What to Expect When Seeing a Therapist for the First Time


Written by Erin Talbot.

Psychotherapy has helped millions of people gain insight and the coping skills needed to live happy and healthy lives. Even those of us who are not experiencing a mental health challenge can sometimes benefit from talking to a professional so we can better understand how our minds and emotions work. Before I went to my first therapy appointment I remember feeling nervous and unsure of what to expect. The idea of opening up to a stranger felt scary to me- will they judge me? Will they think I’m “crazy” for feeling the way I do? Will I be judged for seeing a therapist in the first place?

Now I have seen a few therapists and I feel more familiar and comfortable with the process. Before your first meeting it can be helpful to write down what you are hoping to gain from the experience. Generally the first appointment is about getting to know you and what has been going on in your life thus far. Here are a few things to think about before you go into your first meeting:

1) Family and personal history: Be prepared to answer questions about your family and upbringing. Did you grow up in a stable home environment? Is there a history of mental illness and/or addiction? If you are experiencing mental health symptoms-when did they start? How do they make you feel? It can be hard talking about this stuff so it’s important to remember.

2) Move at your own pace: You do not have to talk about anything you are not comfortable with or not ready to talk about. If you are someone who takes a little more time to open up, that is perfectly ok. For some of us, recounting trauma can be an extremely triggering* experience, and we need to make sure we have the emotional strength before diving into certain topics. It is also ok to be an open book and to get deep right off the bat. You should never feel pressure to do something you are not comfortable with. If the therapist asks you a question you are not ready to answer, you can say “I am not ready to talk about this,” and they will understand.

3) Be honest: I can’t stress this one enough! It seems obvious but I struggled with this during my initial appointments. I downplayed the role of drugs and alcohol in my life and completely withheld the fact that I had an eating disorder. I was so used to hiding my problems it didn’t even feel like I was lying. The truth was I was deeply ashamed of how things really were, I was acutely aware of the stereotypes about women with eating disorders, and I let those beliefs affect what I was willing to talk about. I didn’t want to be “one of those” kinds of girls, but now I realize that the stereotypes around mental illness are not true and I wasn’t weak or stupid for having a mental health condition. Therapists are trained and knowledgeable of these conditions so they will not judge you. They see all kinds of patients, and since 1 in 4 individuals experiences mental illness at some point during their lives, you are not alone or weird in your experience.

4) Be realistic: Therapy is not a quick fix. It helps different people in different ways at different paces. In order for therapy to work you need to work with your therapist. The more they know about you the more adequately they can help you. That being said they are not there just to give you advice. A lot of therapy is getting to know yourself and finding solutions for yourself with the guidance of a professional. It’s also an opportunity to express difficult and complex feelings in a non-judgmental environment. Therapy has helped me manage my symptoms by identifying triggers* and by challenging negative thought patterns. I felt like a weight was lifted off of me when I opened up about things in my life that I had never even realized were weighing me down.

5) Find the therapist that is right FOR YOU: There is no one size fits all treatment option for those of us experiencing a mental health challenge. For most of us, there will be some form of trial and error before we find a treatment, or a combination of treatments, that works. It can feel discouraging at times, but it is worthwhile to keep exploring options because you never know which one will change your life for the better. Therapy is a very personal experience, and sometimes we just don’t click with our therapist. It’s important to try a few sessions before making any rash decisions, but if you’ve given it a genuine shot and things just aren’t progressing, it is OK to find a new therapist. In my experience, I realized I could not truly open up to a male therapist given negative experiences I’ve had with men, so from then on I sought out female therapists and had an easier time talking to them. All therapists are different; they have different specialties and different lived experiences that can impact how you connect with each other. Some people are lucky to find a therapist they connect with right off the bat, and others like myself take a few tries to find someone they feel comfortable with.

I hope after reading this you feel more prepared to take the next step in your recovery. It is perfectly natural to feel anxious before your first few sessions but it gets easier. After a while I actually started to look forward to my appointments, since it was a chance to speak my mind without the fear of burdening others or being judged. Good luck on your journey! Feel free to contact me at eringaeltalbot@gmail.com if you have any questions or just need someone to talk with. 🙂


*(A trigger is something that reminds a person of a traumatic event in their lives, which causes them to relive the experience. For example, a war veteran with Post Traumatic Stress Disorder might experience flashbacks when hearing the sounds of fireworks.)

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