How Therapy Works: What to Expect in Your First Session

Starting Therapy Can Feel Uncertain—Here’s What to Expect

Taking the first step toward therapy is a big decision. For many, it comes with a mix of emotions—hope, uncertainty, and even a little nervousness. It’s common to wonder:

• What do I even talk about in my first session?

• Will I have to share everything right away?

• What if I don’t know what I need from therapy yet?

Understanding what happens in a first session can make the process feel more approachable and help set expectations. Therapy isn’t about having all the answers—it’s about creating a space where you can explore your thoughts, challenges, and goals with support.

Step 1: The First Few Minutes—Getting Comfortable

The first session typically begins with a simple introduction. This is a chance for you and your therapist to get to know each other and establish a foundation of trust.

·      Confidentiality & Paperwork: Your therapist will review privacy policies, your rights as a client, and the ethical guidelines they follow.

·      Setting the Stage: Some therapists may ask broad questions like, “What brings you here today?” while others might take a more structured approach to explore your background and current challenges.

·      No Pressure to Share Everything: It’s okay if you’re unsure where to start. Therapy is a collaborative process, and the conversation will unfold naturally.

Some people find that once they begin talking, their concerns become clearer. Others may take a few sessions before feeling comfortable opening up—and that’s completely normal.

Step 2: Exploring What Brought You to Therapy

Every individual comes to therapy for different reasons. Some have a specific concern they want to address, while others may be navigating a general sense of stress, overwhelm, or uncertainty.

During the first session, your therapist might ask:

• “What made you decide to explore therapy now?”

• “Have you had therapy before? If so, what was helpful—or not?”

• “What are some of the challenges you’re currently facing?”

You don’t need to have clear answers or well-defined goals at this stage. Many people start therapy feeling unsure about what they need—part of the process is gaining clarity over time.

Step 3: Addressing Common Concerns About Therapy

It’s natural to have questions about how therapy works. Many first-time clients wonder:

• What if I don’t know what to say? → That’s okay. A therapist’s role is to guide the conversation in a way that feels comfortable and supportive.

• Will I have to talk about my past? → Only if it’s relevant to your goals. Therapy is about the present just as much as the past.

• What if I feel emotional or overwhelmed? → Emotions are a natural part of therapy, and your therapist is trained to support you through them.

Therapy is a space for self-exploration at a pace that feels right for you.

Step 4: The First Session Wrap-Up

Toward the end of the session, your therapist may check in with questions like:

·      “How are you feeling after this conversation?”

·      “Does this approach feel like a good fit for you?”

·      “Would you like to schedule a follow-up session?”

Some people leave their first session feeling lighter, while others may feel like they’re only beginning to unpack what brought them in. Both experiences are completely valid. Therapy is a process, not a quick fix.

Therapy is About Progress, Not Perfection

There’s no “right” way to start therapy. Some people come in with a clear issue they want to address, while others are simply looking for guidance. The most important step is showing up.

If you’ve been considering therapy but feel uncertain about what to expect, know that it’s okay to start where you are. There’s no rush, no pressure—just a space for you to explore, reflect, and grow.

Considering therapy?

Book a consultation today to learn how Lodestone Psychology can support you.