This post is for people who got are thinking about starting therapy or have their first therapy appointment scheduled (congratulations!), and aren’t sure what to expect. It’s normal to be excited, but also overwhelmed, nervous, and full of questions. So let’s talk about what usually happens in the first few therapy appointments.

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Most people have a general idea about what therapy looks like but aren’t sure about the specifics. Therapy can differ across mental health providers and clinics. In general, you can expect the first few sessions to focus on:

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Getting to know you

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In your first appointment, usually called an “intake”, you’ll meet one-on-one with a trained mental health provider (most often a psychologist, counselor, or clinical social worker). You’ll be asked many questions about who you are and why you’re interested in therapy. Your mental health provider’s goal is to understand what therapy should focus on, and also your unique strengths and challenges. If you have any preferences about the type of therapist you want to work with (for example, a female or Spanish speaking therapist), this is a good time to share it. The clinic or agency should try to best to find you the type of therapist you are looking for.

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From there, you’ll be “matched” with your therapist. This may be the same mental health provider who you had your intake with, but sometimes it’s different. You’ll work with them to find a good time to meet, usually once a week for 45-60 minutes. You and your therapist will decide if your sessions will be virtual (sometimes called “telehealth” or “tele-therapy”) or in person.

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Setting therapy goals

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During the first therapy session, you and your therapist will work together to develop “goals” for therapy. These goals can be big or small, such as:

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• “I want to quit smoking”
• “I want to improve my mood”
• “I want to feel less anxious when meeting new people”
• “I want to process my traumatic experience”
• “I want to learn parenting strategies for when my child acts out”

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Setting these goals helps your therapist know what’s important to you. These goals will also be used to figure out if therapy is working, specifically, figuring out if you’re meeting your goals as you progress in therapy!

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Learning about your therapist’s treatment approach

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Something to remember is that therapists have different styles and approaches to treatment. There’s no “one size fits all” with therapy or therapists. Your therapist will tell you about the treatment approach they use, such as Cognitive Behavioral Therapy (CBT) or Acceptance and Commitment Therapy (ACT). You should feel free to ask your therapist questions about their treatment approach during this first session, and decide if that matches what you’re looking for.

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Learning new skills

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From here, your therapist will help you learn new skills and work towards your therapy goals. Therapy is hard work, so your therapist will support you as you talk about hard topics and push yourself to reach your goals. Some therapists also give you “therapy homework” to do between appointments. This is because it helps to practice what you learn in therapy in your daily life. It’s okay to give your therapist feedback (for example, “I want to try a different skill from the one we’re learning”), especially when you’re just getting to know each other. Your therapist’s job is to make therapy helpful!

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Something to remember is that therapists have different styles and approaches to treatment. There’s no “one size fits all” with therapy or therapists. The first therapist you see may not be the right match – it’s okay to try out a few!

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If you’re still in the process of finding a therapist, Healwise has a national directory of free and low-cost mental health services. We also have guides on finding the right therapist if you’re Black or African American, Latino/x/e or Hispanic (English or Español), Asian American or Pacific Islander, American Indian or Alaska Native, LGBTQ+, or have a disability.