Your First Therapy Session: A Survival Guide
Why do so many people give up on therapy so quickly? Of course, sometimes it’s because they didn’t like their therapist or that they weren’t ready for therapy yet, but those aren’t the only reasons. Far too many people don’t know what to expect during their first few therapy sessions. When those sessions aren’t what they thought they’d be, they get confused, disappointed, or overwhelmed, and drop out.
We want to make sure this doesn’t happen to you and that you stick around long enough to give therapy—and yourself—a chance.
We’re here to help by explaining what’s going on. If you know what to expect during your first few sessions, you’ll be more likely to stick it out and get to the good part of therapy.
Well, This Is Awkward
If your first few sessions feel awkward, you’re not alone. Starting therapy can be especially awkward if you’ve not been in therapy before. But it’s always pretty awkward regardless.
Some of it is that it’s always awkward talking to someone before you get to know them well. You haven’t found a rhythm with them yet. But some of it is unique to therapy.
There are things your therapist needs to learn about you right away, and the questions they ask are the opposite of the surface-level icebreakers you usually talk about. Therapists get deep with you pretty quickly and can ask some hard-hitting questions.
While you might expect your first therapy sessions to be full of life-changing insights, or to feel like a warm hug from the awesome friend you’ve always wanted to have, they probably won’t feel like that. Instead, those first sessions are more likely to feel like an extremely awkward, overly personal job interview as your therapist collects lots of information about you.
It can help to understand that, surprisingly, the purpose of your first few sessions isn’t therapy. Your therapist can’t do the actual therapy until they learn more about you. So they begin with assessment.
By learning some very specific things about your life, including details about your background, history, symptoms, relationships, work, health, and goals, your therapist can more accurately determine how to help you and how to start off on the right track. So, that’s where your therapist will begin.
Collecting the Dots
While you might have told your therapist a lot about yourself on the phone or online when you were setting up your first session, they probably still don’t know enough to know where to begin your work together.
Good therapists use intuition, but they need to collect enough dots before they can start connecting them. And collecting dots is boring.
This can make your first therapy sessions feel stilted. Your therapist may spend a lot of time looking at a computer screen or piece of paper as they take lots of notes. They might not give you a whole lot of feedback during this process. It might make you feel more like you’re at the DMV than in therapy.
If you’re with a good therapist, they should be able to talk you through the process and make you feel more comfortable. Even in an assessment session, you might laugh, or be moved, or have an insight about yourself right away.
But that doesn’t always happen, and even the best therapist can’t get around the fact that they need to get a lot of information from you. Inevitably, this takes away some of the immediacy and warmth you might otherwise feel when you’re with them.
Many therapists complete that initial assessment in one session. Others might take two, or even three sessions to finish. But however long it takes, we encourage you to hang out long enough to get to your first real therapy sessions. This is when you’ll start to build your relationship with your therapist and when you’ll start to experience emotional breakthroughs. It’s when therapy will start to get good.
Getting to Know You
The assessment is undoubtedly the most awkward part of therapy, but the awkwardness doesn’t necessarily end when it’s done.
Just like when you’re dating, or making a new friend, or starting a new job and getting to know your co-workers, it can take some time for you and your therapist to really start to “get” each other and to find your rhythm together.
For example, it might take your therapist a little while to learn what certain subjects mean to you and how to tell when you’re joking. In the same way, it will probably take you a while to get to know your therapist’s quirks, sense of humor, and way of working with you.
In your first sessions, expect to have jokes that misfire and to have to explain more than you’ll need to explain later.
For example, if lettuce makes you really sad, your therapist isn’t going to instantly understand why. But once you tell your story to your therapist, they’ll be more sympathetic and will understand the next time you bring it up. They might even be able to help you figure out the deeper meaning behind the sadness of lettuce. But they’ll have to know your story—the dots that connect lettuce and sadness for you—first.
So give your therapist a chance to get to know you (and give yourself a chance to get to know your therapist) before you decide therapy isn’t working. You might be surprised how quickly you start to make progress once both of you get to know each other a little better.
Expectation Versus Reality
How you learn about therapy can have a huge effect on how you experience your first sessions. It’s easy to get unrealistic ideas about how quickly and easily therapy works from other people’s stories, whether you’ve seen them in the media or heard them from people you know.
A short article you can read in five minutes about how someone gained a crucial insight in therapy might be summarizing five years of work. Reading about it can make it seem like they hopped straight from one insight to another, when there were actually a lot of dull, stuck, and confused times, too.
The opposite can also be true—storytelling conventions can make therapy seem more difficult than it actually is. If you learned about therapy from movies or television, forget about it. The way therapy is depicted in fiction has more to do with how the writer wants to reveal the character than anything else.
By watching Tony Soprano in therapy, for example, we learn how unmotivated he is to confront the truth about himself. We learn he’s not willing or able to walk away from what’s making him panic. If you’re going to therapy with a genuine desire to heal and grow, you’re probably going to be a lot more successful than Tony was.
Hollywood and Barnes and Noble aren’t the only places we find stories. We learn a lot from the stories our loved ones tell us, too. If your mother, friend, or partner had an awesome experience in therapy, you might have great expectations when you go. On the other hand, if someone had a bad experience, or if therapy didn’t do much for them, you might assume therapy won’t work for you, either. But everyone is different.
If something is bothering you about how your sessions are going, talk to your therapist about your concerns. Tell them when you’re confused, upset, or disappointed. A good therapist will be happy to talk to you and will alter their approach without getting defensive.
Many therapists learn different therapy methods so they can tailor their approach to each client. Especially in those early sessions, they may have to experiment and try a few different things before they figure out what suits you best.
Part of the way you get good therapy is to keep working with your therapist and tweaking what you’re doing until it really starts working for you.
Your first therapy sessions will probably feel awkward. If they do, it’s not you—it’s just part of the process. Hold on and get through them and you can get to the part where therapy gets good.
One of the reasons your first sessions might not be what you expect is that a therapist has to start by doing an assessment. This can take a session or two. They have to ask you a lot of questions before they can know how to start working with you. This can be either boring or overwhelming. Just know this isn’t how every session will feel.
Even after you move from the initial assessment to your first actual therapy sessions, it can still feel a little awkward. This is because it will take you and your therapist at least a few sessions to get to know each other and to figure out what does and doesn’t work for you. We encourage you to be patient and give your therapist a chance before you give up on them and quit.
Give Your Therapist a Chance to Get It Right
We don’t want anyone to keep going to a bad therapist, and we strongly encourage you to walk away if you start seeing red flags. But we don’t want you to give up on a new therapist too quickly, either.
Give your new therapist enough time to complete their initial assessment sessions, and to get at least a few sessions beyond that, before you decide you’re not clicking with them or that therapy isn’t working for you. It’s the only way you’ll ever get to where it does work.
Therapists usually choose the profession because they already have certain strengths, including empathy and an intuitive understanding of how people work. They then complete a lot of study and training that helps them refine their knowledge and their skills.
This means that talking to a therapist isn’t the same as talking to a friend. But in the end, therapists are human, too, and they need time to build a good relationship with you just like anyone else would.
Therapy is awesome. That belief is at the heart of what we do at OpenCounseling. We think people should be able to experience the healing power of therapy regardless of their income or life circumstances. But we know that affording therapy is only half of the story.
Far too many people give up on therapy too quickly and miss the chance to experience something life-changing. We want to help you avoid the same fate, so please keep going. You might be surprised by just how amazing therapy will feel after you get through those awkward first sessions.
Stephanie Hairston is a freelance mental health writer who spent several years in the field of adult mental health before transitioning to professional writing and editing. As a clinical social worker, she provided group and individual therapy, crisis intervention services, and psychological assessments.