What to Expect in Your First Therapy Session: Embracing Vulnerability and New Beginnings

Taking the step to start therapy can feel both exciting and overwhelming. There’s always a first time for everything, and this might be the first time you are exploring therapy and wondering what to expect. In my experience as a client and as a therapist, it is completely natural to be nervous during your first session – you’ve never done this before and you are in a vulnerable space asking for help.  In this guide, we’ll explore what you can expect from your initial appointment, how to prepare, and what you might feel afterwards.

#1 You might feel nervous!

Before you walk through the door (or log on for an online session), it’s helpful to have an idea of what lies ahead. Many people have told me they’re anxious about that first step, and that nervous energy can actually be a signal of your readiness to address deep-seated feelings.

Feeling nervous before meeting a new therapist – or attending therapy for the first time is very normal! You can even tell your therapist that you are feeling nervous about being there, and they will likely tell you that everyone gets nervous because attending therapy is vulnerable and you’re not sure how it will go yet. You might be feeling nervous because you don’t know what to expect, or because you want to go to places emotionally you have never gone before. Nerves are not a bad sign, and these are all emotions that can be shared in therapy. If you are feeling worried sharing too much too soon, let your therapist know. Therapists are trained to match your pace and should never pressure you to share more than you are wanting to. 

#2 Talking about Logistics and Confidentiality is part of your first session

• Logistics:
  Whether you’re attending an in-person session or joining an online call, ensure you know the details. Confirm your appointment time, location or platform, session fee, and cancellation policies. This practical preparation can help minimize stress on the day of your appointment. These are things that your therapist or the clinic administrator can answer for you before booking an appointment. I recommend making sure you have those logistical answers before booking an appointment. I also recommend doing a free consultation call with your therapist before booking in to make sure they are the right fit for you.

• Pre-Session Paperwork: Confidentiality and Consent for Counselling
  Many therapists ask new clients to fill out intake forms or questionnaires before the session. This paperwork is not meant to be burdensome; rather, it provides a snapshot of your background and current challenges. Completing these forms ahead of time can help you feel more organized and ready to share. At our practice, we have a confidentiality and consent form as part of our initial paperwork before getting started. Your therapist will verbally go over these policies with you before getting into anything during your first session. Confidentiality ethics vary depending on if counselling is mandated, you are a minor, counselling is for a group (i.e. couples or family therapy), and sometimes depending on your insurance policy. Your therapist will make it very clear what their limits to confidentiality are before you get into anything so you can be informed in the process and only share what you want to. To sum it up: if you are a consenting adult attending therapy of your own accord there are a few limits to confidentiality in therapy: if you or someone else if at risk of being harmed then your therapist needs to legally disclose this to someone to keep whoever it is safe.

#3 Talking about Goals in Counselling 

Many therapists have clients fill out an intake form prior to their session. These forms often ask what’s going on and why you are seeking counselling at this time.

In your first session you will likely talk about what you hope for out of therapy and create goals together. Your therapist can give you feedback about what achieving those goals realistically looks like in therapy. If you don’t know exactly what you want out of therapy – that’s okay! You and your therapist can discover that together. 

#4 You may feel uncomfortable emotions or even cry

Seeking therapy is not always easy, and we know that there was something difficult that likely prompted you to reach out for help. You may feel sad, angry, or upset and even cry in your first therapy session – we have kleenex boxes all over our office for a reason!

As a person who cries when she is sad, angry, frustrated, stressed, happy, and overwhelmed – I understand that tears can be vulnerable and you don’t always want to cry in front of someone else! Therapists want you to know that it is completely okay and normal to cry in therapy. We are not uncomfortable with your sadness or emotions, even if it feels uncomfortable to feel them in therapy. You never need to apologize for crying in counselling.

#5 You can ask questions too!

Therapy is a collaborative process which means you can ask your therapist questions too. You might want to ask them about their experience as a therapist, their typical approach, what they anticipate it looks like to work together.

• Understanding the ‘How’ and ‘Why’:
  If you have questions about the therapeutic techniques, session structure, or even how your emotions (like nervousness or tears) will be handled, speak up. A good therapist encourages questions and values your input.

• Your Right to Feedback:
  Therapy is most effective when it’s a dialogue. If something feels off—be it the pace of the session or the methods being used—let your therapist know. Your feedback is not only welcome; it’s essential in tailoring the process to your needs.

• Clarifying Uncertainties:
  You might wonder about the long-term process, session frequency, or even what happens if you feel overwhelmed. Asking these questions early on can help set clear expectations and provide reassurance throughout your journey.

• Asking about your Therapist:
  Some people want to know more about their therapist than other people – who prefer a “blank slate” therapist. You are always welcome to ask your therapist questions about who they are as a person if that’s helpful for you to know, and they can choose what they would like to disclose.

#6 Your therapist will talk about payment and money

In private practice there is a fee for service. Due to this fact it is important that you speak about money and payment in therapy. Your therapist will have guidelines for how they accept payment, the fee for service, sliding scale prices and when they expect payment. They also may discuss their cancellation policy at this time and what it means to re-schedule or cancel sessions. At Haven Wellness Collective you can find our payment agreement on our website, and it is also something that is discussed in a free consultation call. 

Talking about money can be uncomfortable. Your therapist wants you to know that even though there is a fee for therapy sessions, it does not mean that they care about you any less.

#7 Opening Up Takes Time

One of the most common concerns for first-time therapy clients is how much to share. It’s important to remember that you’re in control of your narrative.

Finding Your Comfort Zone

• The Invitation to Share:
  Your therapist will often begin with gentle, open-ended questions such as, “What brings you here today?” or “Can you share a bit about what you’ve been experiencing?” These questions allow you to choose how much you’d like to reveal initially. There’s no rush to divulge everything at once.

• Pacing Your Story:
  Understand that your first session is merely an introduction. It’s entirely acceptable to share only as much as you feel comfortable with. The session is about establishing a baseline, and you can always explore deeper issues in subsequent meetings.

• Expressing Emotions Freely:
  As mentioned above, it’s completely okay to cry or show vulnerability if that feels natural. Letting your guard down and expressing genuine emotion is part of the process. Even if you feel embarrassed or unsure about crying in front of a stranger, know that your therapist has likely witnessed this many times before—and it’s all part of your healing journey.

#8 You may feel a range of emotions after your session.

Depending on the content of your session and how things went you may feel a range of emotions.

Many people report feeling lighter after getting started and getting some things off their chest. Others might feel tired after feeling their emotions or crying. You may be feeling hopeful about how counselling can help you.

We hope that you will leave feeling listened to, validated and supported. If you continually don’t feel supported by your therapist this may be a sign that this therapist isn’t the right fit. This is absolutely something that you can explore and bring up as feedback to your therapist if you feel safe to disclose this. This may be an opportunity to discover what you need to feel supported as everyone is always a little different. There’s also the possibility that this therapist isn’t the right fit for you. Read more about how to find the right therapist for you here. 

Final Thoughts: Taking the Leap into Therapy

Starting therapy is a courageous decision. It means acknowledging that while you might be nervous—and yes, even tearful—in that first session, you’re taking an important step toward healing. Remember:

• Embrace Your Nerves:
  Feeling anxious at the start is completely normal. Use that energy to fuel your curiosity about your inner world, and understand that those nerves are part of what makes you human.

• Vulnerability is Strength:
  Whether you smile, cry, or simply sit quietly, every emotion you express is a testament to your willingness to grow. It’s okay to be vulnerable—this is where true healing begins.

• Your Journey is Unique:
  Therapy is not a one-size-fits-all experience. Your path will be as unique as you are, and every session, every tear, and every breakthrough is a part of your personal story.

If you’ve been considering therapy, know that your first session is not about having everything figured out. It’s about starting a conversation with yourself, with someone who is there to listen, and with a process that will evolve alongside you. The courage to show up, even when you’re nervous or on the verge of tears, is the first and most important step toward change.