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Your first therapy session with a psychologist: what to expect

You have finally found the courage to book your first appointment with a psychologist or a psychotherapist. Meeting a new therapist for the first time often feels nerve-racking. This is entirely understandable as you may well disclose concealed fears and deeply intimate issues to someone that you have just met. Opening up to a stranger would seem peculiar in most situations in life, but not when it comes to a therapy assessment. Below I am describing what to expect in an initial session so you are not caught off guard and can decide more confidently if you have found the right therapist after this first meeting.  I have also created a video where I explain further what this first session looks like for my clients.



This initial consultation typically functions like an assessment. The therapist may ask you questions about the issues that bring you to therapy and how they developed. It’s also highly likely that he/she will want to find out about your background history and important people in your life. An initial conversation about how you would like to use therapy, your hopes, and possible goals is also common at this stage. This first session is about you being offered the opportunity to tell your story and for your therapist to start getting to know you and forming ideas about how they may be of help to you.

Your therapist may also take time to explain how therapy works, make recommendation about the direction that your sessions shall take, and the therapy style/model that they will be using.  Different therapists have different training and values to which they ascribe. Thus, how much your therapist guides you through this initial session and provides information will vary enormously. It’s also absolutely fine for you to ask your therapist questions about your treatment, including their understanding of your difficulties, the recommended length of the treatment course or the model they use.  The assessment process may last for a few sessions.



The content of therapy sessions is meant to be strictly confidential and not to be disclosed anywhere else, other than in clinical supervision. Clinical supervision is a space where the therapist can reflect with another therapist’s help about their work and is considered to be part of good clinical practice. In supervision client’s identity remain anonymous and the same confidentiality principles apply. There are however circumstances when a therapist ought to break confidentiality as part of their duty of care or when they are obliged by the law. Such circumstances include you disclosing something in the session that would make your therapist fear about your or someone else’s safety.


How do I know that I had a good first session?

This initial appointment provides a chance to reflect on the reasons that brought you to seek help. The mere process of a therapist asking insightful questions of facilitating a safe and non-judgmental space can themselves have a powerful effect. It’s important that you leave the session having felt listened to and experienced the therapist as genuinely interested in you.  Its’ also a good sign if this first session has generated hope about you managing your difficulties. Don’t expect this initial session to provide you with all the answers and coping strategies you need. Therapy is not a quick fix. Finally, don’t necessarily feel alarmed if you experienced intense feelings during the session.


What happens next

If by the end of your first appointment, you are not entirely sure about whether you would like to start seeing this same professional regularly, don’t rush into making a decision.  This initial session is an opportunity to test the water and you may need to ask yourself if this is the right time to commit to therapy. I often encourage new clients to take 48 hours before deciding if they would like to come back for more sessions. Arranging a second appointment before making a commitment to therapeutic work may help you answer any further questions.

Finding the right therapist is also of paramount importance. If you don’t feel that you could easily develop a bond with this professional or that you trust their skills, listen to your intuition. You sometimes have to see a few therapists before selecting one. In my assessment and consultation service, I offer a brief online assessment with the view to link clients to the right therapist across the country, taking into account availability, fee range, location, and expertise as they are all important factors when making up your mind about committing to regular sessions with a therapist.

Starting therapy is an important investment and it’s worth treating this initial session as a meeting that will help you decide if this type of help and the therapist providing it are right for you.



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