Most people arrive at their first therapy session carrying a quiet uncertainty: What am I supposed to say? Where do I even begin? There is no right way to arrive, and nothing you need to rehearse or have figured out beforehand.
You do not need to tell your whole story, find the perfect words, or know exactly what you need. The first session is simply a place to begin. Together, we make sense of what has brought you here and start finding a way forward.
Before the session
You will receive a secure video link for your appointment. All you need is a device with a camera, a stable connection, and somewhere you will not be interrupted for the full 50 minutes.
Some people find it helpful to make a few notes beforehand about what they’d like to discuss. Others prefer to simply see where the conversation goes. Either approach is completely fine.
What happens in the session itself
The practical part
Your psychologist will cover confidentiality and its limits, how fees and cancellations work, and how the sessions will run. Ask anything you want here.
What brought you
The first real question is some version of “what made you get in touch now?” You can start anywhere — the beginning, the middle, or the thing that happened last Tuesday.
Some background
Your psychologist will ask about your current situation: home, work, relationships, sleep, health. This is important because difficulties always exist inside of a context.
What you want to be different
Towards the end, the conversation turns to what you would want to change. A vague answer is fine. “I don’t know, I just can’t keep going like this” is a completely legitimate starting goal.
Next steps
You agree together whether and when to meet again. You can decide about booking future sessions in your own time.
Things people are often surprised by
Sessions one to three: the assessment phase
The first session is the start of a short assessment phase, usually three to four sessions. The first meeting focuses mainly on your reason for coming. The following ones broaden out — early experiences, medical history, education, work and relationships — because patterns in the present are usually easier to understand with some sense of what came before.
You may be asked to complete some general screening measures. These are ordinary clinical questionnaires, not a judgement, and they give both of you a clearer baseline to work from.
At the end of the assessment phase, your psychologist will discuss what they understand of the difficulty, propose an approach, and give you a realistic sense of how many sessions the work is likely to involve.
The short version
You do not need to prepare, you cannot say the wrong thing, and you will not be pushed into anything you are not ready for. The first session is a conversation about what brought you and what you would like to be different. Everything after that is agreed with you, not decided for you.
What if it doesn’t feel right?
Fit matters, and it is not something either of you can guarantee in advance. Research on therapy outcomes consistently finds the working relationship to be one of the stronger predictors of whether therapy helps.1 If after a session or two it does not feel like a fit, say so. A psychologist should be able to hear that without defensiveness and, where useful, help you find someone more suited. That is a normal part of the profession, not a failure.
If you would like to know more about how we work before booking, our questions and answers page covers the practical detail, and you are welcome to send an enquiry with any question at all.
This article is general information, not a substitute for individual professional advice, assessment or treatment. If you are in crisis, please see our emergency resources.
Sources
- Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316–340.
