You’ve Booked Into Therapy - What Should You Expect?
While The Nest doesn’t offer therapy, we understand many people have questions about what to expect and it can be tricky to find the right person to ask.
If you're wondering what to expect when going to therapy for the first time, you’re not the only one. It’s one of the most common things we hear from people in therapy sessions “I didn’t know what to expect”.
Starting therapy can feel uncertain — even if you know you need support. Here’s what typically happens and what you should know before your first session.
Before Your First Therapy Session
Once you book therapy, you may receive some intake paperwork or forms to fill out (or you may not! It depends on the therapist), consent and confidentiality information and practical details (location or video link, fees, cancellation policy)
These forms and information sheets help your therapist understand your background and explain how therapy works. You don’t need to prepare anything perfectly, simply showing up is your only job.
What Happens in the First Therapy Session?
The first therapy session is usually focused on getting to know you as a person. A therapist may call this an assessment or interview, but essentially their job is to get a really good understanding of what’s brought you to therapy, what’s going on in your life, and what your goals are from thearpy.
Your therapist may ask:
What brought you here today?
How long you’ve been feeling this way?
What symptoms you’re experiencing (anxiety, low mood, overwhelm, sleep issues)?
What you hope will improve or what you hope to get out of therapy?
You won’t be expected to share everything immediately. Therapy moves at your pace, and your therapist will steer the conversation by asking questions. It is their job to ask you what they need to know, you don’t need to know what you’re going to say before you get there.
For example,if you don’t know what to say, you can simply start with:
“I’m not sure where to begin, but I know something doesn’t feel right.”
That’s completely normal, and again its the therapists job to ask the next question. There is no such thing as an awkward silence in therapy.
Oh and one more thing - it probably won’t be like the movies. You probably won’t be reclined on a leather sofa, your therapist will not be sitting there judging you, and they won’t simply tell you what to do to ‘fix things’.
Is the First Therapy Session Emotional?
Sometimes, and it really depends on what you’re wanting or willing to talk about. If you don’t want it to be, it doesn’t have to be, but if you’re looking for a space to let emotions out it can certainly be that.
Remember, you remain in control of how much you share so if you want to spend the first session sussing out whether its right for you, that’s ok. In fact, it would probably be helpful to let the therapist know that - they won’t be offended and you won’t be the first person to say it.
Do You Have to Talk About Childhood?
Not necessarily.
Some therapy approaches explore past experiences in depth, while others focus more on current challenges and practical coping strategies. You can always say if something feels too personal to discuss yet, and if there are things you don’t want to talk about then you simply don’t have to.
Therapy During Pregnancy or Major Life Changes
If you’re pregnant or navigating a significant transition, therapy can be especially helpful. Anxiety, intrusive thoughts, and mood changes are common during pregnancy, and many people seek therapy at this stage as proactive and preventative support.
You don’t need to wait until things feel unmanageable to start.
What Happens After the First Therapy Appointment?
At the end of the session, your therapist may:
Summarise what they’ve understood
Suggest a treatment plan
Discuss session frequency
You’re also deciding whether the therapist feels like a good fit. The therapeutic relationship is important, and therapy is a collaborative process so if you disagree with what the therapist has said or want to take things in a different direction definitely let them know.
Attending a therapy appointment can generate a sense of relief afterwards, while others might feel more emotional or tired. These reactions, and many more, are all normal and common so perhaps allow yourself some time after your appointment before whatever comes next in your day.
Not Ready for Therapy Yet?
Unsure if you’re ready for therapy? You might like to take a look at our recent blog How do I know if I need therapy?
If you think you’re not ready for therapy you may prefer to begin with structured self-help tools before committing to therapy. That’s why we’ve designed our Emotions, Mental Wellness and Pregnancy workbook to provide you with a starting point. This is an educational resource designed to help you understand some of the common psychological challenges experienced in pregnancy such as anxiety and low mood, while providing you with simple and easy to use tools to build your own coping strategies.
Importantly, our resources do not replace therapy and if you feel like you would like to talk to someone we definitely encourage you to do so.
Final Thoughts
You don’t need to be in crisis to see a therapist. Many people start therapy because they feel stuck, overwhelmed, anxious, or simply not themselves. Many other start because they have a specific goal they want help with or want to better understand themselves.
Your first therapy session isn’t about being perfect. It’s about beginning. And beginning is often the most important step.