Starting Psychotherapy: What Happens in the First Session

Therapist and client engage in a meaningful conversation during a therapy session, surrounded by calming plants and natural light.

Beginning therapy is a big step. If you’re feeling nervous about your first therapy session, you’re not alone. Many people delay reaching out for help because they aren’t sure what to expect. Knowing what will happen in that first appointment can make the process less intimidating and more approachable.

Preparing for Your First Therapy Session Before your session, you may be asked to fill out some basic intake forms. These forms usually cover your personal information, a brief health history, and what brought you to therapy. They help your therapist understand your background and start shaping a plan to support you.

It’s also helpful to reflect on what you’d like to get out of therapy. Are you looking for tools to manage anxiety? Do you want to work through past trauma? Or are you simply curious about how therapy might help? Bringing even a few thoughts can give your session focus, as not everyone comes in with clear goals.

Meeting Your Therapist and Building Trust

The first therapy session is all about building a foundation of trust. You’ll get a chance to meet your therapist, learn about their approach, and ask any questions you may have. Your therapist will also explain practical details, such as confidentiality, session length, and scheduling.

Therapy is a collaborative process. Trust builds over time, and the first session is simply the start. Your therapist isn’t there to judge but to support and guide you. They may share how they typically work, whether they lean more on talk therapy, trauma-focused approaches, or strategies that emphasize coping skills.

Sharing Your Story at Your Own Pace

You won’t be expected to share your life story in detail right away. The first session usually focuses on getting to know you, your current concerns, and what you hope to achieve. Some people talk freely, while others take time to open up. Both are perfectly fine.

If you are beginning therapy to address childhood sexual abuse or trauma, you may feel uncertain about where to start. Your therapist understands this and will meet you where you are. You can always decide how much or how little to share. For more information about specialized support, you can read more about our CSA therapy services.

Setting Goals in Psychotherapy

Toward the end of the session, your therapist may suggest possible goals for therapy. These are not set in stone but can help guide your next steps. Goals might include improving coping strategies, reducing the impact of past trauma, or learning new ways to handle stress.

You’ll also have the chance to ask questions. If something about the process feels unclear, it’s always okay to speak up. Therapy works best when you feel comfortable and informed.

Common Feelings After the First Session

It’s normal to walk away from your first session with mixed emotions. Some people feel relief after opening up, while others may feel tired or even unsettled. Therapy can bring difficult topics to the surface, but this is often part of the healing process.

Give yourself space after your session to reflect. Journaling, going for a walk, or talking to a trusted friend can help you process your thoughts.

Taking the Next Step in Your Healing Journey

After your first appointment, you and your therapist will decide how often to meet. Weekly sessions are common in the beginning, but the frequency can be adjusted based on your needs. Consistency is key to making progress, even if it feels slow at times.

Starting psychotherapy can feel daunting, but it’s also a sign of courage and self-care. By taking the first step, you are giving yourself the opportunity to heal, grow, and find healthier ways of moving forward.

If you’re ready to begin, you can [book a session today](booking page link). Your first therapy session is the beginning of a journey, and with support, you don’t have to walk it alone. Frequently Asked Questions About The First Therapy Session

Do I need to prepare before my first therapy session?Not much. It helps to think about what brought you to therapy and what you’d like to get out of it, but you don’t need to have all the answers.

Will I have to share everything right away?No. Your therapist will move at your pace. The first session is about starting the conversation and getting comfortable, not telling your whole story at once.

How long does a first therapy session usually last?Most sessions are about 50 minutes, though your therapist will let you know if the format is different.

What if I feel nervous or emotional during the session?That’s normal. Many people feel a mix of relief, nervousness, or even sadness afterward. Therapy is a safe space where these emotions are welcome.

About the Author Karen MacKeigan, RP (Qualifying), RSSW, is a trauma-informed Registered Psychotherapist (Qualifying) and Registered Social Service Worker based in Toronto. With over five years of experience supporting adult survivors of childhood sexual abuse through her work at The Gatehouse, Karen brings an empathetic, client-centered approach to psychotherapy. She draws from a variety of therapeutic modalities to create a warm, safe, and collaborative space where clients feel heard and supported. Karen holds a BA in Psychology, an MA in Counselling Psychology, and diplomas in both Early Childhood Education and Addiction and Mental Health.

Learn more about Karen

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