What to Expect in Your First Therapy Session: A Complete Guide

I still remember my first therapy session as a client, years before I became a therapist myself. I sat in that waiting room, heart racing, wondering: What will they ask me? What if I cry? What if I can't explain what's wrong? What if they judge me?

Now, as a therapist in Thane who works with clients both in-person and online across India, I see this same nervousness in nearly everyone who reaches out for their first session. It's completely normal. You're about to share vulnerable parts of yourself with a stranger, and that takes courage.

So let me demystify the process for you. Here's exactly what to expect in your first therapy session—from the moment you book the appointment to the moment you leave (or log off).

Before the First Session: Booking and Preparation

How Booking Works

When you reach out to schedule your first session, here's what typically happens:

Initial Contact: You'll contact the therapist through their website, email, phone, or messaging platform. I usually respond within 24-48 hours.

Brief Screening: Some therapists do a quick phone or email conversation to ensure they're a good fit for your needs. For example, if you're looking for addiction treatment and a therapist specializes in relationship counseling, they might refer you to someone more appropriate.

Scheduling: You'll choose a time that works for both of you. For online sessions, you'll receive a secure video link. For in-person sessions in Thane, you'll get the office address and any parking or directions you need.

Paperwork: Many therapists send intake forms before your first session. These typically ask for basic information—contact details, emergency contacts, what brings you to therapy, medical history, and any previous therapy experience.

How to Prepare

You don't need to prepare extensively, but here are a few things that can help:

Fill Out Forms Honestly: If you receive intake forms, be as honest as possible. Everything is confidential, and accurate information helps your therapist understand you better from the start.

Think About Your Goals: What do you hope to get from therapy? Even vague thoughts like "I want to feel less anxious" or "I want to improve my relationship" are helpful starting points.

Gather Relevant Information: If you're currently taking any medications, seeing other healthcare providers, or have previous therapy records you'd like to share, having that information handy can be useful.

For Online Sessions: Test your technology beforehand. Make sure your internet connection is stable, your camera and microphone work, and you're in a private space where you can speak freely.

For In-Person Sessions: Plan to arrive 5-10 minutes early so you're not rushed. Bring your ID and payment method if needed.

Be Gentle with Yourself: It's normal to feel nervous. That nervousness is actually a sign that you care about the process and are taking it seriously.

What Happens When You Arrive (Online or In-Person)

In-Person Sessions in Thane

When you arrive at my office for an in-person session:

• The Environment: You'll enter a comfortable, private space designed to feel safe and welcoming. No clinical white walls or intimidating furniture—just a calm space where conversation can happen.

• Initial Greeting: I'll welcome you, offer you water or tea, and give you a moment to settle in. If you need to use the restroom or adjust the temperature, just ask.

• Paperwork: If there are any forms you haven't completed, we'll handle those first. You'll also sign a consent form acknowledging you understand confidentiality, fees, and cancellation policies.

Online Sessions

For online therapy:

• Technical Check: I'll make sure you can see and hear me clearly, and I can see and hear you. If there are any issues, we'll troubleshoot quickly.

• Privacy Confirmation: I'll ask if you're in a private space where you can speak freely. If not, we can reschedule—your privacy and comfort matter more than sticking to the appointment time.

• Setting Expectations: I'll explain what to do if the connection drops (usually, I'll call you) and how to reach me if needed.

The Structure of Your First Session

Most first sessions follow a similar structure, though every therapist has their own style. Here's what typically happens:

Opening (5-10 minutes)

• Building Rapport: We start with easier conversation to help you feel comfortable. I might ask how you found me, how your day is going, or make small talk to ease the initial tension.

• Explaining the Process: I'll explain what to expect today and in future sessions, answer any questions you have about therapy, and clarify confidentiality and its limits.

• Consent and Boundaries: We'll discuss informed consent—your right to ask questions, end therapy at any time, and understand what we're doing and why.

Understanding What Brought You Here (20-30 minutes)

This is the heart of the first session. The therapist will ask about the specific problem that inspired you to seek therapy, what you hope to achieve over the course of treatment, and a brief sketch of your background.

Questions I Typically Ask:

• "What brings you to therapy today?" This is usually the first substantial question. There's no wrong answer. Some people have a specific problem ("I'm having panic attacks"), others have a general feeling ("I just feel stuck"), and both are equally valid.

• "When did you first notice this issue?" Understanding the timeline helps me see patterns and triggers.

• "How is this affecting your daily life?" I want to know the real-world impact—on your work, relationships, sleep, mood, and overall functioning.

• "What have you already tried?" Whether it's self-help books, meditation apps, talking to friends, or previous therapy, knowing what you've attempted tells me what's worked, what hasn't, and where we might go next.

• "What would improvement look like to you?" This helps us establish goals. Even if you're not sure, exploring what "better" might mean to you is valuable.

• "Is there anything happening right now that feels urgent?" I always check for crisis situations or safety concerns that need immediate attention.

Background and Context (15-20 minutes)

I may ask open-ended questions to understand your psychological needs, physical health, and other factors affecting your mental health.

Topics I Might Explore:

• Family Background: Your family structure growing up, relationships with parents and siblings, significant family experiences. This isn't about blaming your parents—it's about understanding patterns.

• Current Relationships: Are you in a relationship? Do you have close friends? How are those relationships going?

• Work/School: What do you do? How do you feel about it? Any stressors there?

• Health History: Physical health issues, sleep patterns, medications, substance use, previous mental health diagnoses or treatment.

• Cultural and Identity Context: Your cultural background, religious or spiritual beliefs, gender identity, sexual orientation—anything that shapes your experience of the world.

• Support System: Who can you turn to when things are hard? What resources do you have?

Don't worry—we won't cover all of this in the first session. It's more about painting a picture of who you are and what you're navigating.

Goal Setting (5-10 minutes)

Toward the end of the first session, we'll talk about:

• What You Hope to Achieve: We'll start identifying concrete goals, even if they're still forming.

• My Initial Thoughts: I'll share my preliminary understanding of what might be helpful and what approach I think might work for you.

• Frequency and Duration: How often should we meet? Weekly is typical for active therapeutic work, but we can adjust based on your needs and schedule.

• Next Steps: What comes after today? Will there be homework? What should you focus on between now and next session?

Closing (5 minutes)

• How Are You Feeling? I'll check in about how the session felt for you.

• Questions? Any remaining questions or concerns?

• Scheduling: We'll book your next appointment.

• Between-Session Support: I'll provide my contact information for emergencies and clarify what constitutes an emergency versus something that can wait until next session.

Common Questions You Might Be Asked

Here are typical first-session questions, so you're not caught off guard:

• "Have you been in therapy before? What was that experience like?"

• "Are you currently taking any medications?"

• "Have you ever had thoughts of harming yourself or others?"

• "What does a typical day look like for you?"

• "How do you usually cope when you're stressed or upset?"

• "What are your strengths? What do you like about yourself?"

• "Is there anything you're worried about regarding therapy or working with me?"

Remember: These questions allow you to share your story at your own pace and help you feel more comfortable. You're never required to answer anything that feels too invasive or uncomfortable.

What You Should Ask Your Therapist

The first session isn't just about the therapist getting to know you—it's also your opportunity to evaluate if they're right for you. Don't hesitate to ask:

About Their Approach:

• "What's your therapeutic approach or orientation?"

• "Have you worked with people dealing with [your specific issue] before?"

• "How do you typically structure sessions?"

About Logistics:

• "What's your cancellation policy?"

• "How do you handle payment and insurance?"

• "What happens if I need support between sessions?"

• "How long do people typically work with you?"

About Fit:

• "Do you have experience working with [my cultural background/identity]?"

• "What's your approach to [specific concern, like medication, family involvement, etc.]?"

A good therapist welcomes these questions and answers them directly and openly.

What You Won't Experience in the First Session

Let me also address what typically doesn't happen in your first session, to manage expectations:

You Won't Be "Fixed": The first session is about assessment and connection, not solving all your problems. If you're starting therapy hoping for breakthroughs in the first session or a quick fix, you might find yourself disappointed.

You Won't Be Given a Diagnosis (Usually): While some therapists provide preliminary assessments, most avoid rushing to diagnosis. Understanding you takes time.

You Won't Dive Into Deep Trauma Work: Unless you specifically need to address something urgent, we usually don't go into intense trauma processing in the first session. We need to build safety and trust first.

You Won't Be Told What to Do: I won't give you a list of instructions for how to live your life. Therapy is collaborative, not prescriptive.

You Won't Be Judged: This one needs emphasis. A competent therapist creates a non-judgmental space. They shouldn't show any signs of judgment—no raising eyebrows, no change in expression when you share difficult things. If you feel judged, that's a red flag about the therapist, not about you.

How to Know If It's a Good Fit

After your first session, reflect on these questions:

Did you feel safe and comfortable? Not necessarily relaxed (nervousness is normal), but did you feel the therapist created a safe space?

Did the therapist listen more than they talked? A good first session has you doing most of the talking.

Did they explain things clearly? You should understand their approach, the process, and what comes next.

Did you feel heard and understood? Even if the therapist didn't solve anything, did you feel they "got" you?

Did they respect your boundaries? If something felt too invasive, did they back off when you indicated discomfort?

Do you feel hopeful about working together? Not necessarily excited (therapy is work), but do you feel like this person could help you?

If the answer to most of these is yes, that's a good sign. If you felt uncomfortable, dismissed, or like something was off, trust that feeling. It's okay to try a different therapist.

Special Considerations for Different Types of Therapy

Couples Therapy First Session

If you're coming with your partner, the first session looks slightly different:

• Both partners share their perspective on what brings you to therapy

• I observe how you interact with each other

• We establish ground rules for respectful communication

• Both partners share relationship history and individual backgrounds

• We discuss what you each hope to achieve

Online Therapy Specific Tips

For virtual sessions:

• Test Everything First: Camera, microphone, internet connection, and the video platform. Do this at least an hour before your session.

• Find Privacy: Ensure you're somewhere private where you won't be interrupted or overheard. If you live with others, let them know you need uninterrupted time.

• Minimize Distractions: Close unnecessary tabs and apps, silence your phone notifications, and position your camera at eye level.

• Headphones Help: They improve sound quality and privacy, especially if you're in a less-than-ideal environment.

• Have a Backup Plan: Know what to do if your internet drops. Usually, the therapist will call you on your phone to continue the session.

• Create Atmosphere: Even though you're at home, try to create a calm space—maybe light a candle, have water nearby, sit comfortably. Small things can help you transition into "therapy mode."

First Session with a Queer-Affirmative Therapist

If you're seeking queer-affirmative therapy specifically:

You shouldn't have to educate your therapist on LGBTQIA+ basics or defend your identity.

In your first session with me or another queer-affirmative practitioner:

• We'll ask about your pronouns and use them consistently

• We'll use inclusive language that doesn't assume heterosexuality or cisgender identity

• We'll understand if you need to discuss coming out, identity exploration, or navigating discrimination

• We'll recognize that your queerness is part of who you are, not a problem to solve

After the First Session: What Happens Next

Immediate Aftermath

It's normal to feel a range of emotions after your first therapy session:

• Relief: "I finally talked to someone about this."

• Vulnerability: "I shared so much—did I overshare?"

• Exhaustion: Therapy is emotionally intensive work.

• Hope: "Maybe this will help."

• Uncertainty: "Did I explain things clearly? Do they understand?"

• Emotional Sensitivity: You might feel more raw or emotional than usual.

All of these reactions are completely normal. Give yourself space to decompress after the session.

Between Sessions

Your therapist might teach you a skill or give you an assignment to complete before your next appointment, such as increasing healthy habits or engaging in a mindfulness exercise.

This isn't homework in the school sense—it's an invitation to notice patterns, try new approaches, or reflect on what we discussed. Engaging with between-session work accelerates progress, but if life gets chaotic and you can't do it, that's okay too. We'll work with whatever you bring to the next session.

How Many Sessions Will You Need?

This depends entirely on your goals and circumstances. During initial sessions, you and your therapist will discuss an estimate of the number of sessions needed, though it typically takes around 6 to 7 sessions minimum.

Some people work with a therapist for a few months to address a specific issue. Others continue for years as they work through deeper patterns or simply value the ongoing support. There's no predetermined timeline—your therapy is tailored to your needs.

What If You Don't Like Your Therapist?

Here's an important truth: not every therapist-client pairing works, and that's okay.

If after your first session (or first few sessions) something feels off, you have options:

Bring It Up: "I'm feeling like we're not connecting on this" or "I'd prefer a different approach" are valid things to say. Good therapists welcome this feedback.

Try a Few Sessions: Sometimes, it takes 2-3 sessions to get comfortable. But if you consistently feel unheard, judged, or uncomfortable, don't force it.

Switch Therapists: It's completely acceptable to try someone else. A professional therapist won't take it personally and might even help you find a better fit.

The therapeutic relationship is one of the strongest predictors of therapy success. Finding the right fit matters more than sticking with the first person you try.

Practical Tips for Making the Most of Your First Session

Be Honest: The more genuine you are, the more helpful therapy will be. You don't have to share everything immediately, but what you do share should be truthful.

It's Okay Not to Have Everything Figured Out: You don't need to come with a perfectly articulated problem or clear goals. "I feel stuck" or "Something's not right" are valid starting points.

You Can Cry: Bring tissues if you think you might need them, but also know that I always have them available. Tears are welcome and normal in therapy.

You Can Also Not Cry: Not everyone cries in therapy. Some people process differently. Both are fine.

Take Notes If It Helps: Some people like to jot down insights or remember important points. That's completely fine.

Give Yourself Time After: If possible, don't schedule something intense immediately after your first session. Give yourself time to decompress.

Follow Up If Needed: If you forgot to mention something important or have questions after the session, most therapists are happy to receive a brief email or message.

Addressing Common First Session Fears

"What if I can't explain what's wrong?" You don't need perfect explanations. Start with how you feel or what's not working, and we'll explore together. I'm trained to help you articulate what's difficult to put into words.

"What if I cry and can't stop?" I'll provide tissues, space, and patience. Crying is one way emotions move through us. When you're ready, we'll continue. I won't rush you or make you feel uncomfortable about your emotions.

"What if they think I'm not 'sick enough' for therapy?" You don't have to be in crisis to deserve support. If something in your life or your inner world is causing you distress, that's enough reason to seek therapy.

"What if I realize therapy isn't for me?" That's information too. Some people need just one session to gain clarity. Others realize timing isn't right. Both are valid outcomes, and a good therapist will support whatever decision you make.

"What if they judge me?" Professional therapists are trained to work with people experiencing all sorts of challenges without judgment. If you do feel judged, that says something about the therapist's skill, not about you. Find someone else.

My Approach to First Sessions

At The Candid Therapist, my first sessions reflect my overall philosophy: honest, collaborative, and centered on you.

I create space for you to tell your story at your own pace. I ask questions to understand your context, but I'm also comfortable with silence when you need time to think. I'll share my preliminary thoughts and approach, but I'm always open to your input and feedback.

Whether we meet in my Thane office or online, my goal in the first session is for you to leave feeling:

• Heard and understood

• Clear about what therapy will involve

• Hopeful that this process can help

• Safe to be vulnerable and honest

I integrate narrative therapy principles, which means I'm interested in the stories you tell about yourself, your relationships, and your life. I'm also trained in queer-affirmative practice, so if you're part of the LGBTQIA+ community, you won't need to explain or defend your identity.

Final Thoughts: You're Taking a Brave Step

If you're reading this because you've scheduled your first therapy session, I want you to know: you're doing something courageous.

Seeking help isn't weakness—it's wisdom. It's recognizing that you don't have to navigate everything alone, that support is available, and that your wellbeing matters enough to invest time and energy into it.

The first session might feel awkward or vulnerable or uncomfortable. That's normal. But it's also often the beginning of meaningful change, deeper self-understanding, and a more authentic, fulfilling life.

You don't have to have it all figured out. You just have to show up.

Ready to schedule your first session? The Candid Therapist offers both online therapy throughout India and in-person sessions in Thane. I create an honest, compassionate space for individuals and couples seeking support with anxiety, relationships, identity exploration, life transitions, and more.

Still have questions before booking? Reach out for a brief consultation. I'm happy to answer any questions and help you determine if we're a good fit to work together.

Taking that first step is the hardest part. From there, we'll navigate the journey together.

The Candid Therapist specializes in creating safe, non-judgmental spaces for therapy, with particular expertise in queer-affirmative counseling, narrative therapy, and relationship work. With an MA in Psychology (Counselling) and training in Narrative Practices, Cognitive Hypnotic Psychotherapy, and Queer Affirmative Counseling, I offer both online and in-person therapy in Thane, meeting you exactly where you are in your journey.