What to Expect in Your First Therapy Session

Many people feel nervous before their first therapy session, especially when they don’t know what to expect. The good news is, you don’t have to have everything figured out to begin. Therapy is not about having the perfect words or knowing your goals in advance. It is about starting a process where you can feel supported, understood, and begin to build a relationship with your therapist. Every first session looks a little different because each therapist and client bring their own style, history, and needs. What most sessions share, though, is a focus on comfort, trust, and getting to know each other before any deeper work begins.

Intake Forms and Agreements

Most therapists will begin by reviewing intake forms or agreements. These cover important topics such as privacy, confidentiality, billing, and scheduling. This is also the time to ask questions you may have about how therapy works. You can also learn more about my services if you want to see the different ways therapy support can look.

Building Rapport and Getting to Know You

One of the main goals of the first session is to build rapport. That means creating a space where you feel safe enough to share what is on your mind. You do not need a rehearsed story or perfectly clear answers. Many people simply explain what has been stressful lately or why they reached out for therapy now. The therapist may ask some guiding questions, but you can share at your own pace.

If you are in your 20s or early 30s and feel anxious, overwhelmed, or unsure of what direction you are going, you may find it reassuring to know you don’t need to have it all figured out before starting therapy.

Talking About Goals (With Room for Flexibility)

You do not need to walk into the first session knowing exactly what you want to work on. Some clients begin with something very specific, while others say they feel stuck, anxious, or overwhelmed without knowing where to start. Together we can begin to shape goals, both short-term and long-term, while recognizing that these may shift over time.

How Deep Will We Go in the First Session?

It is important to know that the first session is not about going deep into trauma unless you feel ready. Many clients think they will have to unpack their most painful experiences right away, but that is not the case. The priority is making sure you feel understood and supported before any deeper work begins.

If trauma healing becomes a goal for you, methods like EMDR Intensives can help process the past safely and effectively when the time is right.

Exploring Therapy Approaches

Depending on the therapist, you might also hear about different methods that could be useful. In my practice, this may include art therapy, EMDR, or somatic approaches. There is no pressure to begin these right away. It is simply an introduction to the tools that may be available as we continue working together. Learn more about Art Therapy here.

Ending the Session and Next Steps

Toward the end of the session, the therapist will usually check in on how you are feeling and talk about what future sessions might look like. You might schedule the next appointment, discuss how often you would like to meet, or take time to reflect on whether the fit feels right. It is completely normal to give yourself space to decide.

Common Fears About First Sessions

“What if I cry?”

Crying in therapy is very common, especially in the first session when you are finally letting yourself slow down and talk about what has been heavy. Tears are not a sign of weakness. They are a normal release. A good therapist will not judge you for crying and will help you regulate if it feels overwhelming. You can also let your therapist know if you feel uncomfortable showing that emotion so they can support you in a way that feels safe.

“What if I have nothing to say?”

It's normal to feel unsure of how to start or to go blank once the session begins. The first session is guided by the therapist, so you will not be left to fill the silence on your own. Many clients begin by sharing what brought them in that day. It might be a recent situation, a pattern they noticed, or even saying, “I don’t really know where to start, but I know I need support.” Any of these is enough to begin the conversation.

“What if I don't feel connected?”

Therapy works best when you feel a genuine connection with your therapist. The first session is also a chance for you to notice how it feels to talk with them. If something feels off, it does not mean therapy will not work for you. It might mean you need a different style or approach. You are allowed to take time to reflect, ask questions, and decide if the therapist feels like the right fit.

Frequently Asked Questions

What should I talk about in my first therapy session?

You can share whatever feels most important to you right now. Many people talk about recent stressors or what made them reach out. You do not need to cover your entire history in the first session.

Do I have to share trauma in my first therapy session?

No. The first session is about comfort and rapport, not going straight into painful memories. You get to decide what feels safe to share.

How long does a first therapy session usually last?

Most sessions are around 45–60 minutes, though some therapists may offer different formats.

What if I don’t feel comfortable with my therapist?

The first session is also about seeing if the fit feels right. It’s okay to take time to decide if you want to continue.

Can I do my first therapy session online?

Yes. At Lenora: Art Therapy and Counseling, all sessions are virtual for clients in New York. Many people find starting therapy from home makes it easier to feel comfortable.

Ready to Take the Next Step? 

Every first therapy session is a little different, but most share the same goal: building a foundation of trust. You do not need to share everything at once, and you certainly do not need to go straight into trauma. What matters most is starting a process that helps you feel supported, understood, and empowered to move forward at a pace that feels right for you.

💡 If you are considering therapy, I provide virtual sessions for young adults across New York. My work often combines art therapy, EMDR, and evidence-based approaches to help with anxiety, trauma, and self-doubt. [Schedule a free consultation here →]