What Actually Happens in Your First Therapy Session?
A lot of people think about booking a first session with real dread about the session itself, which is separate from whatever problem is bringing them in. They picture a blank-faced stranger, a lot of long silence, and some version of "so, tell me about your mother." If that image is part of what has kept you from booking, it is worth knowing how far off it is from what actually happens with me.
So here is what a first session with me is actually like.
It is mostly a conversation
The first session is mostly me getting to know you and you getting a feel for me. I will ask what brought you in now, as opposed to a year ago or a year from now. That timing usually tells me something useful about what happened to push you over the edge of discomfort reaching this level of importance. I will ask what you have tried, what has helped and what has not, if you have seen anyone else for therapy before, what you expect therapy to be like, and what you want to be different six months from now.
You do not have to walk in with it all organized. Plenty of people start with "I am not even sure how to explain this" or “I don’t even know where to start,” and that is a completely fine place to begin. Part of my job is helping you put words to what is going on, so you can free yourself from the pressure to arrive with a tidy summary. There are no bonus points for arriving with it all figured out.
You get to ask me questions too. You likely want to know how I work, whether I have worked with clinical presentations like yours, and what to expect going forward. This is you deciding whether I am the right fit, not only me getting to know you. For therapy to work well, it has to be a mutual fit.
What it is not
Sessions with me are not a stranger nodding silently while you fill the air. I don’t want to bulldoze you, and the most important voice in the room is yours, but I am not here to silently nod at you and send you on your way. I am direct, and I talk. You will not be left doing the entire conversation by yourself.
It is not a lifetime commitment that you sign in the first 45 minutes with me. A first session is a starting point. If it turns out we are not the right match, that is genuinely useful information, and a good therapist would rather help you find the right fit than keep you out of politeness.
And it is not the session where you are expected to pry open the hardest thing you carry; that takes time. We will likely touch on that thing as it probably brought you to the session, but we will not open up the wound and clear it out so quickly. We move at a pace that is actually doable, not always entirely comfortable but within the bounds of what you can handle. Trust comes before the deepest material, and that order is on purpose.
The practical part, since that is part of the nerves
Sessions are virtual, so you will be somewhere private and comfortable of your choosing rather than a waiting room. I send the intake paperwork ahead of time, so the first session is for talking, not forms. I will review the forms and use them to help guide our intake, asking for more information on what you provided. Early on, we get clear on what you want to work on and roughly how we will get there, because I do not do therapy that drifts for months without a point. You should leave that first session with some sense of direction, even if it is early and rough.
You do not need to prepare anything to impress me. If it helps to jot down the two or three things most on your mind beforehand, go for it, but that is for you, not a requirement for me. I am running the session to help you feel comfortable and ease you into what it is like to work with me.
If you have been putting off booking
If the mystery of that first session has been part of what is stopping you, I hope this shrinks the fear of the unknown at least a little. The hardest part is almost always deciding to book, not the session itself. Once people are actually in it, most are surprised by how ordinary and how comfortable it feels.
If you would rather get a sense of whether we are a fit before committing to a full session, that is exactly what a short consultation is for. You can see what I am like and how we interact without commitment to future sessions.