What Happens in Your First Therapy Session? A Step-by-Step Guide

Preparing for Your First Therapy Appointment

Starting therapy often brings a mix of relief and anxiety. Many people worry about what they should say, how personal they need to be, or whether they’ll be judged. The first therapy session is designed to help you feel oriented, safe, and informed — not pressured.

Step 1: Introductions and Logistics

Your therapist will begin by reviewing confidentiality, informed consent, and session structure. This includes explaining how privacy works, limits to confidentiality, and how telehealth sessions operate if you’re meeting online.

This portion ensures you understand your rights and feel comfortable moving forward.

Step 2: Discussing What Brought You In

You’ll be invited to share what led you to seek therapy. This can be brief or detailed — there’s no expectation to tell your entire life story. Many clients start by describing recent stressors, emotions, or concerns.

If you’re unsure where to begin, that’s okay. Therapists are trained to guide the conversation gently.

Step 3: Exploring Goals for Therapy

Together, you’ll discuss what you hope to gain from therapy. Goals may include reducing anxiety, improving relationships, coping with stress, or understanding emotional patterns.

These goals can change over time and are revisited as therapy progresses.

Step 4: What You’ll Leave With

Many clients leave the first session feeling relieved or lighter. While deep change takes time, simply being heard in a nonjudgmental space can feel validating.

You may also receive initial coping strategies or reflections to consider between sessions.

First Sessions at Southview Counseling

At Southview Counseling, first sessions are paced with care. Whether you’re starting therapy for the first time or returning after a break, the focus is on creating a supportive, respectful experience that meets you where you are.