Your First Therapy Session

Author: Dr. Vrolijk   |   Updated: August 23, 2025   |   Disclaimer   |   Review Process   |   References

Author: Dr. Vrolijk   

Updated: August 23, 2025   

Disclaimer   |   Review Process   |   References

Starting therapy is a big step, and it’s normal to have questions. This page explains what to expect before, during, and after your first session. There is also information on common concerns like what to talk about and how to deal with cost.

On This Page:

Two people sit facing each other in chairs during a therapy session in a calm office with natural light and plants

Before Your First Session

It’s completely normal to feel nervous about your first therapy session. Many people worry they don’t have “real” problems or wonder if they should wait until things get worse. You don’t need to be in crisis to benefit from therapy. Even if you feel mostly fine, talking to someone can help you understand yourself better and learn skills for the future.

What to Bring

  • ID
  • Insurance card (if you have one)

If You Can (But Not Necessary)

  • Fill out paperwork if some was sent
  • List of current medications (including vitamins and supplements)
  • List of past medical conditions
  • List of medications you’ve taken

If You Want to Prepare

  • Think about your goals. What do you hope to get from therapy?
  • Write down questions  you want to ask.
  • What’s bothering you the most? This can be a good starting point.

✷ You don’t need to have everything figured out before you go. Your therapist will help guide the conversation.

What to Expect

Your first therapy session is mostly about getting to know each other. You won’t solve all your problems in the first session, but it’s an important start.

When to Get There

  • Check your appointment confirmation – some places specify arrival time
  • Generally, arrive 15-20 minutes early for paperwork and to get settled
  • Give yourself extra time – rushing adds unnecessary stress

Before the Session: Paperwork & Logistics

  • Health history forms
  • Insurance and payment information
  • Consent forms and privacy policies
  • Emergency contact information

Important: It’s okay if you need help with any of this paperwork. You can tell your provider you don’t know something.

During the Session: Getting to Know Each Other

Your therapist will ask about your symptoms and concerns. You will usually talk about:

  • What brought you to therapy
  • Your goals
  • What type of help might work best
  • How often to meet

You will also talk about expectations like:

  • Confidentiality
  • How to contact them between sessions (if needed)
  • Scheduling your next appointment

This session may be longer than future ones (60-90 minutes).

What to Tell Your Therapist

Therapist in blue sweater listens attentively to patient during first therapy session in bright office with window

You can tell your therapist anything. There’s no right or wrong topics. 

Some people have a hard time knowing where to start. Or you might struggle with thinking of anything to talk about. It’s okay to say something like “I’m not sure why I’m here” or “I don’t know what’s wrong.” Your therapist can help you figure it out.

Some Topics that Might Be Helpful to Share

  • Your symptoms: How you’ve been feeling physically and emotionally
  • Your daily life: How your concerns are affecting work, relationships, sleep, etc.
  • Your history: Previous therapy, medications, major life events
  • Your concerns about therapy: Any worries or past bad experiences
  • What you hope to gain: Your goals and expectations
Therapist in blue sweater listens attentively to patient during first therapy session in bright office with window

If You're Having a Hard Time Describing Feelings

That’s okay! Part of therapy is learning how to identify and describe these feelings. Most people don’t learn how to do this until they go to therapy. Your therapist will help you understand and describe these feelings.

✷ You don’t have to share everything today. Therapy is a process. You can share more over time as you build trust.

Quick Answers

What if I don't know what to talk about?

This is one of the most common concerns! You can start by saying exactly that: “I don’t know what to talk about.” Your therapist will ask questions to help guide the conversation.

If preparing would help you, you can write down:

  • What brought you to therapy
  • How you’ve been feeling lately
  • Anything else that has been on your mind
Can I go to therapy if I feel fine?

Absolutely! Therapy isn’t just for crisis situations.

Many people go to therapy to:

  • Understand themselves better
  • Improve relationships
  • Build coping skills
  • Work on personal growth
  • Get support through a challenging situation

Think of it like going to the gym for your mental health. You don’t just go to the gym when you need to recover from an injury. You go to be healthier in the rest of your life. 

One things to note: If you’re using insurance, they need a diagnosis code. This is the same as other medical care you get. Ask your therapist about what they will use. 

How long does therapy take?

It varies greatly depending on your goals and situation. Some people benefit from just a few sessions for specific issues. Others find longer-term therapy helpful. What might help you depends on what you’re dealing with and how your brain works.

Is everything I say confidential?

Most therapy conversations are private. Usually, you have to give written permission for your therapist to talk to anyone about you.

If they think you will hurt yourself or someone else: Your therapist has to tell someone under US law. Therapists only report this when they think it’s actually going to happen. They will call to protect you and other people.

Having thoughts about hurting yourself or others is different from being at high risk of doing it. It’s important to share these thoughts, so you can get help.

You can always ask your therapist what will and won’t be reported.

What if I cry? Do I have to cry?

Some people cry during therapy whereas others don’t. Both are okay. Therapists are trained to handle strong emotions and will provide support. Other people never cry in therapy. They also understand that everyone expresses emotions differently.

How often will I have to go to therapy?

Everyone is different. Some people go once a month while other people go 2-3 times a week. This depends on what you need, your schedule, and budget. Your therapist will usually recommend a certain schedule. But it’s up to you how often you want to go.

What about cost and scheduling?

There are many options to deal with cost. Some therapists will charge you less based on your income (called sliding scale). Insurance might cover mental health providers too. Even if a therapist doesn’t take your insurance, you may be able to send in an out-of-network claim.

Scheduling can be challenging for many people. Some therapists see people later in the day or weekend. Or you might be able to do Telehealth.

Learn more about therapy costs and scheduling on our finding mental healthcare page.

What happens if I miss an appointment?

Contact your therapist as soon as possible. Most therapists understand that life happens and will work with you. You can ask about their cancellation policy if you’re worried about this.

What if I can't afford regular session?

Discuss payment options with your therapist. Many offer sliding scale fees, payment plans, or can help you find more affordable options.

Can I stop whenever I want?

Yes, therapy is completely voluntary. The exception is if a court is requiring you to go.

You can end therapy at any time. Many therapists appreciate when patients let them know they want to stop. They will worry if a patient suddenly stops seeing them. They will often want to have a final conversation about your progress and next steps.

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