What to Expect in Your First Therapy Session

Hi, I’m Cory Anderson, owner of and one of the therapists at Integrity Counseling Group. I’ve been doing therapy in San Diego for more than 10 years. In that time, I’ve had hundreds of first sessions with new clients! Here’s a peek into what to expect in your first therapy session.

The Pre-Session Phone Call

You may find it helpful to speak with a potential therapist before the first session. This gives both of you a chance to get to know each other and discern if you might be a good fit to work together. The therapist can also share a little bit about his or her experience and the therapy techniques he or she uses.

The phone call also determines a lot about what the first session will look like and who exactly the client will be. Your potential therapist will want to know if you are coming in by yourself or with a family member, plus what types of situations you are looking to address.

Typical first sessions are about information gathering and beginning assessment. If there is a current crisis going on, it’s important to establish that over the phone, so you can set clear goals and expectations for the first session.

Lastly, the phone call clarifies the logistics like scheduling, location, and fee for the session.

The First Therapy Session

Most likely, your new therapist will use the first few therapy sessions to get to know you. You will be asked to give a history or your life and any medical and/or psychological conditions. You can also share about your past experiences with therapy and what did or did not go well.

It’s also important to establish your goals for therapy early on. Your new therapist may ask questions such as “How would you know when we are done with therapy?” and “What would be different in your life once the issue that brought you here is resolved?”

That said, you can certainly ask for help with a pressing issue. Just know that the full benefits of therapy will come with time.

I often start first therapy sessions by saying something such as, “I know this is our first session, and you might have some questions. Feel free to ask as we go along. I will do my best to gather some background information, but I realize that you have a lot going on right now and you need some immediate help with that. So, feel free to start where you need.”

I want clients to leave the first session feeling like we have connected and that I understand their particular problem. I also want clients to feel relief knowing that they have begun the process of getting help.

Setting Expectations

You probably are looking for a therapist who is a good listener and will validate your emotions and needs. You may also want someone who can help you process the situation that brought you into therapy. These are fundamental to a good session.

In the type of trauma and addiction therapy I practice, I listen and help clients process their behaviors and emotions. However, they also usually want some clear direction and input through feedback, assessments, and homework. If this is the kind of therapy you need, it’s important to voice your desires along these lines.

Remember that you don’t have to commit to a therapist or therapy in general just because you go to the first session. It usually takes a few sessions to get a feel for a new therapist and vice versa.

If you don’t feel like the therapist is a good match, you can definitely express that and there might be something that can be done differently in the sessions, or it might be appropriate to get some referrals. A therapist with healthy boundaries will not take this personally and will be committed to helping you find the right fit.

Feel free to ask your therapist any questions you have. We will let you know if a question is too personal for us to answer without blurring therapeutic boundaries. Ultimately, this process is about you!

Cory Anderson, LMFT, CSAT, is the founder and director of Integrity Counseling Group, where he leads a team that specializes in treating sex addiction and trauma through a strengths-based, solutions-focused approach. He has received post-graduate training from the International Institute for Trauma and Addiction Professionals and is trained in EMDR.