What to Expect in Therapy: A First-Timer’s Guide

Reviewed by Joseph Demers, PhD, Licensed Psychologist

Taking the first step toward starting therapy can feel both empowering and intimidating. You may have a lot of questions about what therapy involves, how it works, and what you need to do to prepare. Whether you’re seeking support for stress, anxiety, relationships, or another mental health concern, therapy can provide valuable tools for growth and healing.

If you’ve never been to therapy before, you’re not alone in wondering what to expect. This guide will help you feel more prepared, whether you’re exploring online therapy or in-person sessions.

The First Step: Finding the Right Therapist

Before your first therapy session, you’ll need to find a therapist who aligns with your needs. Therapists have different specializations and approaches, so take time to consider:

What are your goals for therapy? Are you looking for help with anxiety, stress management, relationships, or something else?
What types of therapy interest you? Options include behavior therapy, cognitive behavioral therapy (CBT), psychodynamic therapy, and family therapy, among others.
Are you looking for online therapy or in-person sessions? Online options offer flexibility, while in-person therapy may feel more personal.

Once you find a therapist who seems like a good fit, reach out to schedule your first session.

* For information about the different types of therapist credentials, see our blog post titled “The Difference Between Counseling and Therapy”

What Happens in the First Therapy Session?

Your first therapy session, also known as an intake, is a chance for both you and your therapist to get to know each other. You won’t be expected to dive into everything immediately. Instead, your therapist will guide the conversation, helping you explore your concerns at a pace that feels comfortable.

Here’s what you can expect in your first session:

Discussing Why You’re Seeking Therapy

Your therapist will likely ask what brought you to therapy and what challenges you’re facing. You don’t need to have all the answers—just sharing what’s been on your mind is enough.

Setting Goals for Therapy

Together, you’ll start defining your goals for therapy. These goals can be broad, like improving emotional well-being, or specific, like managing stress better or improving communication in relationships.

Exploring Your Background

Your therapist may ask about your personal history, relationships, and previous experiences with mental health care. This helps them understand your unique perspective and tailor their approach to best support you.

Understanding the Therapy Process

Each therapist works differently. Your therapist will explain their methods, whether they focus on behavior therapy, cognitive restructuring, or another type of therapy. They’ll also discuss confidentiality, session structure, and how therapy works in the long run.

Answering Your Questions

This is your time to ask a lot of questions—about the therapist’s style, the therapy process, or what to expect moving forward.

How Therapy Works Over Time

Therapy is not a quick fix—it’s a journey that unfolds over multiple sessions. You will work with your therapist to:

Identify and understand thought patterns or behaviors that may be affecting your well-being.
Develop coping strategies for stress, anxiety, or other challenges.
Improve self-awareness and emotional regulation.
Strengthen communication and problem-solving skills.
Take action to change problematic patterns of behavior

Some sessions may feel deeply insightful, while others might feel like small steps forward. Both are normal parts of the process.

Consistency Matters

To get the most out of therapy, regular sessions are key. Your therapist will recommend a schedule that fits your needs, whether weekly, biweekly, or monthly. In general, starting with weekly sessions helps develop some early momentum toward making meaningful changes in your life.

Feeling Comfortable in Therapy

It’s natural to feel nervous in the beginning, but therapy is meant to be a judgment-free space where you can explore your thoughts and feelings openly. A good therapist will help you feel comfortable by creating a supportive, understanding environment.

If at any point you feel uncertain about your therapist’s approach, it’s okay to discuss it. Therapy should feel like a collaboration, and your comfort is essential to making progress.

Online Therapy vs. In-Person Therapy

Many therapists now offer online therapy, providing a convenient way to access support from home. Here’s how it compares:

Online Therapy

More flexible and accessible, especially for busy schedules
Useful for individuals who live in remote area
Works well for individuals who can tune out distractions during online meetings

In-Person Therapy

Opens more dimension for personal connection
Provides a comfortable physical space dedicated to mental health work
May feel more structured for some individuals

Both options can be effective—it comes down to what works best for your lifestyle.

How to Make the Most of Therapy

Once you’ve started therapy, here are a few ways to make the experience as beneficial as possible:

Be Honest and Open: Therapy is most effective when you share your thoughts and feelings openly. It’s okay if it takes time to feel fully comfortable.

Reflect Between Sessions: Journaling or noting key takeaways after each therapy session can help reinforce insights and track your progress.

Apply What You Learn: Therapy isn’t just about talking—it’s about using the tools and strategies discussed in sessions in your daily life.

Ask Questions: If something isn’t clear, don’t hesitate to ask. Your therapist is there to help guide you.

Be Patient with the Process: Growth takes time. Some sessions will feel more productive than others, but all contribute to long-term progress.

Take the First Step Toward Your Mental Well-Being

If you’re considering starting therapy, know that you don’t have to navigate it alone. Sasco River Center offers compassionate, professional therapy services to support individuals and families in reaching their mental health goals.

We provide both in-person and online therapy for residents in Fairfield, Southport, Darien, and surrounding areas. We also have several providers who can offer remote sessions to individuals in one of the 40 states participating in PSYPACT. Whether you’re exploring therapy for the first time or looking to reconnect with mental health support, we’re here to help.