New to Therapy? What to Expect in Your First Session

Starting therapy for the first time can feel like a big leap, especially when you don’t know what to expect. Whether you’re a teen, a young adult, or an adult (welcome!), it’s completely normal to feel nervous before your first appointment. In fact, many people share the same questions and worries:

What will I have to talk about?

Will the therapist think I’m “too much” or not struggling enough?

What if I don’t know how to open up?

If any of that sounds familiar, you’re not alone.

This post walks you through what typically happens in your first therapy session (often called an “intake”), common fears, and how to make the most of it.

Common First-Time Therapy Fears

It’s okay to be anxious; therapy is about showing up as you are. Some common concerns we hear include:

• “What if I don’t know what to say?” That’s our job to help with. You don’t need to have everything figured out or prepared. Your therapist will guide the conversation.

• “Will I be judged?” Therapy is a non-judgmental space. We’re here to understand you, not to evaluate or shame you.

• “What if I cry or get emotional?” That’s okay too. Emotions are welcome here. You’re allowed to feel whatever comes up. We've seen and heard it before and honestly expect it. If you're having a virtual session, having a tissue box nearby can be reassuring. If you are at our clinic, we definitely stock up on the tissue boxes so no worries there.

• “What if I don’t like my therapist?” Finding the right fit is important. The first session is also about getting a sense of whether this therapist is a good match for you. Treat it like a first date - get a sense of whether it might be for you or not. It is common for people to meet a few therapists and decide from there. Therapists are aware of this and do not get offended (and if they do, that can be a red flag...).

What Happens in the First Session?

The first session is usually about getting to know you. It’s not therapy in the traditional sense (yet), but it’s an important starting point. Here's what to expect in that first 50-60 minute session:

1. Introductions & Setting the Tone

We’ll introduce ourselves and let you know what to expect from the session. You’ll be able to ask questions and share any preferences you have.

2. Consent and Confidentiality

Before diving in, your therapist will explain how therapy works, including your rights as a client, how your information is kept private, and any limits to confidentiality. In general, what you share in therapy stays private although there are a few important exceptions:

• If there's a serious risk of harm to you or someone else

• If a child under 16 is at risk of harm or neglect

• If a court orders your records

These limits are just a few; before your session, you should receive a detailed intake form that reviews all of the limitations to confidentiality. We review them in the intake session verbally in order to make sure you understand and to give you an opportunity to ask any questions.

3. Why You're Coming In

We’ll ask what brought you in; this could be something specific (like anxiety, trouble at school, relationships, low mood), or more general (feeling stuck or overwhelmed).

4. Background Info

We’ll ask about your life: childhood, school or work, family, friendships, past experiences with mental health, and anything else that helps us understand your world.

5. Goals for Therapy

If you have a sense of what you’d like help with, great. If not, we’ll explore it together.

6. Explaining Next Steps

At the end of the session, we’ll talk about what ongoing therapy might look like: frequency of sessions, what approaches we might use, and your questions about the process. We get that therapy takes resources (time, energy, and money) and we want everyone to be on the same page about next steps.

Tips for Your First Therapy Session

• It’s okay to be honest about being nervous. We expect it!

• There’s no pressure to “perform.” You don’t need to tell your whole story at once.

• Bring questions. If you’re unsure about therapy, the process, or even how confidentiality works, ask away.

• Take your time. Therapy is a process, and the first session is just the beginning.

Final Thoughts

Starting therapy can be intimidating, AND it’s also brave. The first session is a space for curiosity, not perfection.

If you’re thinking of reaching out, we’re here to help. If you have any questions or are interested in our services, please feel free to reach out to us info@onepsychology.ca or complete the New Client Form.