Navigating Your First Therapy Session: 5 Key Elements Explained

For many people, meeting for the first time with a new therapist can seem overwhelming. It's normal and understandable to feel nervous...but you have a voice inside that's calling you to be brave and keep going, you're on the right track! Discomfort is a necessary ingredient to growth and positive change.

By sharing 5 key elements of the first therapy session, I hope first-time clients know what to expect and feel more at ease navigating the process. I promise, your first meeting with a therapist can provide a sense of immediate relief and hope as you embark on this journey. Therapists are prepared for clients to feel hesitant, and will do their best to help you settle in and feel more comfortable.

1. Introductions

I like to start by briefly introducing myself and sharing a bit of my background. I do this so we begin to build some rapport and mutual understanding of each other. I also do this to take the pressure off the client to speak first and give you some time to get comfortable. For example, I share that I came to this job as a second career and my authentic passion, as well as some details about my personal life and interests. 

I also share that my approach is grounded in Cognitive Behavioral Therapy and what that means. But depending on the issues and goals we identify, I will tailor my approach to draw from an eclectic mix of evidence-based treatments that are most effective for your unique needs.

2. Setting the Agenda

Next, I give an overview of how I generally structure the first few sessions and ask if the client agrees or would like to add anything. Typically the agenda includes:

• Identifying and discussing your current concerns

• "Assessment" questions to get a broader picture of your background, life progression, relationships and development

• Begin discussing goals and objectives of working together, and this all will likely continue into the next session (if you decide to move forward)

3. What's bringing you to therapy now?

At this point, I'm eager to understand and help you articulate why you're coming here at this time. I will actively listen and reflect what I hear back to you to ensure you feel seen and understood.

Things we might discuss include:

• What's concerning you?

• What are some symptoms you're experiencing that you'd like to see improve?

• Have you ever done therapy before? If so, what worked well for you and what do you wish was different? This helps me to tailor an approach based on any preferences or skills that are already working for you!

• What's a typical day in your life like?

• How would you know if therapy is helping you, what would be different and what changes might you see?

This is a helpful way to think about goal setting. And ultimately, I want clients to recognize their tangible progress along the journey. It's important for us to know that what we're doing together is helpful!

4. Reflections and Next Steps

I will ask the client for any thoughts on the first session and how they're feeling thus far. If we have done nothing else, I want a client to experience a sense of being seen, heard and understood. This is at the heart of what makes a therapist and client a good fit. If we can achieve that, then many other things will fall into place.

I recommend you head home and take time to reflect on whether you'd like to move forward, and if so, I usually recommend a cadence that we will meet, and a potential time for our next visit, but with the understanding that you are the decision maker.

5. Building on your Strengths

Last but not least, you will leave with something new in your toolkit. I strongly believe most people walk away from their first session with renewed hope and confidence about feeling better. No matter what things may be overwhelming in day to day life, therapy provides a set time and space to unpack and feel relief. Every client has unique strengths and tools, and together we will keep adding to your toolkit. Believe it or not, I have some great ideas that can be implemented right away after a first session and I will make sure you leave feeling ready to use them!

I hope this overview provides you with some peace of mind about starting therapy. You can trust your inner voice knowing that you can and will move beyond feeling stuck. Together, we will unlock your unique strengths and potential on your journey toward growth and healing!