What to Expect in Your First Therapy Session

Hello there and Welcome Back to The Therapist Diaries! 

So, you’ve made the leap and booked a therapy session. Whether it’s your very first time in therapy or you’re trying again with a new therapist, that first meeting can bring up a lot of feelings—nervousness, curiosity, hope, or maybe even a bit of dread. All of it is valid.

A question people often ask is: What actually happens in the first session? The truth is, there’s no one-size-fits-all answer. Every therapist has their own approach, depending on their training and modality. But no matter the method—CBT, psychodynamic, somatic work, EMDR, or something else entirely—there’s one central goal in that initial hour: to begin building a relationship.

Getting to Know You (and Letting You Know Them)

Think of the first session less as a deep dive into your biggest trauma and more like the first chapter of a book. The therapist is starting to get a sense of your story—where you’ve been, what’s bringing you in, and what you hope to find. You might talk about current stressors, symptoms you’re dealing with, and a little about your past. Some therapists take a structured approach, asking lots of questions; others might lean into a more open, conversational flow. Both are valid. There’s no “right” way to show up.

Your therapist will usually explain things like confidentiality (and its limits), their style of working, and what to expect moving forward. You might get asked about your mental health history, family, work, relationships, or even how you typically handle stress. If something feels too personal or sudden, it’s okay to say, “I’m not ready to talk about that yet.” This is your space.

What If I Don’t Know My Goals?

Here’s something most people don’t realize: You don’t have to walk in with perfect clarity about what you want from therapy. 

Many people come in saying things like, “I don’t know, I just feel off,” or “I’m tired all the time,” or “I keep ending up in the same kind of relationship.” That’s enough to start. Together, you and your therapist will begin to connect the dots. Therapy is about discovering—not performing.

Even if you come in with specific goals—like managing panic attacks or setting boundaries—you might find that those goals shift over time. That’s not a failure; it’s growth.

Maybe therapy starts as a space to deal with anxiety, but you begin to realize there are deep-rooted patterns from childhood you want to explore. Or maybe you thought you needed help with your relationship, but end up discovering you’ve never really had a space to know yourself. That evolution is natural—and it’s actually one of the most beautiful things about the process.

The Fit Goes Both Ways

The first session is also a time to get a feel for your therapist. Do you feel heard? Respected? Do they explain things in a way that makes sense to you? You don’t have to know right away if it’s the perfect match but trust your gut. You’re allowed to take your time.

And don’t be afraid to ask questions. You might say:

• “What’s your style or approach to therapy?”

• “What does progress usually look like in your experience?”

• “How do you usually work with someone dealing with [insert concern]?”

• “What happens if my goals change over time?”

Any good therapist will welcome these questions. You’re allowed to be curious—this is a collaborative relationship, not a lecture.

After the Session

You might walk away feeling relieved, or a little raw. You might even feel unsure. That’s okay. Therapy isn’t magic—it’s a process. Sometimes the hardest part is just showing up that first time, especially when you’re used to handling everything on your own. So if you did that? That’s a big deal.

You won’t solve everything in the first session. You’re not supposed to. But if you leave feeling even a tiny bit more hopeful, a little more seen, or a little less alone—that’s a strong start.

Final Thoughts

Your therapy journey won’t be a straight line, and that’s the point. Let your goals grow with you. Let yourself take up space without knowing exactly where it’s all going yet. That’s brave. That’s healing.

And no matter what, remember: therapy doesn’t require you to have it all together. It only asks that you come as you are.

Until next time—be kind to your mind.

—The Therapist Diaries

*** For professional inquiries please reach out to georgina.m.lloyd@outlook.com