The First Session of Therapy (aka The Intake Session)

The first session (or first few sessions) of therapy can be nerve wracking - I get it! The space between acknowledging that your’e ready for therapy and making the phone call/ sending the email can require courage and humility. If you’re there - kudos for making that first step!

The intake session of therapy is all about building safety, allowing the therapist to understand you and where you’re currently at in life, and setting the stage for the work to follow. The intake session is NOT a test or an interrogation. I’ll expand on what to expect when showing up to your first session - hopefully to ease any nerves that you may have.

1. It’s Okay to Feel Nervous

Anxiety is an expected and normal human response to the unknown - it’s okay to be nervous or anxious! Many people may worry that they’ll say the “wrong thing” or “not know where to start.” Rest assured, there are no wrong answers. As therapists, we hope you can show up to your intake session with authenticity and honesty, so we can meet you where you are at. Our job is to be a guide as you explore the roots of your current problems and walk alongside you as you find your way to healing.

2. The Intake is a Two-Way Conversation

The intake session isn’t meant to be all about you - it is your chance to ask your therapist questions and learn about how they approach the therapy process. It’s also your chance to see how you feel with them. At the end of the day, therapists are humans, and a large part of the healing process is building a connection with your therapist. If you are feeling hesitations or don’t feel like it’s a good fit - TELL THEM. Please. :) They should be able to discuss the feelings and help you decide on your best next step.

Questions are welcomed and encouraged! If for some reason your therapist is resistant to questions, proceed with caution and decide if that is the right kind of therapist for you.

Some recommended questions to ask (if you’re unsure):

• What is your experience?

• Do you have any specialties/areas of interest?

• What kind of training do you have?

• What kind of therapeutic approaches to you commonly use with clients with (your presenting concern)?

3. We’ll Start With Logistics

Expect some brief paperwork or administrative details: insurance, consent, confidentiality, policies. Your therapist will likely start off with covering the basics to make sure you know your rights and responsibilities as a client. You may sign the papers in their office or online beforehand.

Your therapist will also discuss payment/insurance details. If you are using insurance, it is often your responsibility to make sure that you are aware of your mental health coverage under your current policy. I usually recommend calling your insurance company directly to ask about your coverage and what you should expect. Please make sure to discuss this with your therapist to decide how to move forward with payment and scheduling.

If you are confused at any point, please voice your confusion or questions so your therapist can help you understand. They want you to be aware of what to expect and what their legal responsibilities are.

4. We Talk About What Brought You Here

You don’t have to have a perfectly rehearsed story - speak from the heart. I may ask: “What made you decide to reach out?” or “What’s been feeling heavy lately?” It’s your therapist’s job to learn about your concerns, your history, and your goals for therapy. Be as honest as you can (or feel comfortable being). Your therapist cannot read your mind, and as intimidating or difficult as it might seem to put words to your most difficult thoughts/feelings, we cannot help you if we aren’t aware of what is going on.

Honesty takes courage, and it’s your therapist’s duty to hold space for that honesty.

5. We Explore Your History—At Your Pace

As stated before, we will explore your history - what makes you, you. I may ask about: Your mental health history, family dynamics, relationships, life transitions, and past treatment or trauma (if relevant and safe). But remember, you never have to share more than you’re ready for. If you feel uncomfortable answering a question, tell your therapist that.

6. We Clarify Your Goals

We will discuss what your goals are - in life and in therapy. What would “feeling better” look like for you? These goals can be vague or specific—either is fine. This gives us a jumping-off point for the beginning of our work together. We can refine your goals together as therapy unfolds, so don’t feel constrained to the goals you set in your first session.

7. I’ll Ask About Your Strengths, Too

Therapy isn’t just about problems—it’s also about what’s already working. We’ll explore your coping skills, support system, and personal resilience. Your strengths and established skills are a huge part of who you are and will be vital to explore and strengthen in your healing journey.

8. You Can Set Boundaries From the Start

If you are feeling unsure or uncomfortable, you can ask not to talk about certain topics right away. Your therapist’s goal is to help you feel safe to explore yourself more deeply. If talking about something feels like too much - please tell your therapist! Plus, it’s a great way to practice setting boundaries. :)

You can also tell your therapist if you’ve had bad therapy experiences in the past and what you need to feel safe this time. Feel free to expand on what works and what doesn’t work for you in therapy.

9. We’ll Discuss Scheduling and Frequency

We’ll decide how often we’ll meet. This may depend on your availability, financial considerations, and goals. Your therapist may give you a recommendation on frequency, but it’s up to you how often you would like to/are able to meet.

We’ll also talk about session logistics (virtual vs. in person, rescheduling policies, etc.).

10. The First Session is Just the Beginning

You don’t have to cover everything in one hour. The full intake process may take several sessions, as will getting comfortable with your therapist and learning to trust the space.

You won’t leave with all the answers—but you may leave with a sense of relief that you’re not in it alone.

Final Words

Starting therapy is such a courageous step. The first session is about beginning a relationship where healing can unfold gradually, in a way that’s paced and tailored to your needs.

As your therapist, my goal is to walk alongside you as you explore what it means to be you, how to achieve your goals, and how to heal to be the happiest, most fulfilled version of yourself.