First Therapy Session Questions: What to Say and How to Prepare for First Therapy Session

What to Expect and How to Prepare For Your First Therapy Session In Chicago or Online

You have decided that you are motivated and interested in starting therapy. You have done the work to find a therapist who might be a good fit; you have had a consultation that answered your questions, and you have scheduled that first session. 

If it has been a while since you have been in therapy, or if the process is entirely new to you, you might be wondering what you should expect from your first therapy session.

First Therapy Session Questions

In-Office versus Telehealth: How to Get to Your First Therapy Session?

If you will be meeting your therapist in an office setting, your therapist may have provided you with information about the office location, public transportation, parking, and how to find the office space. They may have a waiting room where you sit until they come to get you; they may have an alert system where you flip a switch or press a button to notify them that you are there, or they may have a staffed desk where you check-in. In some cases, the therapist may require that you text them to notify them of your arrival, or they may need to buzz you into a building or provide you with a code for entry. You might want to ask the therapist about what to expect for that first session so that you know the protocol.

If you will be meeting with your therapist online, the therapist will likely send you some instructions about how to access your telehealth session. In many cases, this may be as simple as clicking through a link that is sent to you by your therapist. Sometimes, you may need to install an app or download software to allow you to access your telehealth session, especially if you are accessing your appointment from a smartphone or tablet. 

What to Expect When You Arrive at Your First Therapy Session in Chicago or First Therapy Session Online?

If you will be using telehealth for your sessions, you may want to give yourself a little extra time before the first appointment to make sure that you have received the link or other information to access your appointment and that you have download any apps or software that might be necessary to log into the session from your device. 

Many online platforms will have a “waiting room” screen that you will see while you wait for the therapist to join you or to “let you in” to the online therapy session at the time of your session. If you are struggling for any reason to access your appointment online, it is a good idea to reach out to the therapist or office through whatever contact information has been provided to indicate that you need some help to get into the appointment. Since the therapist has reserved the session time for you, it is likely that they will be on-hand and available to support you in troubleshooting, or that someone in their office can help you to get where you need to go online for your session.

If you are meeting your therapist at their office, you want to allow yourself time to get there on time for your appointment so that you aren’t feeling rushed or stressed. In many cases, your therapist may have provided you with paperwork to complete online in advance of the appointment, but sometimes your therapist might ask you to come early to that first appointment to complete the necessary paperwork in the office prior to the start of your first appointment. 

How to Prepare for Therapy Session?

Whether you are working through paperwork or not, you may want to prepare yourself to sit for a bit in a waiting area until your therapist is ready to start your appointment. If you tend to be anxious or uncomfortable in unfamiliar environments or situations, you might want to bring something calming or distracting to occupy you while you wait. Some offices might have a beverage or a snack station where you can grab water, coffee, a cup of tea, or something to nibble on before your appointment.

If you are connecting to your session via telehealth from work, home, or elsewhere you may already be in a familiar and comfortable environment as you await your session. Regardless of the setting where you will have your session, many people find that it is helpful to try to take a few minutes to settle themselves and think about what they want to ask or share with the counselor in this first meeting. 

First Therapy Session: Questions to Expect and Initial Therapy Session Questions to Ask

Once your first session begins, the therapist will likely take a little time to review the practice policies, the rules for confidentiality, and other key points of information to make sure that you understand. You should be provided with an opportunity to ask questions that you might have. It is okay if you can’t think of anything to ask; you can always ask the therapist questions later. It is also alright if you have questions for the counselor. They want to provide you with the information that you need to make an informed choice to engage in therapy with them and to feel comfortable doing so. 

Many clinicians will use the first session as an opportunity to get to know you; understand the nature and extent of your problem, and determine how they think that they can help you move toward your therapeutic goals. They will likely ask questions about what has motivated you to seek out therapy at this time and what the challenges are that you hope to address through therapy. You will probably be asked more questions to help the therapist better understand the extent of the problem or problems, the history of the issues, how they are affecting your life, and what you have already attempted to try to address the situation, including other experiences with therapy. You might be asked about how you would know when the problem has been solved, and what your hopes or goals are for therapy. 

In addition to gathering information about the problem that motivated you to seek out therapy, your therapist will also likely ask questions about your life and history that may not be directly related to the reason that you sought out therapy, but are an important part of a comprehensive initial assessment. You may be asked questions about your family, childhood, school, work, and relationship history; questions about experiences and lifestyle habits including sleeping, eating, physical activity, healthy and unhealthy coping behaviors, substance use, or leisure activities; information about relationships or sources of support; personal and family history of significant medical or mental health struggles; and other questions to help the therapist begin to get a better understanding of you. 

You will also want to make sure that you take an opportunity in the initial therapy session to ask all of your first therapy session questions that may not have been addressed during the consultation call; or that came to mind while completing the first session paperwork. The end of the first session is also a good opportunity to ask questions about the therapist’s treatment recommendations or how they think that they will approach treatment with you to help you achieve your therapeutic goals now that they have had an opportunity to learn more about you.

First Therapy Session Anxiety and What to Say in First Therapy Session

Some people come to that first session really ready to get support with their struggles. They may find it easy to talk at length about what has been going on for them and why they have sought help from the therapist. These individuals might feel an immediate level of comfort with their therapist or are very familiar with how therapy works, and they dive right in. 

For other people, it can be hard to know what to say in your first therapy session. It may feel a bit awkward or uncomfortable sharing a lot of personal information with someone who is essentially a stranger. You may have anxiety about what to say and what not to share. It is helpful to be honest and open with your therapist so that they can more effectively support you in addressing the issues that have brought you to therapy. It is okay if you don’t feel ready or able to share everything that is important for your therapist to know in that very first session, or if there isn’t time to talk about everything in that first session. It can take some time to develop a trusting relationship with your therapist and feel ready to dig into deeper areas of your struggles.

How to End the First Therapy Session and Next Steps?

As the first session draws to a close, the therapist may offer feedback about their thoughts for moving forward. They may discuss the frequency of sessions that they would recommend; clarify the treatment goals as they understand them, and share their thoughts about how they plan to address those goals therapeutically. 

If the therapist offers feedback about treatment goals and a plan to schedule additional appointments, they will likely ask you about your thoughts and confirm scheduling for future meetings. If you ended the first session with reservations about continuing for any reason, that is okay. You should not feel any pressure to schedule future appointments with them. If however, you are comfortable with scheduling another session with the therapist, that is a great next step.

In some cases, the clinician may conclude the first session by making a referral suggestion to a different provider or a different level of care if they believe that your needs are outside of the scope of their clinical practice or expertise. For some people, being offered referral suggestions can feel like a rejection, and it can be disappointing after the efforts of getting to and through the first session. This disappointment is understandable.

It may help to consider that the clinician has used the time to more fully explore your treatment needs, and they are offering their professional opinion about the appropriate treatment to more effectively help you achieve your goals. Therapists are ethically required to work within the boundaries of their training and expertise, and a therapist would ultimately be doing you a disservice if they did not refer you to other providers in circumstances where they did not think that they were qualified or able to meet your needs for support.

Taking Time to Reflect and How Will You Feel After Your First Therapy Session?

The first therapy session often covers a lot of ground and it may stir up memories and emotions that take a little time to settle. You may want to plan to have time to decompress or take it easier for a while following your first therapy session. It is also a good idea to reflect on how you felt in the first session overall, and with the therapist, to determine your comfort with their therapy process, treatment plan, and with them. 

Comfort and Honesty When Starting Therapy: When to Lean in and When to Find a New Therapist?

It is natural to have the therapeutic relationship take time to develop, and it may be a while before you feel comfortable being fully open and honest with your therapist about your most personal thoughts and experiences. It is worth noting however that any therapist, even the very best therapist, will likely be limited in their ability to help you with your concerns if you are uncomfortable, unable, or unwilling to share honestly with them. Additionally, being dishonest with a therapist about factors that may be related to your reasons for seeking treatment, can significantly compromise progress toward your treatment goals.

If you feel reluctant to talk honestly with a therapist because you don’t “click” with them or you expect that they won’t understand, it might be worth giving it a try with a smaller vulnerable disclosure and see how they respond. You might also consider talking with the therapist about your struggles to share. Therapists are trained professionals, and you may be surprised by feeling understood and supported in ways that you haven’t been in other relationships in the past. Being open with your therapist in your initial sessions and seeing how they respond can help to facilitate the development of a trusting and connected therapeutic relationship, and enhance the effectiveness of your therapy.

If however, the therapist does not seem like a good fit for you or you just do not feel comfortable being open and honest with them after the first session or the first few sessions, it may be time to explore other therapists to find someone with whom you feel a stronger connection so that you can be helped more effectively. The function of therapy is to help you address the areas of your life that you are struggling with and to help you feel better. Your first therapy session is a significant step in that direction even if you ultimately end up working with a different therapist.

Knowing What to Expect from Your First Therapy Session and Moving Forward With Confidence 

I hope that you have found answers to many of your first therapy session questions and feel prepared for a successful first therapy session in Chicago, along the North Shore, or online via telehealth. If you have any more questions about what to expect in the first session or if you would like to discuss whether I might be a good fit to help you achieve your goals for therapy, contact me for a free 15-minute phone consultation. If I am not the right therapist for you, I will do my best to point you in a helpful direction. 

If you are looking for help with parent burnout or caregiver burnout; affirming therapy for LGBTQIA+, culturally diverse, neurodivergent, and other marginalized individuals; stress and anxiety; trauma and PTSD; Eye Movement Desensitization and Reprocessing (EMDR); therapy online in many states across the U.S., in Chicago, or along the North Shore, you can read more about how I can help here.