what to expect from therapy

What to Expect in Your First Therapy Session

Starting therapy is always a great first step toward healing and growth. So, give yourself the credit for taking this crucial step, and for prioritizing your psychological well-being!


Despite the initial anxiety a lot of us face, the first therapy session lays the foundation for self-discovery and emotional well-being. In this blog, we will talk about a few helpful pointers and facts that you can keep in mind as you begin your journey.


Duration of the session

Therapy sessions last anywhere between 45 min – 60 min. It always helps to arrive on time and settle down before your session starts!


Personal background

Your therapist will ask you questions about your background to better understand your circumstances and context. She will also use these questions to explore your areas of strength, stressors, interests, etc. At times, certain questions may feel too private such as sexual orientation, whether you are sexually active or not, substance use, etc. These questions are asked by the therapist to form a holistic understanding of your case.  Other questions may include childhood history, relationships with friends/peers, trauma history if any, education, romantic relationships, parental dynamics/conflicts, siblings, and occupation, to name a few.

Try to be open and honest with your responses. At the same time, if you are not comfortable answering a question, it is completely ok to say that to your therapist.


Presenting concerns

Your therapist might begin by asking you questions like “What brings you here today?”. This helps her understand the more urgent and pressing reasons that inspired you to begin therapy. Additionally, the therapist may also enquire if you are suffering from any other physical ailments and if you are undergoing treatment for the same.


Previous experience with therapy, if any

Some of us may have experienced therapy previously. Your therapist would like to know about your previous experience with Therapy, if any, as it tells her at what different points did you reach out, what were your takeaways, and your reasons for stopping therapy in the past.  It will also help her understand your expectations from the process.



We may share some of our deepest and darkest fears during Therapy. Considering the vulnerability that it brings along; the aspect of confidentiality is strictly maintained. This helps in building trust and creates a secure space to feel comfortable.

However, there are also natural constraints and limits to confidentiality, instances when the contract of confidentiality must be broken to safeguard your physical safety as the client. Threats of self-harm, suicidal thoughts, and threats to harm others are a few such instances wherein the therapist may decide to inform appropriate authorities.


Goal setting

One of the main steps of therapy is to decide upon “Therapy goals”. Goal setting is a collaborative process between you and your therapist, and a reflection of what you want to achieve from the process. Once set, these goals are used to assess the progress that you make during Therapy. Goals can be short-term, intermediate, and long-term goals. Some examples of goals are:

  • Short-term goal: exercising thrice a week
  • Long-term goal: Building assertiveness skills

While starting therapy, it’s important to think deeply about your goals and the reasons why they are important for you.


Treatment plan

Devising a treatment plan is of paramount importance in therapy and starts in the first session. Having a solid treatment plan provides both structure and direction to the course of therapy. Your therapist will develop your treatment plan based on her orientation and approach, your presenting concerns, and the goals that are defined during the session.


Frequency and number of sessions

Your therapist will define the number and frequency of sessions based on your concerns and severity of distress. She will also consider important practical factors such as your profession, convenience, need for travel, etc. It’s important to have sufficient time between sessions, so you can implement the behavioral changes discussed and learned in therapy.



The work you do outside of the therapy room can be just as meaningful as the work you do inside. At the end of the session, the therapist may discuss some tasks/activities for you to do before the next session. These may include devising a routine plan, sleep-wake cycle, physical exercise, maintaining a thought record, mood diary, etc.



Oftentimes, your therapist may also carry out certain diagnostic assessments during your first visit. Assessments involve paper-pencil tests that include questions about your mood, stress levels, anxiety, and overall functioning. These assessments are used to diagnose underlying clinical conditions if any, and objectively evaluate your progress during therapy.


What can you do to prepare for the first session?

It’s always a good idea to prepare for your first session, so you can make the most of it!

Here are a few useful pointers to keep in mind:

  1. Arrive on time to absorb the benefit of the entire therapy session.
  2. Carry a diary and a pen. It helps to note down important elements discussed in the session.
  3. Prepare a list of questions that you may want to ask your therapist. Here are some of the common ones:
    • Your therapist’s educational background, licensure, and years of experience.
    • What is the primary therapeutic modality practiced by her? As an example, is she trained in psychodynamic therapy or CBT or family therapy, etc.).
    • How and when would you pay for the sessions?
    • Frequency of sessions and the expected length of therapy
  4. Finally, carrying a bottle of water always helps!

Therapy is a deliberate process that will require some effort and commitment from you. It works, but it’s not a quick fix!

It helps if you understand the process well and are actively involved throughout to derive the maximum benefits.


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