What happens in the first therapy session?

While there are more conversations in the media about therapy, it is still difficult to know what to expect from a first session if you've never had therapy before. I'd suggest forgetting all TV and film portrayals of therapy sessions before you start because they are often wildly inappropriate and inaccurate!

All therapies and therapists are a bit different but a typical first session will be different to the following ones because it is likely to involve:

Contracting This is where you and the therapist discuss how you are going to work together safely and ethically. It will involve topics such as confidentiality, data protection, frequency and length of sessions, reviews and payment.

Getting to know each other I usually ask a lot more questions in the first session comparitive to subsequent ones. It shouldn't feel like an interrogation, though! There is often a lot of anxiety in the first session so questions help to provide some structure. Some clients start talking about all of their challenges from the start, others take a bit of time to get comfortable. I'll adjust to what is helpful for you. You can (and should) always tell a therapist if they are asking too many or not enough questions for you personally.

As well as these elements which will take less time in following sessions, the nerves of a first session also mean it is often different to experiences going forwards. Trust your instinct about whether a therapist is going to work for you but also be mindful that you're not letting anxiety colour your judgement after session one.

The first session can also be a useful time to start considering exactly what you are hoping to get out of sessions. Some people have clear, solid goals but that is not the case for everyone. Through the first couple of sessions as you start to get to know each other, it might become a little easier to pinpoint the areas you want to focus on. Personally, if a therapist asks me about something and I feel resistance to responding then that is usually an indication that I need to face that thing.

Remember that you set the pace and you have a right to change your mind. If you pour out your heart in session one because it feels like a relief to finally be able to talk to someone, you do not have to do this in every session that follows. Each session, you have control over what you share and how much you share. If a therapist asks about something you mentioned in a previous session and you have realised it feels too soon to dig into that, don't be afraid to say so.

Overall, first sessions bring nerves for both the therapist and client. You are entering into a new relationship and like all types of relationships, the feelings about starting something new can be mixed. Allow the anxiety, excitement, anticipation and whatever else is coming up to just happen. It is all a normal response to the beginning of a new journey.