What I Wish I Knew Before My First Therapy Session

Before your first therapy session, it’s helpful to know that feeling nervous is normal, you don’t have to say everything, and there’s no “right” way to begin. Therapists expect a wide range of emotions and starting points, from excitement to uncertainty, and will meet you exactly where you are.

My hands were sweating. I was 90% sure I’d say something weird. And I had no idea how to start. That was me before my first therapy session. If you’re in that place now, here’s what I wish I’d known before I sat down to start.

 1. You Don’t Have to “Prepare”

You don’t need a script, backstory, or an emotional PowerPoint to share why you’re here. You can start with: “I don’t really know how to do this.”

In your first session, your therapist will do most of the talking. They’ll be asking you plenty of questions like why you’re seeking care and getting a history of your mental health. This will help them understand your needs and develop a treatment plan. 

2. It’s Okay to Talk About “Small Stuff”

I thought I needed to bring capital-T trauma. But therapy is also for:

• Burnout
• Breakups
• Self-esteem
• General “meh” feelings

If something matters to you, it matters in therapy.  Starting with smaller topics, or even “getting to know you” topics can help build rapport and trust with your therapist. Those conversations can help break the ice, garner a laugh or two (yes, it’s okay to laugh in therapy) and can even lead to deeper insights over time. 

3. You Might Cry, Or Not

I didn’t cry. I felt awkward. That’s also normal. Some people sob. Others talk about grocery lists. It’s all valid. Your emotional response might change from session to session, so what happens the first time isn’t necessarily a predictor for the entire therapy experience. Let go of some of that internalized judgement and allow yourself to just be you!

4. Your Therapist Is Trained for This

They’re not judging your story. They’re trained to hold it. They won’t be shocked, weirded out, or disappointed- they have truly heard it all

5. You Can End With “I Don’t Know What That Was... But Thank You”

That was my exit line. My therapist smiled. And I came back the next week.  If you’d like an exit line, try ending the session by saying “one thing I’m taking with me from today is….” Having an exit line is completely optional; sometimes simply logging off or leaving without a scripted ending is totally fine, too.

From Spring Health: You don’t have to feel ready. You just have to start. We’ll help you find a therapist who makes that first step a little less scary.