What to Expect in Your First Therapy Session: A Guide for Adults in Illinois & Michigan
Starting therapy can feel intimidating, especially if you’ve never been before. You might wonder: What will I say? What will the therapist ask? Will it feel awkward? These are all completely normal questions. Knowing what to expect can take some of the pressure off and help you walk in feeling more prepared.
The truth is, your first therapy session is not about having the perfect words or solving every problem. It’s about connection, curiosity, and taking the first step toward support.
What Happens Before Your First Session
Before your first appointment, most therapists will send intake paperwork. While it might feel like a lot at first, this paperwork is important because it gives your therapist a picture of who you are and what you need. It usually covers:
◦ Basic background information. Name, contact information, emergency contact, and demographic details.
◦ Medical and mental health history. Past diagnoses, medications, family history, or other relevant background.
◦ What you’d like to focus on in therapy. Your current struggles, areas of concern, or goals.
This isn’t about locking you into a plan; it’s simply a starting point that helps your therapist prepare to support you from day one.
What the First Therapy Session Usually Looks Like
Your first session is about connection, not perfection. There’s no script you need to follow and no wrong way to “do therapy.” In most cases, you can expect to:
◦ Share a little about what brought you to therapy. You don’t need to have the full story ready; just enough to help your therapist understand what feels heavy right now.
◦ Answer some questions about your history, daily life, and current struggles. This helps your therapist put your experiences into context.
◦ Learn about your therapist’s style and approach. They might explain the types of therapy they use (like CBT, ACT, or narrative therapy) and how sessions will typically flow.
◦ Set initial goals together. These can be small, like wanting to feel less anxious at work, or broader, like improving self-esteem or relationships.
Remember: the first session is as much about you getting to know your therapist as it is about them getting to know you.
Questions You Might Hear From Your Therapist
Every therapist has a unique style, but some common first-session questions include:
◦ What made you decide to start therapy now?
◦ Have you ever been in therapy before?
◦ What do you hope will feel different in your life as a result of therapy?
◦ What does support look like for you?
These questions aren’t tests. They’re simply ways for your therapist to understand your story, your needs, and your hopes.
How to Prepare for Your First Therapy Session
You don’t have to have everything figured out before your first session, but a little preparation can ease nerves and help you feel grounded. Here are some ideas:
◦ Write down what’s been weighing on you. Even a few bullet points can give you clarity when it’s time to share.
◦ Think of a few goals. Ask yourself: What do I hope therapy will help me with? Even if the answer is “I just want to feel better,” that’s a valid starting point.
◦ Remember: it’s okay to feel nervous. Most people do. The first step is often the hardest, and your therapist knows this.
If you’re starting online therapy, you might also want to:
◦ Find a quiet, private space for your session.
◦ Test your internet connection and camera.
◦ Bring a notebook if you like to jot things down afterward.
Therapy Is a Process, Not a One-Time Fix
It’s natural to want answers quickly, but therapy isn’t about solving everything in a single session. Instead, it’s about building trust and creating a safe space over time. Each session builds on the last, and progress often comes in small but meaningful steps.
You may leave your first session feeling lighter, or you may leave with more questions than answers. Both are normal. What matters most is that you’ve begun.
A Gentle Reminder: It’s Okay to Start Small
Therapy doesn’t require you to be perfectly prepared or fully certain about what you want to work on. Your therapist will meet you where you are. The first session is simply about beginning; showing up for yourself, taking a breath, and opening the door to support.
