What to Expect at Your First Individual Therapy Session
/Written by Concentric Counselor Michelle Mannino Purkey, LMFT
Starting mental health therapy is an important step toward taking care of your mental and emotional well‑being. It’s completely normal to feel unsure, nervous, or even a little overwhelmed before your first therapy session. Many people wonder what they’re supposed to say or what questions they should ask.
The good news is that the first appointment is usually gentle and structured. Your therapist’s main goal is to help you feel comfortable. You don’t have to worry about saying the “right” thing. Instead, simply try to be open and honest about what brings you to therapy and how you’ve been feeling.
Below is an overview of what you can expect from your first individual therapy or counseling session, which is often referred to as the intake session.
What You Can Expect from Your First Individual Therapy or Intake Session
The first appointment is often referred to as the intake session. Below is what you can expect to occur during your first intake appointment.
Warm Welcome & Rapport Building
First, your therapist will likely start with light conversation to ease any tension you may be experiencing. Any feelings you share will be validated as your therapist wants you to immediately feel heard, understood and supported. This is an opportunity to start the process of building trust and safety between your therapist and you.
Introduction to the Therapy Process
During the next part of the intake session, the therapist will explain their role in the therapy process and describe their therapeutic approach. At this time, the therapist will also review consent forms, approach to appointments and practice policies. The length and frequency of therapy sessions will be discussed as well.
The therapist will explain confidentiality and its limits, such as situations involving safety concerns. You will also be informed about the best ways to communicate with the therapist outside of sessions. In addition, the therapist will review policies regarding late cancellations and missed appointments.
This is also an opportunity for you to ask any questions you may have to gain a clearer understanding of the therapy process and expectations. While it’s the job of the therapist to ask questions, it is important you feel comfortable asking questions you may have as well.
Explore Your Concerns & Goals
Most of the intake session will center on the concerns you want to address and the goals you hope to reach. You and your therapist will work together to clarify what you want from this process.
Common topics to be explored:
● What you hope to change or understand
● Your current stressors
● Symptoms you are experiencing
Your Therapist Will Ask You Questions
In addition to sharing your concerns, stressors, symptoms, and hope for therapy, your therapist will ask you a variety of questions exploring a number of areas of your life to better understand you. This can be viewed as the biopsychosocial experiences or intake questions. For example, your therapist may ask questions that pertain to:
● Your support system
● Your medical history
● Any past therapy experiences
● Any cultural factors
● Other background and experiences such as what is happening at school, work, in your relationships, or traumas
You may not be able to answer all of the questions asked of you and that is okay. This is an opportunity for your therapist to get a general overview, with future sessions used to ask more detailed questions. You aren’t expected to have perfect answers or complete clarity right away - the therapist is looking to build a relationship with you, better understand you, note any themes, patterns and starting points.
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After Your First Session
After a first individual session, you might feel tired, anxious, emotionally strong, encouraged, hopeful, reflective, or many other things. There’s no “correct” reaction. Everyone processes therapy differently. Paying attention to your feelings after the session is useful information. Sharing those reactions with your therapist next time helps them adjust their approach and offer coping strategies or exercises that support you between sessions.
How to Know If the Therapist Is the Right Fit
While a therapy practice may try to match you with a therapist who specializes in your specific concerns, that may not always be possible. As a result, the first therapist you see may not feel like the right fit. It can be helpful to attend three to five individual therapy sessions before deciding whether the therapist is a good match for your needs.
A good fit often feels like:
● You feel listened to
● You feel respected
● You don’t feel rushed
● You feel safe being honest
● You sense potential for trust
● You feel this therapist can help you
General Tips
Being honest and open with your therapist allows them to best support you with the challenges you are seeking help for. Try to set realistic expectations noting therapy is a gradual process and is often best described as a marathon rather than a sprint.
Schedule appointments at times when you can be mentally present and engaged. It may also be helpful to consider what you are doing before your session so that it isn’t something that leaves you rushed, distracted, or emotionally overwhelmed.
Consistency is key when starting mental health therapy because it creates the structure needed for real change. While it’s normal for things to come up in life, research shows consistency provides greater healing and opportunities for growth. Specifically, weekly sessions help you build trust with your therapist and practice new skills often enough for them to stick. Showing up regularly shows prioritizing yourself, keeps momentum going, even during weeks when motivation dips. Over time, those small, repeated steps add up to meaningful progress.
Additionally, try to plan for a little time after your session to reflect or give yourself space to process any emotions that may surface. Remember that it is okay to switch therapists if you do not feel a connection. Finding the right fit is an important part of the therapeutic process.
Above all, be kind and gentle with yourself. Choosing to seek support is a meaningful step toward caring for your mental and emotional well-being. Healing isn’t linear, and it is okay to move at the pace that feels right for you.
About Concentric Counseling & Consulting:
Concentric is a mental health group practice offering individual therapy, couples and relationship counseling, tween and adolescent support, family therapy, couples intensives, and consulting services. Our therapists work with a wide range of concerns, including anxiety, depression, mood-related challenges, complex and developmental trauma (C‑PTSD), relationship and family difficulties, school and peer issues, relational trauma, mind–body connection, life transitions, acute and chronic stress, grief and loss, identity and purpose exploration, substance misuse, and unresolved family‑of‑origin experiences.
Many of our clinicians and therapists also bring additional areas of specialization, which you can explore on their individual bios.
We provide care 7 days a week, with in‑person sessions available at our Chicago offices in The Loop and Sauganash, as well as virtual teletherapy for added flexibility. If you are ready to learn more or get started, reach out to us here.