What to expect in your first therapy session

July 19, 2023 | Amanda Cramer

Taking the first step to finding a therapist can be intimidating, especially if you don’t know what to expect. It’s natural to feel nervous or uncertain. Remember: Therapy should be a safe space for you to explore your thoughts and feelings without judgment. Connecting with the right therapist is key. So if you don’t feel a connection, it is OK to ask for a referral for someone whose style is a better fit – maybe more academic, maybe more eclectic. Some people prefer a gentle therapist while others appreciate more direct therapists. All therapists offer a unique experience.

Intake Assessment

Your first therapy session will begin with an intake assessment. An intake is typically a session where you and your therapist explore what you’re looking for in therapy, issues you’d like to focus on, and whether you are a mutual fit. The therapist will ask you questions about your current situation, symptoms, history, and goals. Based on this information, the therapist will create a treatment plan that is tailored to your needs.


It’s important to know that everything you discuss during therapy is confidential. Your therapist cannot share your information with anyone else without your written consent. Exceptions to this involve legal and ethical obligations to report or disclose information due to safety concerns, such as child abuse, suicidal intentions, or intent to harm others. You can trust that what you say in therapy stays in therapy.

Setting goals and expectations

Your therapist will work with you to set goals for your therapy sessions. These goals will be based on your individual needs in therapy. Your therapist will also discuss what you can expect from therapy sessions, such as how often you will meet, the length of the sessions, and the modalities of therapy that will be used during your treatment. Sometimes you might not know initially what your goals are, so your therapist can help you clarify these as your therapeutic relationship evolves. As you attend sessions, your therapist will help highlight your progress in reaching your goals.

Types of therapy

There are so many different approaches and modalities of therapy, it would be impossible to name them all here. However, a few common forms include cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), psychodynamic therapy, and humanistic therapy. Many therapists offer a blend of therapeutic styles where they incorporate concepts from several therapeutic modalities to meet you where you are. Your therapist will explain the type of therapy they plan to use and how it can benefit you.

Comfort level

Your therapist understands that it is difficult to open up about personal issues. They will create a safe and comfortable environment for you to share your thoughts and feelings without judgment. Remember that therapy is a collaborative process, and you are in control of the topics you discuss and how much you share. Your therapist may remind you that it is OK to open up in layers and that sometimes you may need to gain some initial skills to process some of the deeper issues.

Duration of therapy

The duration of therapy will vary based on your needs and goals. Some people may need only a few sessions, while others may benefit from ongoing therapy. Your therapist will work with you to determine how long therapy will last and what you can expect in terms of progress and outcomes. In order to see progress for a single issue, a typical treatment plan is around 12 weeks. Building initial therapeutic momentum typically means you will meet weekly with your therapist for some time and then move to a biweekly or monthly schedule.

In conclusion, seeking mental health therapy can be a big step, but it can also be a positive and life-changing experience. During your first therapy session, you can expect to have a conversation with your therapist to get to know each other, set goals for therapy, and discuss the types of therapy offered. That typically does not feel specifically therapeutic right away. Remember that therapy is supposed to be a safe space for you to explore your thoughts and feelings, and your therapist is there to support you on your journey.

Amanda Cramer, LICSW, MPH, is an integrative therapist at Omaha Integrative Care. She loves the beach and spending time with her husband, two kiddos, and two pups. 

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