Starting mental health services can feel like a big step, and for many, it comes with a mix of emotions—relief, anxiety, hope, and even fear. The idea of opening up to a stranger about personal struggles may feel overwhelming. You might wonder, Will my therapist judge me? Will I have to talk about everything in the first session? What if I don’t feel a connection? These are completely normal concerns.
This guide will walk you through what to expect in your first session, ease some of the common fears, and highlight the importance of the intake appointment in shaping your mental health treatment journey.
Understanding the First Session: The Intake Appointment
Your first appointment is different from regular, ongoing therapy sessions. Known as the intake session, this meeting is primarily about gathering information, setting expectations, and beginning to build a therapeutic relationship. While therapy sessions usually focus on working through concerns, developing coping strategies, and fostering insight, the intake session serves as the foundation upon which your treatment will be built.
What Happens During the Intake Appointment?
- Paperwork and Logistics
- Before diving into the session, you’ll complete paperwork, including consent forms, privacy policies (HIPAA in the U.S.), and questionnaires about your symptoms and history. This helps your therapist understand your background before you even begin talking.
- If you’re using insurance, billing details will also be discussed.
- Getting to Know You
- Your therapist will ask about what brings you to therapy and what you hope to gain from it.
- They’ll likely inquire about your mental health history, including previous therapy experiences, medical history, and any current medications.
- Questions about your personal background, such as your relationships, family dynamics, career, and lifestyle, may also come up.
- Identifying Challenges and Strengths
- While the intake session focuses on understanding what’s bringing you into therapy, it’s also about highlighting strengths and resilience.
- Your therapist may explore coping mechanisms you’ve used in the past, support systems in your life, and areas where you already feel strong.
- Introduction to the Therapy Process
- Your therapist will explain how sessions typically work, their therapeutic style, and any approaches they recommend (such as cognitive-behavioral therapy, Eye Movement Desensitization or Reprocessing (EMDR), or mindfulness techniques).
- This is a good time to ask questions about their experience, how they handle specific concerns, or what you can expect from treatment.
- Collaborative Goal-Setting
- While you may not map out an entire treatment plan in the first session, your therapist will start identifying some key areas to work on.
- They may offer some initial impressions and discuss potential directions for your care.
Addressing Common Fears About Therapy
“What if I don’t know what to say?”
Many people worry they won’t know where to start or how to express themselves. Remember, your therapist is there to guide the conversation. They’ll ask questions to help you open up at your own pace. There’s no ‘right’ way to start therapy — just showing up is a significant first step.
“Will my therapist judge me?”
Therapists are trained professionals who approach every client with empathy and a non-judgmental stance. Their role is to understand, not to criticize. Whatever you’re struggling with, they’ve likely worked with others facing similar challenges.
“Do I have to talk about everything right away?”
No, you’re not expected to disclose everything in the first session. Therapy is a process, and you have full control over what you share and when. If certain topics feel too sensitive to discuss at first, you can let your therapist know, and they’ll respect your pace.
“What if I don’t feel a connection with my therapist?”
While the first session is about information-gathering, it’s also an opportunity to assess whether you feel comfortable with your therapist. You should feel heard, understood, and respected. If you don’t feel a connection after a few sessions, it’s okay to explore other options. A good therapeutic fit is essential to effective treatment. If at any time you’d like to consider switching to another provider you feel more comfortable working with, you can always reach out to us! No one will take it personally! We want all our clients to feel comfortable working with the right therapist for them.
How the First Session Informs the Treatment Plan
A treatment plan is a roadmap for therapy, outlining goals and strategies to address your concerns. The intake session helps shape this plan by identifying key issues and discussing what success in therapy might look like for you. Your therapist will use this as a roadmap to ensure we’re working towards overall symptom improvement and greater wellbeing. Below are some of the components of a treatment plan most therapists will include to ensure we’re working together, collaboratively, to get you feeling better.
Components of a Treatment Plan
- Primary Concerns: What brought you to therapy? Are you dealing with anxiety, depression, trauma, relationship issues, or something else?
- Goals: What do you hope to achieve? Some sample goals might include reducing anxiety, improving self-esteem, healing from past trauma, or developing healthier relationships.
- Therapeutic Approach: Your therapist may suggest specific interventions tailored to your needs, such as cognitive restructuring for anxiety or mindfulness techniques for stress reduction.
- Session Frequency: Most people benefit from weekly sessions to start, and as symptoms improve, they reduce the session frequency to biweekly or even monthly. Though there are other factors we consider including the severity of your concerns and scheduling needs.
- Progress Evaluation: Therapy is an evolving process, and your treatment plan will be adjusted as needed based on your progress and feedback. Our therapists regularly track progress, and formally update the treatment plan every 3 to 4 months.
The Importance of Feeling Comfortable in Your First Session
One of the most valuable aspects of the intake session is establishing an initial bond with your therapist. While deep trust takes time to develop, you should leave the session feeling a sense of connection and hope.
Signs that your first session went well include:
- Feeling heard and validated
- Gaining a clearer understanding of how therapy will work
- Experiencing a sense of relief, even if emotions were stirred up
- Leaving with a plan for next steps
If you walk away feeling unsure or disconnected, give it a few more sessions to see if the dynamic improves. If it doesn’t, it’s completely okay to seek out another therapist who might be a better fit.
Final Thoughts: Embracing the Process
Starting therapy is a courageous step toward growth and healing. While the first session may feel nerve-wracking, it sets the foundation for meaningful work ahead. Remember that therapy is a journey—one where you’re in control, and your therapist is there to support you every step of the way.
If you’re considering therapy, approach it with an open mind and patience for the process. The most important thing is that you’re showing up for yourself, and that in itself is a powerful act of self-care.
