What Should I Expect at My First Therapy Session?

Your first therapy session is mostly about getting to know each other. You’re not going to solve all your problems in 50 minutes, and your therapist knows that. The goal is to figure out if you’re a good fit and start building the foundation for the work you’ll do together.

If you’re nervous, that’s completely normal. Most people feel at least a little awkward talking to a stranger about personal stuff. But therapists do this every day. They’re not going to judge you or be shocked by anything you say. By the time you leave, you’ll probably feel relieved that it wasn’t as scary as you imagined.

Before you get into the real conversation, there’s usually some paperwork to handle. Your therapist will go over things like confidentiality, which means what they can and can’t share with other people. The short version is that almost everything you say stays between you and your therapist.

You might also fill out some forms about your background, mental health history, and what’s bringing you to therapy. Some practices send this stuff ahead of time so you can fill it out before your appointment. If you’re coming to our Philadelphia office or doing a video session, we’ll make sure you have everything you need before your first visit.

This paperwork might feel like a hassle, but it helps your therapist understand your situation before you even start talking.

Your therapist will ask questions to get a sense of who you are and what you’re dealing with. Expect questions like these.

What brings you to therapy right now? They want to know what made you pick up the phone and schedule this appointment. For a lot of people who start therapy in Philadelphia with us, it’s not one big thing. It’s a bunch of smaller things that piled up.

How long have you been dealing with this? Knowing whether something started last month or ten years ago helps your therapist understand what they’re working with.

Have you been in therapy before? If you have, they’ll want to know what worked and what didn’t. If you haven’t, they’ll explain how the process works.

What does your support system look like? They’ll ask about family, friends, and other people in your life. This helps them understand what resources you have outside of therapy.

You don’t have to have perfect answers to these questions. Just answer honestly, even if that means saying ‘I don’t know’ or ‘I’m not sure how to explain it.’ And if you’re not sure what to talk about in therapy, that’s completely normal. Your therapist will help you find a starting point.

Here’s something that might take the pressure off. You don’t have to tell your whole life story in the first session. Your therapist isn’t expecting you to spill every secret you’ve ever had. That would be overwhelming for both of you.

Think of the first session as an introduction. You’re giving your therapist the headlines, not the full article. The deeper stuff can come later as you build trust. Most people feel more comfortable opening up after a few sessions when they know their therapist a little better.

If there’s something you’re not ready to talk about yet, that’s okay. You can say “I’m not ready to get into that today” and a good therapist will respect that.

Some people cry in their first session. Others feel totally fine. There’s no right or wrong way to react. Therapy can bring up feelings you’ve been pushing down, and sometimes those feelings come out unexpectedly.

If you do get emotional, your therapist won’t be surprised or uncomfortable. They’re trained to handle this. And honestly, crying in therapy is one of the most normal things in the world. It often means you’re finally letting yourself feel something you’ve been avoiding.

On the other hand, if you don’t feel emotional at all, that doesn’t mean anything is wrong. Everyone processes things differently. Some people need more time to warm up.

Part of the first session is deciding if you and your therapist are a good match. Not every therapist works for every person, and that’s okay. The relationship between you and your therapist matters more than almost anything else when it comes to whether therapy will help.

Pay attention to how you feel during the session. Do you feel comfortable talking to this person? Do they seem to understand what you’re saying? Do you feel heard and not judged?

You don’t have to make a decision right away. It’s fine to go home and think about it. Some people know immediately that a therapist is right for them. Others need a session or two to figure it out. If after a few sessions something still feels off, here’s what to do if you don’t like your therapist.

Near the end of your first session, your therapist might summarize what you talked about and share some initial thoughts. They might suggest a direction for therapy or talk about what approach they think would help.

You’ll also schedule your next appointment. Most people start with weekly sessions to build momentum. If that doesn’t work with your schedule, your therapist can help you figure out what’s realistic.

Sometimes therapists give homework after the first session. This might be something small like noticing when you feel anxious during the week or trying a breathing exercise before bed. Doing these assignments between sessions helps you get more out of therapy.

At our practice in Center City, first sessions run the same length as regular sessions (typically 50 minutes). We use that time to understand what you’re dealing with, learn about your background, and figure out how we can help.

We offer in-person therapy in Philadelphia and Haddonfield, with online sessions available throughout Pennsylvania and New Jersey. Whether you’re coming from Rittenhouse Square, Northern Liberties, or driving in from the suburbs, we want you to feel comfortable from the moment you walk in.

We also offer a free 15 minute phone consultation before your first session. This gives you a chance to ask questions and get a sense of whether we might be a good fit before committing to a full appointment.

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