First Therapy Session? Here’s What to Expect

Taking the first step toward therapy is a brave and significant decision. Whether you’re dealing with anxiety, stress, relationship issues, or simply seeking self-improvement, starting therapy shows a commitment to your mental well-being. It's completely normal to feel nervous, curious, or even anxious about that first session - it's the great unknown!

In India, the need for mental health support is increasingly being acknowledged. The National Mental Health Survey (2015-16) revealed that nearly 10.6% of adults in India suffer from some form of mental disorder, and recent data suggests a rising burden, especially among youth. The good news is that people are seeking help: the government's Tele-MANAS helpline, launched in 2022, has handled over 1.81 million calls as of early 2025, demonstrating a growing willingness to reach out. Understanding what to expect can help ease those first-session jitters.

Addressing the Jitters: Common Concerns

Many people share the same worries before their first session. Knowing these fears are normal can be comforting.

• Fear of Judgment: "Will they think my problems are silly?" Therapists are trained professionals who offer a non-judgmental and safe space. Their role is to help you, not to evaluate your worth.

• Worry about Sharing: "What if I can't talk about my feelings?" You don't have to share everything all at once. Therapy is a process, and you get to set the pace. It's okay to start slow and only share what you’re comfortable with.

• Uncertainty of the Process: "What exactly will we do?" The first session is largely about laying the groundwork, which we’ll cover in detail below.

The First 10 Minutes: Logistics and Comfort

Your therapist will likely start by making sure you're comfortable and covering essential logistics.

1. Welcome and Introductions: The therapist will introduce themselves and their credentials. This is a good time to get a feel for their personality and communication style.

2. Confidentiality: This is one of the most important parts. Your therapist will explain the concept of confidentiality - meaning what you discuss is private and outline the limits of confidentiality. These limits typically apply only in situations where there is a risk of harm to yourself or others, which they are legally and ethically bound to report.

3. Paperwork & Policies: They may briefly go over intake forms (which you might have completed beforehand), payment, cancellation policies, and the general structure of a session.

The Core Conversation: Getting to Know You

After the formalities, the session will shift to a discussion designed to understand you and your current situation. Think of this as a "getting-to-know-you" or intake session.

The Therapist Will Likely Ask:

• "What brings you to therapy today?" This is the main question. Be as honest as you can about your primary concerns, feelings, or problems.

• "Have you had therapy before?" If yes, they'll want to know what worked and what didn't.

• Questions About Your History: They'll ask for a general overview of your life, including your family background, relationships, work/school life, major stressors, and any relevant mental health history. This holistic view helps them understand the context of your issues.

• What are your goals? If you have specific things you want to achieve, like reducing anxiety or improving communication, share them. If your goal is simply to "feel better," that's a perfect starting point, too! Your therapist will help you refine this.

What You Should Do:

• Be Open, Not Perfect: You don't need a perfectly structured narrative. If you forget something, it's okay. You can come prepared with a few notes if that helps you organize your thoughts.

• Ask Questions: Your first session is also an interview for you. Ask your therapist about their therapeutic approach (e.g., CBT, psychodynamic, etc.) and their experience treating issues similar to yours. "Goodness of fit" – feeling a strong connection and trust—is crucial for successful therapy.

Wrapping Up: Next Steps

As the session nears its end, your therapist will typically summarize what was discussed and offer an initial sense of the path forward.

• Initial Impressions: They may share some initial thoughts or their professional understanding of what you've shared.

• Next Steps: You’ll likely discuss how often you should meet (e.g., weekly) and schedule your next appointment.

• The Follow-Up: You probably won't reach a resolution or mastery of your issues in this single session, but simply being truly heard often provides an immediate, powerful sense of relief and validation. Schedule some self-care time afterward - perhaps a quiet walk, a cup of tea, or journaling.

  
  

Remember: Your first therapy session is just the beginning. It's an act of self-care and a step toward a healthier mind. Be proud of yourself for showing up.