What to Expect in Your First Therapy Session: A Complete Guide
You've finally done it. You've booked your first therapy session.
Maybe you're relieved. Maybe you're nervous. Maybe you're wondering what on earth you're supposed to say or do.
All of these feelings are completely normal.
As a psychotherapist in Elsternwick and Malvern East, I know that first session anxiety is real. You're about to sit with a stranger and talk about your most vulnerable experiences. Of course you're nervous.
But here's what I want you to know: your therapist understands this. We expect first-session nerves. We've seen it hundreds of times. And we know how to help you feel comfortable.
Let me walk you through exactly what happens in a first therapy session so you know what to expect—and can show up feeling prepared instead of panicked.
Before Your First Session: How to Prepare
You Don't Need to Prepare Much (Really)
First, let go of the pressure to have everything figured out. You don't need to:
Write out your entire life story
Have a clear agenda or list of topics
Know exactly why you're struggling
Be able to articulate everything perfectly
Have all your thoughts organised
Your therapist will guide the conversation. That's literally our job.
What You CAN Do (If It Helps You Feel Better)
Jot down a few notes:
What's been bothering you most lately?
What made you decide to book therapy now?
Any major life events or changes recently?
What you're hoping therapy might help with
Consider practical questions you want to ask:
How does therapy actually work?
How often should we meet?
What's your approach?
What if we're not a good fit?
Arrive a few minutes early (or log on early for telehealth) so you're not rushed or flustered.
Remember: There's no "right" way to prepare. Showing up is the important part.
What Actually Happens in a First Therapy Session
The Welcome and Settling In (5-10 minutes)
What your therapist is doing: Creating a comfortable, safe environment. Explaining confidentiality and what to expect. Making small talk to help you relax.
What you might feel: Nervous. Awkward. Maybe wondering if you should just leave. This is normal. Give it a few minutes.
What to expect: Your therapist will likely explain:
How long sessions are (usually 60 minutes)
Confidentiality and its limits
Their cancellation policy
How therapy typically works
That you can ask questions anytime
Exploring What Brings You to Therapy (20-30 minutes)
What your therapist will ask:
"What brings you to therapy?"
"What's been going on for you?"
"When did you start noticing these difficulties?"
"What made you decide to reach out now?"
“Do you have goals for therapy?”
What they're actually doing: Understanding your current struggles, gathering information about your life, and starting to get to know you as a person—not just a set of symptoms.
You might discuss:
Current symptoms or struggles
How long you've been dealing with this
What's worked or hasn't worked in the past
Your support system
Major life events or stressors
Your daily functioning
What you've tried so far
What you DON'T have to do:
Share everything in the first session
Talk about anything you're not ready to discuss
Have perfect answers
Know exactly what's wrong
It's okay to say:
"I don't know"
"I'm not sure how to explain this"
"Can we come back to that?"
"I'm not ready to talk about that yet"
Background and History (10-15 minutes)
What your therapist will ask about:
Family background (briefly)
Relationship history
Work or school situation
Previous therapy experiences
Mental health history
Medical history if relevant
Current medications
Substance use
Why they're asking: To understand context. Your current struggles didn't appear in a vacuum—understanding your background helps your therapist support you better.
Important: You control how much detail you share. "I had a difficult childhood" is a complete answer if that's all you want to say right now.
Goal Setting and Next Steps (5-10 minutes)
What your therapist will ask:
"What would you like to work on?"
"If therapy goes well, what would be different?"
"What does 'better' look like for you?"
What they're doing: Collaboratively setting direction for your work together. Good therapy has goals—even if those goals evolve.
You might also discuss:
How often you'll meet (usually weekly to start)
What approach or techniques might be helpful
What to expect in ongoing sessions
Any immediate coping strategies or tools
When you'll meet next
Closing and Check-In (5 minutes)
Your therapist will likely ask:
"How did today feel for you?"
"Do you have any questions?"
"Does this feel like a good fit?"
This is your chance to:
Share how the session felt
Ask anything you've been wondering
Voice any concerns
Clarify anything confusing
And then you're done! You made it through your first session.
What First Sessions Feel Like (The Real, Honest Truth)
For Most People, First Sessions Are:
Awkward:
You're talking to a stranger about personal things. Of course it's awkward. This gets SO much easier after session 2-3.
Exhausting:
Emotional work is tiring. Talking about difficult things drains your energy. Plan to rest afterward.
Vulnerable:
Opening up feels scary. You might cry. You might feel exposed. Your therapist expects this and won't judge you.
Somewhat surface-level:
You're both still getting to know each other. Deep work happens later, once trust is built.
A mix of relief and anxiety:
Relief that you finally started. Anxiety about whether you said the "right" things or if this will actually help.
You Might Feel:
During the session:
Nervous or shaky
Emotional (tears are totally normal and expected)
Like you're rambling or not making sense
Uncertain if you're doing it "right"
Surprisingly comfortable (sometimes it just clicks!)
After the session:
Exhausted
Raw or tender
Worried about what you shared
Hopeful
Skeptical
All of the above
All normal. Every single feeling is valid.
Common First Session Worries (And the Reality)
"What if I cry?"
The worry: You'll look weak, dramatic, or out of control.
The reality: Therapists see tears constantly. Crying means you're human and feeling things. We have tissues. We're not judging. Cry all you need.
"What if I don't know what to say?"
The worry: You'll sit there in awkward silence with nothing to talk about.
The reality: Your therapist will ask questions and guide the conversation. Silence is okay too—sometimes that's when important things surface.
"What if they think my problems aren't serious enough?"
The worry: They'll think you're wasting their time or being dramatic.
The reality: If you're struggling, it's serious enough. Good therapists never minimize your experience. You deserve support regardless of how "bad" you think it is.
"What if I don't like them or they don't like me?"
The worry: You won't connect and you'll have wasted time and money.
The reality: Fit matters! If you don't connect with a therapist, that's valuable information. You can try someone else. It's not a failure—it's about finding the right match.
"What if they judge me?"
The worry: They'll think you're broken, damaged, or beyond help.
The reality: Professional therapists are trained to be non-judgmental. We've heard it all. Nothing you say will shock us. Our job is to understand and support, not judge.
"What if I'm too much or too boring?"
The worry: You'll overwhelm them with problems or bore them with mundane issues.
The reality: You're not too much. You're not too boring. Therapists choose this work because we care about people's real, messy, complicated experiences.
What Your Therapist Is Actually Thinking
Spoiler: They're not judging you. Here's what they're probably thinking:
"I hope they feel comfortable"
We want you to feel safe. We're actively working to create a welcoming space.
"I wonder what they're most worried about"
We're thinking about how to help you feel at ease and what might be underneath your concerns.
"How can I help this person?"
We're already thinking about approaches, strategies, and what might support you.
"They're being really brave"
We recognize how hard it is to start therapy. We respect your courage.
"I hope they come back"
We know first sessions are awkward. We hope you'll give it a few more sessions to see if we're a good fit.
Questions You Can (And Should) Ask Your Therapist
Don't be afraid to ask questions! Here are good ones:
About their approach:
"What's your therapeutic approach?"
"How do you typically work with [your issue]?"
"What can I expect from our sessions?"
About logistics:
"How often should we meet?"
"How long might therapy take?"
"What happens if I need to cancel?"
"Can I contact you between sessions?"
About fit:
"Have you worked with people dealing with [your issue]?"
"What's your experience with [specific concern]?"
"What if I feel like we're not a good fit?"
About the process:
"What should I do between sessions?"
"How will we know if therapy is working?"
"Will you give me homework or exercises?"
Good therapists welcome questions. It shows you're engaged and thinking about your care.
Red Flags in a First Session
Most first sessions go well. But watch for these warning signs:
🚩 Therapist does all the talking (therapy should be about you, not them)
🚩 You feel judged or criticized (therapy should feel safe, not shameful)
🚩 They make promises or guarantees ("I'll cure you" is a red flag)
🚩 They push you to discuss trauma before you're ready (good therapists respect your pace)
🚩 Boundary violations (inappropriate questions, too much self-disclosure, anything that feels "off")
🚩 They dismiss your concerns ("that's not a big deal" or "you're overreacting")
🚩 They pressure you to book more sessions immediately (you should feel free to think about it)
Trust your gut. If something feels wrong, it probably is. You can try a different therapist.
After Your First Session: What to Do
Immediate Self-Care
Give yourself 30-60 minutes of buffer time after therapy if possible.
Don't rush straight back into demands
Do something gentle (walk, coffee, quiet time)
Hydrate and have a snack
Journal if it helps process
Rest if you feel drained
Reflect on the Experience
Ask yourself:
Did I feel heard and understood?
Did the therapist seem genuinely interested and caring?
Do I feel comfortable with this person?
Can I see myself opening up more over time?
Did they answer my questions satisfactorily?
Does their approach make sense for what I need?
Important: The first session doesn't have to be perfect. Give it 2-3 sessions before deciding if it's a good fit.
Decide About Next Steps
If it felt good: Book your next appointment before you leave (or immediately after telehealth sessions).
If you're unsure: That's normal! Most people need 2-3 sessions to know if a therapist is right for them. Give it another try.
If it felt wrong: Trust your instincts. Thank them for their time and try someone else. No explanation needed.
Between Sessions
Notice patterns in your daily life
Use any coping strategies discussed
Jot down anything you want to bring up next time
Be patient with yourself—change takes time
What Happens in Session 2 and Beyond
Good news: Session 2 is usually much easier.
Why?
You know what to expect now
The initial awkwardness is gone
You've established some rapport
You can dive a bit deeper
Sessions 2-5 typically involve:
Building on what you discussed in session 1
Going deeper into patterns and history
Developing coping strategies
Beginning to work on goals
Building trust and therapeutic relationship
By session 5-6, you're usually:
Feeling comfortable with your therapist
Doing deeper therapeutic work
Seeing some changes or insights
Developing momentum in therapy
Remember: Therapy is a process. Real change takes time. Trust the process.
Different Therapy Approaches and What to Expect
Depending on your therapist's style, first sessions might vary:
CBT (Cognitive Behavioral Therapy):
More structured, might include assessments or worksheets, focus on thoughts and behaviors.
Psychodynamic Therapy:
More exploratory, focus on patterns and past experiences, less structured.
ACT (Acceptance and Commitment Therapy):
Focus on values and acceptance, might discuss goals and what matters to you.
Person-Centered Therapy:
Very client-led, therapist follows your direction, warm and supportive.
Trauma-Focused Therapy:
Emphasizes safety and stabilization before processing trauma, may discuss grounding techniques.
As an integrative therapist, I combine approaches based on what YOU need. We'll figure out together what works best.
For Online/Telehealth First Sessions
If your first session is via telehealth, here are extra tips:
Tech setup:
Test your internet connection beforehand
Ensure your camera and microphone work
Have a backup plan (phone number) if tech fails
Use headphones for privacy and better sound
Environment:
Find a private, quiet space
Ensure you won't be interrupted
Have tissues, water, notepad nearby
Get comfortable—this is your space
Unique benefits of telehealth:
You're in your own comfortable environment
No travel time or stress
Can immediately rest after in your own space
Often easier to fit into busy schedules
Potential challenges:
Slightly harder to build rapport through a screen (but still very possible!)
Tech issues can be frustrating
Need to be more intentional about privacy
First Session Checklist
Before you go:
Confirm appointment time and location (or video link)
Arrive/log in 5-10 minutes early
Bring insurance information if applicable
Have payment method ready
Jot down any questions or topics
Give yourself buffer time after
During the session:
Be honest about how you're feeling
Ask questions when you have them
Say if something doesn't feel right
Remember: there's no "right" way to do this
After the session:
Book next appointment if it felt good
Practice self-care
Reflect on the experience
Be patient with yourself
The Most Important Thing to Remember
Your first therapy session doesn't have to be perfect.
You don't have to say the right things. You don't have to have everything figured out. You don't have to impress your therapist or "perform" mental health correctly.
You just have to show up and be honest about what you're experiencing.
That's it. That's enough.
The therapeutic relationship builds over time. Trust develops gradually. Change happens slowly.
Give yourself—and your therapist—a few sessions to settle in.
And remember: starting therapy is one of the bravest, most self-compassionate things you can do.
You're already doing the hard part just by showing up.
Ready to Book Your First Session?
I'm Indi Bruch, an integrative psychotherapist in Elsternwick and Malvern East (also offering telehealth across Australia). I create warm, non-judgmental spaces where you can be completely yourself.
What you can expect in your first session with me:
A welcoming, comfortable environment
No pressure to share more than you're ready for
Collaborative exploration of what brings you to therapy
Clear explanation of how we'll work together
Space for all your questions
Genuine care and attention
I specialize in:
Anxiety and depression
Relationship patterns and difficulties
Trauma and past experiences
Life transitions
Self-worth and identity
Perinatal mental health
Currently accepting new clients for in-person and telehealth sessions.
📧 Book your first session: www.indibruch.com.au
Free 15-minute consultations available if you want to chat before committing to a full session.
The hardest part is starting. But you're ready. Let's do this together.
FAQ: First Therapy Sessions
How long is a first therapy session?
Usually 50-60 minutes, same as regular sessions. Some therapists offer longer intake sessions (75-90 minutes).
Will I have to talk about my childhood?
Only if it's relevant and you're comfortable. You control what you share.
What if I don't want to answer a question?
Just say so! "I'm not comfortable discussing that right now" is always acceptable.
Should I bring anything?
Just yourself. Some people bring notes or questions, but it's not required.
How much does a first session cost?
This varies by therapist. Some charge the same as regular sessions, others charge more for intake. Ask when booking.
Can I bring someone with me?
Usually no—therapy is confidential and individual. But you can ask your therapist if there's a specific reason.
What if I'm too anxious to talk?
Tell your therapist! "I'm really nervous" is a great place to start. They'll help you feel more comfortable.
Do I have to commit to ongoing therapy after the first session?
No! You can try it out and decide afterward if it feels right.
Keywords: first therapy session, what to expect in therapy, starting therapy, first time therapy, therapy session, what happens in therapy, therapist Elsternwick, Malvern East therapist, online therapy first session, telehealth therapy, therapy for beginners, how therapy works, anxiety therapy, depression counselling, therapy near me
