How Therapy Works: Breaking down the first session

Whether this is your first time in therapy or you’ve started and stopped with a different therapist, meeting someone new can feel scary and intimidating. This blog is here to walk you through the key takeaways that can help you feel more prepared, and hopefully more comfortable, going into your first therapy session.

The Basics

Most therapy sessions start with the basics: your name, age, and where you’re located. Your therapist may ask where you’re taking the session from—especially for online therapy. This is important because of something called confidentiality, which includes having a private space where no one can overhear you. Sometimes that might mean joining from your car, a private office at work, or a quiet study room at school.

Sharing Your History

During your first session or one of the early ones, we’ll often go into your history and background. This might include questions about your childhood, where you grew up, what your family was like, what the dynamics were, and who your support system was. It’s all part of helping your therapist understand your world.

Logistical Details

We’ll also cover important therapy logistics like confidentiality, cancellation policies, and intake paperwork.

Confidentiality is a foundational part of therapy. It means what you share stays private, with just a few legal exceptions—like if you share that you plan to harm yourself or someone else, or if there’s suspected child or elder abuse. Therapists are mandated reporters, and our goal is always to keep you and those around you safe.

Most therapists also have cancellation policies. Mine is 48 hours (others may be 24 or 72). If you cancel within that window, you’re typically responsible for the full session fee. That’s because your therapist has set aside that time just for you. Life happens though—always reach out if an emergency comes up. Therapists are human too.

You might be asked to review or sign several forms—like intake paperwork, informed consent, releases of information, insurance info, or assessments. The first session is a great time to ask any questions you have about any of that.

Ask Your Questions!

Your first therapy session is a great space to ask any questions that are on your mind. Maybe you’re wondering if you can text your therapist or how to get in touch between sessions. Every therapist works a little differently—don’t be afraid to ask!

Setting Goals

Last but not least, you’ll want to talk about your goals. What are you hoping to get out of therapy? How will you know if things are improving? You don’t need to have all the answers—many people don’t! If you’re unsure, your therapist can help guide you toward goals that feel aligned and meaningful.

Final Thoughts

Starting therapy, especially online therapy, can bring up a mix of emotions. The more you know what to expect, the more empowered you’ll feel walking into your first session. Whether you’re navigating a life transition, managing anxiety or depression, or simply feeling stuck, therapy can be a supportive space to figure things out—one step at a time.