What Will My Therapist Ask Me In Our First Session?

You’ve found a therapist. You’ve had a phone consultation. Your first appointment is on the calendar. But what is your therapist going to ask you during your first session?

There can be a lot of anxiety around that first therapy appointment, and that makes total sense. You’re embarking on a new journey, sharing your innermost thoughts and feelings with a total stranger, and, if this is your first time working with the therapist, it might all be new to you.

We want you to be as prepared as possible going into your first therapy appointment so you can focus less and on the stress and more on getting the care you deserve! Here are a few things your therapist might ask you during your first appointment.

First, remember to take advantage of that initial phone consultation with your therapist

To help ease the process of connecting with a therapist you trust, at MyWellbeing, we work with therapists who offer free phone consultations before your first in-person appointment. This phone consultation typically lasts about fifteen minutes and gives you and the therapist the chance to briefly connect before an actual session. When you find any therapist, be sure to see if they offer a free phone consultation to gauge fit before investing time, energy, and money into your first appointment.

It can be helpful to think of a few things ahead of your phone consultation, such as:

• What are my goals in therapy? Whatever your goals are: communicate them to your therapist!
• If you’ve been in therapy before, what worked with the last therapist? Consider what you enjoyed about whoever previously helped you. Did they validate your struggle? Did they teach you skills to combat your stress and anxiety? Were they relatable? Did they share their observations?
• What didn’t work the last time you saw a therapist? It’s critical to acknowledge what didn’t work during past therapy experiences if you have that info to work with.

If you’ve never seen a therapist before, that’s totally fine! Focus on your goals and what you’re looking to get out of working with your therapist and go from there. Once you actually get the therapist on the phone, a few questions you could ask in your phone consultation are:

• What might an average session look like?
• How active are you in the therapy? Do you expect me to primarily lead or do you guide me?
• What is your training?
• Have you ever worked with someone who [has your particular obstacle or issue area]?

You can also share why you’re interested in beginning therapy, your previous experience with therapy, if any, anything you’re hoping to work on, and logistics such as the therapist’s fee and whether they offer a sliding scale, their cancellation policy, whether they partner with other professionals like psychiatrists or nutritionists, how they accept payment, and what interactions look like between sessions, including whether you are able to text or email your therapist in between appointments.

Also consider whether or not you’re open to taking medications (although you don’t have to decide now). If you’re seeing a psychiatrist (an M.D. or D.O. who specializes in mental health) or a nurse practitioner, that’s an option; psychologists, counselors, and social workers can’t prescribe, but may refer you if that’s a recommended part of your treatment.

Once you’ve discussed fit and logistics, you might be ready to go!

So once you book your first appointment, what can you expect from your first full session?

The first therapy session is similar to the first time that you meet anyone new. Even though you had your phone consultation, you’ll most likely spend the first part of your therapy session getting to know one another even more.

While your therapist will have questions for you in order to get a fuller understanding of your experience and goals for therapy, they’re not going to dive right into the tough questions straight away. They want you to feel comfortable being open and honest with them, so they’ll ease you into the conversation before you move on to more complicated topics.

Before you pour your heart out, your therapist is going to want to get a good understanding of who you are and your history. This could include things like information about your family, relationships, friends, education, and employment history. They might also ask you about your behaviors, feelings, and current coping strategies.

Information about your childhood, beliefs, and upbringing can help inform them about how your past has shaped you. They’ll also want to get a better picture of your personality and thought processes, as all of this information will give them context regarding the issues you’re bringing to your sessions.

Here are a few questions your therapist might ask in your first therapy session, if they haven’t already addressed them in the phone consultation:

• Have you attended therapy in the past?
• What are your symptoms?
• Do you have a family history of mental health struggles?
• How is your home life and work life?
• Do you have a history of self-harm or suicidal ideation?
• What do you hope to get from therapy?
• What do you want to accomplish in your sessions?
• How have you been coping with the problem(s) that brought you to therapy?
• How are your relationships or how connected do you feel to the people in your life?

Above all, your therapist will want to gain clarity around why you’re seeking therapy and what your goals are (and it’s fine if you don’t have a solid answer for this yet!). They might use a structured interview or a more free-flowing conversation; it all depends on their style and what messages they’re picking up from you.

If you have a problem that you’re ready and willing to state right off the bat, they might ask how long you’ve been experiencing it, what you’ve done to try to cope, what the underlying cause might be, how often it occurs and at what level of severity, and if you remember what your life was like before this problem began.

While the first visit might feel more like a meet-and-greet, future visits will be more therapeutic in nature. In following sessions, you and your therapist might dig a little deeper and begin to explore a specific problem, symptom, or trauma you mentioned in the first appointment.

Although therapy is hard work, you should feel safe, respected, accepted, and respected. If you ever feel like you don’t want to answer a question or discuss a topic quite yet, just say so. You can still use your first few sessions to assess whether or not the therapist you chose feels like a good fit. And feel free to keep asking your therapist questions during your first session and any subsequent sessions.

How much do I have to share in therapy?

Again, what you share is up to you, and you should feel no pressure to share or address a topic before you’re ready. Communicate your needs to your therapist as best you can so they’re able to support you, and don’t be afraid to disagree with your therapist or give them feedback about your experience. It can feel uncomfortable at first, but therapy is your space for you.

It’s totally understandable that you may need more time before diving into personal issues or past trauma, so take things slow if that feels right to you. At the same time, every session doesn’t have to be groundbreaking. Even if you feel like you have nothing to talk about at first, if you stay open minded, you and your therapist will have the opportunity to talk about whatever is going on in your life and you might find out that you end up breaking a little ground after all.

Don’t worry if the first therapy session feels slow

Your first therapy appointment is more about getting to know your therapist, letting them get to know you, and giving them the background they need to help you on your therapy journey. If you’re starting therapy hoping for breakthroughs in the first session or a quick fix, you might find out that things move a little slower than you had anticipated. You’ll have plenty of time to go deeper in your therapy sessions, so don’t give up! This is simply part of the therapy journey.

The relationship between you and your therapist is probably the most important aspect of therapy, and an open and trusting relationship takes time to develop. It’ll also take a few sessions for your therapist to know you well enough to know what to ask you, what you need, and how to interpret your words, actions, and reactions.

We often suggest that, if you and your therapist are indeed a good fit, you try therapy for at least six months. The further along you get, the more breakthroughs you’ll have. If you’ve been attending appointments for a few months with no improvement, have an honest conversation with your therapist about your concerns and work together to see if there’s another way forward.

Above all, therapy is about you and your needs

At the end of your first session, your therapist will likely review what you discussed, offer some of their thoughts, and share a plan for how you might work together. A diagnosis can take a few visits, but your therapist should at the very least share what they suggest you work on and how you might do it, including possible techniques or methods, how long it could take (although they’re not always going to have an answer to this), and whether they have any homework or activities for you in between sessions.

Your therapist should make you feel safe, heard and acknowledged. They’re there to meet you where you are. Remember that your therapist should never criticize you or make you feel judged for what you feel, think, say, or anything you have experienced. And if you decide that your first therapist isn’t a great fit, that’s okay, too. It may take a little time to find a therapist who’s the right match for you.

If you’re still wondering whether therapy is right for you, here are a few ways to help you find out, and if you’re already ready to go, we can help you make a plan to start therapy. Wherever you are in your therapy journey, we’re here for you—and your therapist will be, too.