First therapy session? Here’s what to expect.

Prachi Naik
Dec 5, 2025
2 min read

Your first therapy session lays the groundwork for a trusting therapist–client relationship. Your therapist and you can get to know each other and establish a rapport based on trust and honesty from both sides.

Here’s what to expect during your first therapy session:

a psychotherapist greeting her therapy client

Introductions:

The therapist will introduce themselves with their name, pronouns, their education and work experience. The therapist will take down demographic information about you: name, pronouns, gender, sexual orientation, education, work information, socio-economic class etc.

Therapy process and confidentiality:

man in psychotherapy session with a psychologist

Your therapist will review the therapy process they follow. They will explain the confidentiality policy i.e. what is shared in therapy, stays in therapy. They will also share exceptions to the confidentiality agreement which usually include instances such as harm to yourself or others amongst others.

Feel free to ask questions and give feedback to your therapist as this will make the process honest and genuine.

Exploring reason you sought therapy:

person holding a note with the question word Why

The therapist will try to understand the reasons why you decided to start therapy— whether it's a recent event or an ongoing concern. It helps if you share experiences or instances to explain your concerns to the therapist.

The therapist may choose to delve into the issue at hand at deep or may reserve that for later sessions.

Life overview:

Therapist taking down notes in online counselling session

Your concerns may not just affect one area of your life. The therapist will check into - medical, family, childhood histories; relationships, professional life. The therapist will also try to gain information about daily well-being such as sleep, mood, and appetite.

This may happen in the first session itself or may be spaced in a few sessions.

Goal setting:

Goal setting depends on the therapeutic approach followed by a therapist. It may happen in the first session or after a couple of sessions when the therapist better understands your issues.

Some therapy styles rely on structured therapy sessions whereas others rely on the client deciding on the agenda of every session. Most therapists follow an eclectic approach i.e. a mix of different styles of therapies based on the client and issue presented in therapy. Talk to your therapist about what works best for you.

Assessment:

two people holding a Rorschach inkblot test card

Your therapist may rely on screening tools for issues like anxiety or depression. Screening tools help a therapist understand your concerns better and act as a guide for further testing if required. Your therapist may also refer you to a clinical psychologist or psychiatrist for diagnostic evaluation if required.

Your first session is a beginning- an opportunity to know each other and build a strong therapeutic relationship. Therapy is a collaborative process- so share as much as you can especially if the therapeutic style isn’t working for you. With time, consistency, and effort, it can support your growth and healing.