What to Expect at Your First Therapy Appointment

What to Expect at Your First Therapy Appointment

It’s no secret that I’m a big fan of therapy. While it can sometimes be hard and scary to ask for help, most people experience a sense of relief just in making their first therapy appointment. But then comes the question of what to expect at that initial appointment. While each therapist is different, there are a few basics that are consistent among most therapists, myself included. So if you’re worried or curious about that first therapy appointment, read on to get an idea of what you can expect.


Yep, there’s paperwork. Trust me, we don’t like having a packet of forms any more than you do. But it’s part of establishing a new healthcare relationship. The forms will ask about identifying information, contact info, and insurance information, as well as some personal, medical, and family history. Your therapist will probably also include a form outlining HIPAA, as well as some details about their practice. While forms can sometimes feel like an annoying formality, we also use these to help guide the first session, making the most out of our time together.


“What’s bringing you in?” It’s a broad starting question for the first therapy appointment, and we intend it that way. We want to hear in your words what’s going on, how you’re feeling, and how you talk about it. We want to leave a space for whatever emotions come up. Initially, we probably won’t interrupt a whole lot, unless something needs immediate clarification. After you’ve shared for a bit, we may follow-up on some specific questions or pieces of information that you shared.



We’ll talk timeframe. Expect to hear questions like, “How long has this been going on? How often does this happen? Have you ever felt this way before?” While these won’t be asked in rapid fire, we want to get a sense for whether or not this is a fairly new and recent issue or if it’s something you’ve been struggling with for a while.


Be prepared for us to ask about trauma, thoughts of suicide, and substance use. While these questions might seem a bit intense or forward for the first therapy appointment, they’re really important. Your therapist will likely ask about these in such a gentle and caring way that they won’t feel uncomfortable. We won’t usually press for details that you’re not ready to give. We do our best to respect your boundaries in sharing and opening up. Also, many therapists, myself included, ask about these issues on their forms. This helps us be even more thoughtful when asking questions about sensitive topics.


Think about your goals for therapy. Near the end of my first appointment with clients, I often ask, “What are your goals for therapy? What are you hoping to get from this process?” This helps your therapist make sure both of you are on the same page. It helps direct the work in a way that feels productive and helpful for both of you. We want you to get what you want from therapy! Your therapist may also offer their two cents about possible goals for treatment.


Let’s get a game plan going. Near the end of the appointment, your therapist will probably share some of their initial impressions, as well as their recommendations for follow-up treatment. We will also share some details about our practice, how to get in touch with us, and other small details regarding billing, scheduling, or accessing our building. This helps you get an idea of what the process will look like moving forward.


Most clients breathe a huge sigh of relief after the first therapy appointment, acknowledging that it was less scary than they had imagined. It often feels more like a conversation than an awkward question and answer session. Our hope is for you to leave the appointment feeling heard, listened to, and understood. We want you to feel hopeful moving forward, like things could improve and feel different. But we also know that there might still be some uncertainty or skepticism about the process. And that’s ok. Therapy is new for most people, and it’s scary to open up.


If you’re thinking about therapy, give it a try. It’s a unique experience, one that can be deeply helpful. Not sure whether or not you need therapy? Check out this post to find out whether or not therapy is right for you.

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