What Does a Typical First Therapy Session Look Like?

They don’t all look the same, but here are some things you’ll probably experience.

by Rachel Linder

There’s no question that the idea of starting therapy can be intimidating—especially when you’re not exactly sure what you’re going to be walking into. Of course, not all therapy sessions will look the same, and depending on the type of therapy session and your therapist, you could be looking at very different situations. When it comes to your typical talk-therapy sessions, though, there are often relative similarities.

You won’t necessarily be laying down on a couch like Sigmund Freud’s patients, but there is often some type of couch, chaise or bench in the room. The goal when it comes to talk-therapy is to work on problem-solving the challenges in your life when it comes to mental health. So, Freud found that by having clients lie down, they were better able to speak freely and express themselves, a term he labelled “free-association” when not forced to make eye-contact with the professional. Although many psychologists now will have you sitting in a chair facing them, that element of comfort still remains, and often the design of the rooms are meant to appear less like a doctor’s office and more like a living room.

As with any first doctor’s appointment, the first session will usually start with the therapist asking the patient a series of questions. Things like: What brings you to therapy? What are some of the symptoms you’re experiencing? What are particular goals that you hope to be able to work on throughout the sessions? These will help the therapist get to know you better and also help to outline exactly where to go in your sessions moving forward—essentially it helps to set a game-plan to get you feeling your best.

You’ll notice throughout the therapy session, the therapist will be taking notes, often in a notebook or a pad of paper. Don’t freak out. They’re not judging you or writing all this information down to share with others. Therapy sessions are confidential (the American Psychological Association goes into more detail on all you have to know about understanding confidentiality). They’re simply keeping notes so that they can remember all that was said from session to session, as well as draw conclusions.

Another thing some therapists will do is after the session ends, which usually lasts 45-55 minutes, they will spend the remaining time once you’ve left reviewing the notes and coming up with further analysis based on things you’ve said. This just helps them to be fully prepared for when your next session comes around.

Usually, after the first session of asking the introductory questions, future sessions will be structured differently where the therapist is doing less of the talking and the time will be more focused on strategizing to work on a particular challenge.

It’s important after your first few sessions, you take a step back and do some analysis yourself. Think about whether or not you’re feeling the benefits of therapy, as it’s not always right for everyone, but this is never a reason not to give it a try.