Welcome back to my series “New to therapy”! You’ve made it through all the steps to get an appointment scheduled, and now you’re anxiously awaiting the first session with a new therapist. Maybe you’re even wondering what the heck you should be expecting. Today, we’re going to give you a glance into the mind of a therapist, and an idea of what to expect from your first session together.

A brief aside before we begin-I will discuss what I have experienced in the first session as the therapist, and while I will do my best to give an inclusive overview, I may miss something. This post will look mostly at the first session in an out-patient private practice setting, as that is what I know. Please be aware that other types of treatment (inpatient, partial hospitalization, intensive outpatient, etc.) might have a totally different first session than what will be described below. Now, we can get started.

As a therapist, I usually think of the first session as a “getting to know you” session. My main goal here is to make sure I know what you’re looking for in therapy and ensuring that I can provide it. The first session is also used to gather information and begin creating a collaborative plan forward. Prior to the initial session with a client, I have them complete paperwork, one part of which is an “intake questionnaire”. This helps me, as the clinician, get a very brief idea of what I’m working with and how to start. It also lets me know if there are any specific areas where I need to ask specific questions. The intake paperwork can help me answer the basic questions, such as:  How well is the client functioning? What symptoms are bothering them specifically. How do they describe the issue that is bringing to them therapy? Does the client have a mental health diagnosis, and are they taking medications for this diagnosis? These questions help me tailor the focus of the first session and gives me some good insight into how to best help the client.

I will usually start my initial session with a client by discussing the paperwork with the client. I’ll ask if the client had any questions or concerns, discuss the key points (confidentiality, being a supervisee, etc.). From there, I may mention certain answers from the paperwork that I want to discuss. For example, I may ask a client who has previously been to therapy to discuss what they received treatment for, was it different than what they’re seeking treatment for now? Also checking in to see if there was anything a previous therapist did that the client really enjoyed (or really didn’t enjoy). I will also ask clarifying questions about symptom frequency or duration. This could look like- “When you say you have panic attacks ‘a lot’, what does that mean? How many do you have in a week? How long do they typically last?”. From there, we work to get to know each other. Clients may ask if I have a theoretical framework, or if I have experience in their specific area.

In the end, the first session is nothing to be afraid of. I know that anxiety is not so easily swayed but I hope the information I’ve provided has left you feeling confident you can handle whatever comes your way. If you have any specific questions or want more information, please feel free to email me and ask. As always, we wish you the best on your new journey to feeling better and are so happy to have you here!


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