What Really Happens in Your First Therapy Session

Starting therapy can feel intimidating. Many people wonder what to expect, worry about saying the “right” thing, or fear being judged. The truth is, your first therapy session is simply a conversation: a chance for you and your therapist to get to know each other and begin building a safe, supportive relationship.

Breaking the ice

Most therapists start the first session with introductions and a brief overview of what therapy will look like. They may explain confidentiality, answer questions about the process, and reassure you that this is your space. You do not need to prepare a speech - just show up as you are.

Sharing your story

Your therapist will likely ask what brought you to therapy. This is your opportunity to talk about your concerns, whether it is anxiety, depression, stress, or challenges in relationships. You do not have to share everything all at once; therapy moves at your pace.

Setting goals together

Part of the first session often involves discussing what you hope to gain from therapy. For some, the goal is reducing symptoms like worry or sadness. For others, it may be improving relationships, managing stress, or simply having a safe place to talk. Clear goals help guide the direction of your sessions, but it's okay if you don't know your goals right away.

Asking questions

Your first therapy session is also your chance to ask questions. You might want to know about your therapist’s style, approach, or experience. Therapy works best when it feels like a good fit, so it is important to feel comfortable with your provider.

Normalizing the process

Many people leave their first therapy session feeling relieved. Simply having a space to share openly can ease some of the burden. It is normal to feel nervous at the start, but therapy is not about perfection - it is about progress.

At Etheridge Psychology, we provide therapy in Cary, NC, for children, teens, and adults. If you have been considering counseling but feel unsure about what the first session will be like, know that it is a safe, welcoming step toward feeling better and building lasting change.