Going to Therapy

What to Expect from your First Session

Why Therapy?

If you’ve made an appointment and are approaching your first session, congratulations, you’ve made the first step! If you’re wondering if therapy is for you, perhaps the following information may be useful in helping you decide.  Therapy serves a few different purposes; it can be used to help manage certain mental health issues such as anxiety, depression and trauma, but it is also a great tool to promote personal growth, developing healthy strategies and maximizing experiences. 

Seeking therapy is not essentially about being at a point of desperation or suffering, rather therapy is actually an opportunity to better one’s outlook on life by giving us the strategic tools to better manage an ever-fast changing world with more confidence, relience and understanding. 

Before Your First Session

If you’re still considering, or even if you’ve made an appointment, there are some things to consider before you go for your first session.  Therapy is helpful in the long run, as it helps to process certain issues and making the experiences work for you, but it can be uncomfortable in the beginning.  The discomfort that comes from opening up and having all the emotions being stirred up is to be expected, but your therapist will support you through it to ensure that you only go as far as you can handle at the moment. 

It’s useful to consider these issues before, and ensuring that therapy is the right choice for you at the moment.  Therapy is for YOU!  Therefore, it needs to work for you, and you need to feel ready for it before you embark on the therapeutic journey.  It’s good to ask yourself questions to assess your own readiness.  Are you ready and open to explore feelings and behaviors?  To be open about sensitive topics?  Are you comfortable being vulnerable and discussing these topics with your therapist?

During Your First Session

The first thing on the agenda during your first therapy session will likely be introductions.  You and your therapist will introduce yourselves to each other and start familiarising yourselves with each other to start building a therapeutic relationship.  This introduction is also important for you to see how you will communicate with each other. 

It is also customary for the therapist to introduce the type of therapy they practice.  They would provide some information about the therapeutic process, such as the length of the process and an explanation of what sessions may entail.  This may also be negotiated with you as the client to ensure that both therapist and client are on the same page.  It’s important to remember that therapy is not static, but is fluid, hence the tentative outline of the process set in the first session may change depending on your needs as the client. 

It’s also useful to remember that the therapeutic process is different for everyone, may change from person to person, and you may experience it differently than other people you know are attending therapy. 

Other logistical issues may be discussed; these include payment and cancellations.   The therapist would also usually ask about any concerns or worries that you have about therapy, so that these may be discussed to ensure that you feel safe and comfortable opening up and doing the work.  Boundaries are usually also set and negotiated at this stage, such as if you can contact your therapist in between sessions and certain things that may be off-limits for either of you.

Very importantly, it is important to begin exploring what it is you want to explore in therapy, and what you are looking to get out of this experience. Your therapist will need you to establish your needs.  They will probably inquire about the issues you would like to tackle in therapy and how you would like them to be addressed together.  It’s also common for the therapist to ask about how you had been managing and coping with these issues before you started therapy.  This way, they can get an idea of what worked for you and be able to start formulating ways in which they can best help and support you.  It’s also good to discuss your expectations of therapy so that these can be discussed and adjusted as needed between you both. 


A very important issue that needs to be addressed is the issue of confidentiality.  For a lot of people, this is a rather big concern.  Your therapist will discuss their policy on confidentiality with you during your first session.  Confidentiality fosters trust which allows for the development of a healthy therapeutic relationship between client and therapist.  Typically, everything that is said in sessions with your therapist is confidential.  There are two notable exceptions to this, which your therapist will advise you of. 

These two exceptions are therapist supervision, and concerns about safety.  Therapists have supervision sessions with other experienced therapists.  These supervisions sessions are useful as they help support your therapist so that they can be able to better support you.  

The other exception is concerns regarding safety.  If your therapist is concerned about your safety or the safety of others, they are obliged to report this to the right authority.  The therapist will advise you of this obligation in the first session, and should also inform you that a limit of confidentiality has been reached and that they will need to inform someone of a certain issue before they do so.   

After Your First Session

You may want to plan something to help you relax and wind down after your first therapy session.  Quite a few people tend to adopt this as their routine. Therapy sessions are usually quite emotionally charged and may be heavy in content, and therfore having something you enjoy doing, or something that helps you settle your emotions may be useful.  These habits can include going for a coffee with someone or having some time alone, perhaps going for a walk.  Your therapist will help you contain your feelings  and you willboth work to close the session well before you leave. Having some self-care planned for after a therapy session is a great way to help you process what you explored.

After your session, it’s time to reflect.  You would need to reflect on how you felt during the session and in the aftermath of the session.  You need to assess how you would feel about going in for another session, and reflect on your level of comfort and safety.  As we’ve already mentioned, the first few sessions may bring up some feelings of discomfort as you start opening up about certain issues.  It’s important to remember that therapy is a process.  The issues you present will not be resolved in one session. 

It’s good to reflect on how you felt with your therapist.  Did you feel comfortable with them?  Would you feel comfortable going back to them?  Do you trust them to support you?  If you feel uncomfortable with the person, you may want to switch to a different therapist.  Because therapy is so individual, it follows that you will not click with every therapist.  Research has shown that the most important factor determining the outcome of therapy, even more important than the techniques or modalities used, is the therapeutic relationship. Take some time to reflect whether you felt safe, unjudged and supported.

Your therapist may have given you some in-between session tasks for you to.  It’s important to try your best to do these tasks as these would be material that will guide your next session.  Keep in mind that these tasks are there to help you practice what you discuss in therapy. They are not tests that you can pass or fail, but rather exercises to determine how what you discuss in therapy works for you in the real world.

You may also want to discuss how you felt during and after the session with a friend or family.  Therapy is a very intimate and individual process.  It’s up to you how much you share with others.  If you think that you would like to discuss this with other people in your life in between sessions, it’s ok to do so.  This is also useful to do if you feel you need support in between sessions.

In your next session, don’t be afraid to share these reflections with your therapist.  This opens a channel of communication and shared reflection on which the therapist can help support you.  You may also take down some notes between sessions of things you would like to discuss with your therapist.


If You Feel Unsafe After a Session

Being that therapy requires the client to be somewhat vulnerable with their emotions, it may be too much to bear sometimes.  If the feelings that are evoked are too much for you to handle, or you feel that you cannot handle another session, there are a few things you can do. 

It may be wise to speak to your therapist about these feelings so that the intensity level is adjusted for future sessions.  It’s also useful to identify and make use of external supports in between sessions if needed.  These can be people you trust like friends or family, or could also be reaching out to emotional and mental health support services for support.