Play-by-Play: First session with a therapist

What to expect when meeting with a therapist for the first time

~5 min read

Similar to the value of visualizing a new skill or play before giving it a try, it can be helpful to approach your first therapy session with an idea of how it might go. A little bit of preparation can go a long way to help to ease anxiety, so we’ve put together a guide to walk you through your first online session with a therapist. At this point, you’ve likely already had an initial 10-20 minute free phone conversation, which all therapists on Galea Health offer, to get a general sense of the therapist’s practice and style.

Goal of the First Session

The first session, which is often referred to as an intake, is like a warm up or practice lap. The goal is to get a feel for the particular therapist with whom you’re meeting. The main goal of this session is for you to test the waters and decide whether you feel like it would be valuable to continue with this therapist. At the same time, the therapist’s goal is to piece together a picture of who you are and how they can best support you.

Length of Therapy

Since the first session is focused on gathering background information and laying the groundwork, it might be a bit shorter or longer than future sessions; for example, it might be either 30 minutes or 1 hour rather than 45 minutes. Beforehand, it could be worthwhile to ask how long the session will be so that you can pace yourself. Although it is helpful to know how long the session will be, it’s the therapist’s responsibility to end the session on-time, so there’s no pressure to check the clock throughout the session.

Getting Started

Depending on the therapist and their practice, you will likely be given various paperwork to fill out before the first session. These forms will be sent to you to complete electronically, and you will be able to fill them out on your own time. The paperwork generally includes consent forms, confidentiality notices, and policies about billing. They might also include short-answer questions about why you are seeking therapy, such as what symptoms you are experiencing and what you hope to get out of therapy. Answer these questions as honestly as possible while keeping in mind that exploring these questions with your therapist is a part of therapy. As with any paperwork, take your time to read through it carefully, and if you have any questions, don’t hesitate to reach out to your therapist.

Meeting Your Therapist

Hey, hi, how are you? Although the dynamic might feel unfamiliar, your session will likely begin the way many interactions and relationships begin: with an introduction. You might use this as an opportunity to build some common ground or to talk about things that you are more comfortable discussing, such as where you grew up, your sport, etc. Remember: this is a marathon, not a sprint. If you’re feeling uneasy, feel free to use this time to get your feet under you before discussing more sensitive topics. Also, know that silence can be your friend, and you can always take a second or two or sixty to collect your thoughts.

Questions Your Therapist Might Ask

After the initial introductions, the conversation might veer more toward why you decided to give therapy a try. The therapist will probably ask questions such as:

• “What brought you to therapy?”
• “What goals are you hoping to achieve through therapy?”
• “What symptoms or feelings of distress are you experiencing?”

Maybe you’ve had trouble falling asleep because of racing thoughts, so you’ve felt more tired and distracted during class and practice. Or maybe you’ve been sleeping more than usual, yet you still feel more tired and distracted throughout the day. Any examples of your thoughts, feelings, and symptoms and how they have impacted your day-to-day life are important talking points. They will also probably ask questions about your family history and more about your current situation. These questions could include:

• “Is there a history of mental health conditions in your family?”
• “How would you describe your current relationships (family, friends, roommates/teammates, romantic)?”
• “What is your living situation like?”
• “What sport do you play, and what role does athletics play in your life?”

It might be helpful to think about your answers to these questions before your first session. However, if you’re not sure about how you’re feeling or why you’re feeling that way, no worries. Figuring out the answers to these questions is part of what therapy is about.

Questions to Ask Your Therapist

Therapy is a team effort, so communication should come from both sides. Before, during, or after you answer the questions posed to you, feel free to ask the therapist questions, too. You might consider asking:

• “What are your strengths as a therapist?”
• “What training and expertise do you have as a therapist?”
• “When would you need to break confidentiality during a session?”
• “How long do you typically see clients for?”
• “Do you assign ‘homework’ or tasks to complete between sessions?”

Again, although the dynamic might feel unfamiliar, you are ultimately trying to get a sense of how you two work together, so it is important that you feel comfortable asking questions to your therapist.

Feedback is crucial to the success of a team. During the latter parts of the session, your therapist might take some time to reflect on the conversation. To make sure they are processing an accurate-to-you version of your story and who you are, they might repeat back the information you have told them in their own words. They might also ask questions pertaining to how you thought the session went, such as, “How do you feel about the conversation we had?” Feel free to use this time to provide any feedback about the session, such as whether you preferred times when they asked questions or times when you led the conversation.

It’s also important for you to continue to reflect on the session after it is over. When you do so, ask yourself:

Is Your Therapist Right For You?

At this point, you might already know that the conversation was valuable and you are ready to schedule another session. If so, your therapist will probably allow you to book the next session right then and there. However, if you’re unsure about whether you want to continue with this therapist, no sweat. Just let them know that you’ll follow-up about moving forward. Feel free to say, “Thank you so much for your time. I really appreciated learning more about your practice. I’m still considering a few options, so is it okay if I get back to you later?” If you’re wondering how to know whether they are a good fit, the National Alliance on Mental Illnesses suggests you ask yourself the following questions:

• Do they challenge you?
• Do they check-in with you?
• Do they guide you to your goals?
• Do they help you learn?
• Do they show acceptance and compassion?
• Do they treat you as an equal?

Either way, honesty is still the most important aspect of this interaction, and you are under no obligation to continue with a therapist if you feel like they aren’t the best match. If the first therapy session didn’t go as planned or you didn’t feel like you clicked with the therapist, that’s okay. Keep tabs on what you did and didn’t like about the session, and schedule a call with another therapist. It might also be helpful to browse through the finding a therapist post on our blog for more guidance on style and goals.

Next Steps

Each initial session will vary, but hopefully you now have a clearer picture of how your initial session with a therapist might go. In addition to thinking about your symptoms, questions, and goals prior to the session, it might be helpful to write them down so that you can refer to them during the session. Feel free to reference the bullet points in this post to quickly and easily review potential talking points. At the same time, there is no pressure to know how you feel, what you want to say, and what you want to get out of therapy before you attend your first session. Thinking about, questioning, and discovering answers to these points are all a part of the process, and you know what they say about the process: trust it. Or at least give it a shot.