in your mind is also difficult because there are many different therapeutic approaches that your therapist might be trained in.
Some examples of various therapy modalities are:
- Cognitive behavioral therapy (CBT) – One of the most common approaches at the moment. CBT is highly effective and well-researched and is primarily based on working with cognition (thoughts).
- Psychodynamic therapy – Based on the idea that talking about problems can increase people’s self-awareness and help them find active solutions.
- Psychoanalysis – This therapy approach is based on the idea that all psychological distress is rooted in the unconscious mind. For this reason, psychoanalysis-based interventions aim to work with unconscious and repressed thoughts.
Regardless of the interventions employed by your therapist, the main thing to consider is that they are targeted to your needs and goals. Some therapists can employ interventions from different schools of therapy when they help their clients reach their goals.
What About Online Therapy?
If online therapy works better for you, you can confidently use this option long-term. All information mentioned in this article about the first therapy session is relevant both to online therapy and online counseling sessions and in-person interventions.
Research shows that online therapy is efficient, flexible, convenient, and can even decrease the first therapy session anxiety some people might feel at the beginning. Many get amazing results from online therapy sessions and feel less stressed about getting to the session on time or commuting to the therapist’s office.
Besides flexibility and convenience, online therapy and online counseling also have the added benefit of increasing client retention. This means that, given that people feel less stressed about attending online sessions, they are more likely to stick to their therapeutic process in the long run.
In short, there aren’t many substantial differences between in-person and online therapy sessions. The structure of the therapeutic intervention is largely the same, and the only thing that is changed is the environment.
Getting Started With Therapy
If you are nervous about how to prepare for the first therapy session, know that this is a temporary emotional state. Most likely, it will go away once you get acquainted with your therapist.
You can better prepare for the first therapy session by reflecting on your reasons for seeking therapy and defining some goals you would like to work on. Remember that, at the end of the day, the relationship you build with your therapist requires some of the qualities you bring into any other relationship, such as honesty, openness, and collaborative spirit.