Deciding to start therapy is often the hardest part. Once you have made that decision, a new set of worries tends to arrive. What will it actually be like? What will they ask me? Do I have to talk about everything on the first visit? What if I cry?
These are completely normal questions, and almost everyone feels some nervousness before a first session. I want to take some of the mystery out of it, so you can walk in (or log on) feeling a little more prepared.
Before the session
Before your first appointment, I ask you to fill in some intake paperwork. It covers your contact details, a short history, any medications you take, and what you hope to get out of therapy.
The paperwork gives us a starting point, so we can make good use of our time together, and it helps me understand anything that affects your safety. Answer honestly, but there is no need to overthink it.
You might also think loosely about what brought you to therapy. You do not need a prepared speech or a list of problems in order of importance. A general sense of why now, and what feels most pressing, is plenty.
What the first session looks like
The first session is not like therapy in the films. Nobody will ask about your childhood in the first five minutes, unless that is what you want to talk about, and you will not be expected to share your deepest secrets straight away.
Instead, it is a conversation. I explain how therapy works and go over the practical details, like confidentiality and scheduling. Then I ask some open questions to understand what is happening in your life and what you would like to change. You might hear questions like these:
- What brought you to therapy at this point in your life?
- Have you been in therapy before, and what was it like?
- What does a typical day look like for you right now?
- Is there anything you want me to know about your history or your family?
- What would you most like to get out of our work together?
You are in charge of how much you share. Nothing difficult has to be discussed before you are ready. The first session is mostly about getting to know each other and deciding whether we are a good fit.
If you are a parent bringing a child aged 3 to 12, the first session is usually with you on your own, so we can talk openly about what you have noticed at home.
The relationship matters
Research has long pointed to the relationship between you and your therapist as one of the most important parts of therapy, whatever approach is used. A large review of the research by Flückiger and colleagues (2018) found a consistent link between a strong working relationship and how helpful people found therapy.
So the first session is as much about you getting a feel for me as it is about me getting to know you. Do you feel heard? Do you feel safe? Does this seem like someone you could trust over time? Those are the questions that matter most.
If something does not feel right, that is worth knowing. It does not mean therapy is not for you. It may simply mean a different therapist would suit you better, and I will tell you honestly if I think that is the case.
How you might feel afterward
People have all sorts of reactions after a first session. Some feel relief, as if they have finally put something heavy down. Others feel tired, which makes sense after an hour of being more open than most of us are in daily life. Some feel a bit unsettled, especially if the conversation touched on something they have been avoiding.
All of these are normal. Give yourself some space afterward. Go for a walk, make a cup of tea, or sit in the car for a few minutes before you drive. You have done something brave.
How many sessions will you need?
It depends on what you are working through, so I cannot give you a set number. Some approaches have a clear structure. Cognitive Processing Therapy for PTSD, for example, is usually about 12 weekly sessions. Other work is more open-ended. We agree on a plan together early on and review progress regularly, so you always know where things stand.
How to get the most out of therapy
- Be honest. Therapy works with what you bring into the room, and I am not there to judge you.
- Come regularly. Most people come weekly at first. Long gaps can make it harder to keep going.
- Try things between sessions. If I suggest an exercise or ask you to notice something during the week, give it a go.
- Tell me if something is not working. If an approach does not fit, say so. I welcome that feedback.
Ready to take the first step?
If you have been thinking about therapy but have not quite made the call, I understand the hesitation. It takes courage to ask for help. I offer a free phone consultation, so we can talk about what you are looking for before you commit to anything. No pressure, just a conversation.
Call me at 503-495-5072 or send a message. My office is in King City, a few minutes from central Tigard, and I also offer telehealth anywhere in Oregon for teens, adults and parent sessions.