What Does a First Therapy Session Actually Look Like?

The hardest part of starting therapy isn't the therapy itself — it's the not knowing what to expect. Most people have a vague sense of what therapy looks like from movies or TV, and almost none of it is accurate. So let me walk you through what a first session with me actually involves.

Before You Walk In

Before your first appointment, you'll fill out some basic intake paperwork. It covers your background, what's bringing you in, and some standard consent information. Nothing unusual — just the practical stuff that gives me a starting point so we're not spending our whole first session on logistics.

If you're doing telehealth, you'll get a secure video link. Same process, just from wherever you're comfortable.

The First Few Minutes

I'm not going to ask you to lie on a couch. There's no couch. It's two chairs in a comfortable room, or two screens on a video call. The first few minutes are about settling in. I'll introduce myself, explain how I work, and ask you what brought you here.

And here's what most people don't expect: it's okay if your answer isn't clean or well-rehearsed. "I'm not even sure why I'm here" is something I hear regularly, and it's a completely valid starting point. You don't need a speech prepared.

What We'll Talk About

The first session is mostly about me getting to know you and you getting a feel for me. I'll ask questions — about what's been going on, what your life looks like day to day, and what you're hoping to get out of this. Some of that might touch on your history, but we're not going to dive deep into your childhood on day one unless that's where you want to go.

Think of it more like a conversation with a clear purpose. I'm listening for patterns — the things that come up repeatedly in your life, the ways you've been coping, and where the friction is. You're figuring out whether this feels like a good fit.

It's Not an Interrogation

One thing I want to be clear about: you're in control of what you share and when. The first session isn't about spilling everything. It's about establishing a connection and a direction. If something feels too heavy to get into right away, that's fine. We'll get there when you're ready.

There's no right way to do a first session. Some people are open books from the start. Others are cautious and measured. Both are fine. The pace is yours.

What I'm Doing on My End

While you're talking, I'm doing a few things. I'm listening — not just to what you're saying, but to how you're saying it. I'm noting what seems to carry the most weight for you. And I'm starting to form a picture of what might be most helpful to focus on going forward.

By the end of the first session, I'll usually share some initial thoughts. Not a diagnosis or a verdict — more like, "Here's what I'm noticing, and here's how I think we might approach this." It's collaborative. You're not being told what's wrong with you. You're being offered a framework for making sense of what you're experiencing.

What Happens After

At the end of the session, we'll talk about whether you want to continue and what a good rhythm looks like. Most people start with weekly sessions. Some shift to every other week once things settle. There's no long-term commitment required — you can take it one session at a time.

The most common thing I hear after a first session is: "That wasn't as bad as I thought it would be." Most people leave feeling lighter, even if nothing got "solved." Just the act of saying things out loud to someone who's trained to listen — that alone does something.

Ready to See for Yourself?

If you've been thinking about starting therapy but the unknown has been keeping you on the sideline, I get it. But now you know what to expect. The rest is just showing up.

For a more detailed walkthrough, check out my What to Expect page. And if you're ready, you can book your first session below.