Commonly Asked Questions for a First Therapy Appointment

Starting therapy is a brave and important step—but it can also feel unfamiliar and even a little intimidating. Whether you’ve been thinking about therapy for a while or were recently encouraged by a loved one or provider, you might have some questions about what to expect in your first session.

Below are some of the most commonly asked questions people have before their first therapy appointment—along with honest, reassuring answers.

1. What will happen during my first therapy session?

The first session is mostly about getting to know each other. You’ll have a chance to share what’s been bringing you in—whether it’s anxiety, stress, relationship struggles, life transitions, or something else. Your therapist may ask about your current challenges, background, and what you’re hoping to get out of therapy.

It’s also a time for you to ask questions and get a feel for whether this feels like a good fit. Therapy is a collaborative process, and finding the right therapeutic relationship is an important part of that.

2. Do I need to prepare anything beforehand?

You don’t need to come with anything specific—but it can be helpful to reflect on:

• What’s been bothering you lately?

• What goals or changes are you hoping for?

• What’s worked (or hasn’t worked) in past attempts to cope?

Some people jot down a few notes beforehand or think through what they want from therapy. Others simply show up and start where they are—that’s completely okay too.

3. Will I have to talk about everything right away?

No. You’re in control of the pace. You never have to talk about anything before you’re ready. Trust and comfort take time, and your therapist understands that. The first session is not meant to be a deep dive into everything, but a beginning.

4. How long is each session, and how often will we meet?

Most therapy sessions last about 50 minutes. In the beginning, sessions are often weekly, but this can vary depending on your needs and the type of therapy. Together, you and your therapist will find a rhythm that works best for you.

5. Is everything I say confidential?

Yes—with a few important exceptions. Therapists are legally and ethically bound to protect your privacy. However, there are a few situations where they’re required to break confidentiality, such as:

• If there’s a serious risk of harm to yourself or others

• If there’s suspected abuse or neglect of a child, elder, or dependent adult

Your therapist will explain these limits clearly, so you know what to expect.

6. What if I don’t feel a connection with the therapist?

That’s completely okay. Therapy works best when you feel safe and understood. If after a few sessions it doesn’t feel like the right fit, it’s okay to bring that up. A good therapist will support you in finding someone who is a better match.

7. Will I get advice or solutions right away?

Therapy is not always about quick fixes or advice-giving. Instead, your therapist will help you explore your thoughts, emotions, and patterns in a supportive and nonjudgmental space. Over time, you’ll develop insights and tools that are tailored to your life and goals.

8. What if I get emotional or cry?

That’s a normal—and welcome—part of therapy. Many people feel a wave of emotion in their first session simply because they finally have a space to let down their guard. Your therapist is there to support you, not to judge or rush you through those feelings.

Final Thoughts

If you’re considering starting therapy, know that you’re not alone in your questions or concerns. Feeling nervous is completely normal. But taking that first step is often the beginning of meaningful growth and healing. Your first appointment doesn’t have to be perfect—it just has to be a beginning.