The first therapy session is the hardest—not because the session itself is grueling, but simply because trying new and foreign things can cause some butterflies in your stomach. For some people, that intimidation may cause them to procrastinate booking that appointment.
“Fear of the unknown” is a common phenomenon, and the best cure is to do your research ahead of time so you know what to expect. Here are a few key facts that might make your first therapy session a bit less scary:
1. It’s okay if you “don’t know what to say.”
Whether you’re not much of a talker or just don’t know how much to disclose to this total stranger, you have nothing to fear. The therapist will typically lead the conversation in the first session, which is known as the intake session.
“Experienced therapists know how unnerving therapy can be for a new client,” says Sal Raichbach, PsyD, licensed psychologist at Ambrosia Treatment Center. “If you can’t think of anything to say, don’t worry. Just say whatever comes to mind. One of the nice things about therapy is that almost any thought you offer is acceptable.”
If there are moments of silence, don’t panic. Your therapist may be giving you a pause to think, reflect, or add to your previous point. This is normal, and it doesn’t mean you’re doing anything wrong or that you're "bad" at therapy.
2. No, you don’t need to spill all your darkest secrets on Day 1.
“Often, your first session will be an assessment in which the therapist will be asking you a series of questions just to get to know you better and to create a good foundation for subsequent sessions,” says Ibinye Osibodu-Onyali, LMFT, of The Zinnia Practice in California. “It’s similar to a doctor taking your medical history.”
“I typically begin by asking clients to tell me about their current life circumstances, their family and friend relationships, and any relevant history,” adds Laura Braziel, MMFT, LPC, LMFT, owner of Authentic Relational Counseling in Houston, TX. “It’s mostly a get-to-know-you.”
Beyond the first session, opening up might get easier as you learn to trust your therapist and the process. And don’t worry about being judged as you open up, whether it’s on the first or twenty-first session.
“Due to their own life experiences, the training they have received, and the hundreds of other clients they have worked with, [therapists] recognize that judgment is irrelevant,” says Braziel. “Everyone has cause for how they have gotten to where they are.”
3. You might not “click” with your therapist.
You can expect your therapist to ask you for feedback at the end of the session. They may ask directly how you felt about your connection with them, or ask you more indirect questions, like what you’re looking for from therapy or from a therapist. They might also ask if you want to book a second appointment with them.
There’s one rule for this kinda awkward exchange: Be honest. Forcing yourself to continue working with someone you don’t jive with could be a waste of time, money, and energy, and it might even worsen your mental health.
“If you don’t feel understood or comfortable after your first session, it may not be the right fit,” says Braziel. “Counselors are people with personalities and mannerisms, too, and not everyone is going to match up well … If you aren’t satisfied with your counselor, then try someone else. Good counselors won’t take that personally at all.”
If you’re not sure, here are clues that your therapist isn’t a good fit for you.
Psychotherapies. Bethesda, MD: National Institute on Mental Health. (Accessed on January 15, 2022 at https://www.nimh.nih.gov/health/topics/psychotherapies/index.shtml.