What to Expect in Your First Therapy Session
- Andra Gemmell
- Mar 18
- 7 min read
While starting therapy can be an exciting opportunity for change and well-being improvement, it can also bring about a lot of anxiety and uncertainty about what to expect in the first counselling sessions...
But Before Your First Therapy Session…
One of the first difficult things to consider in your therapeutic journey is how to know if you need therapy and which therapist to choose.
If you're still in the process of deciding which therapist might be right for you, our guide “Do I Need Therapy? Here’s How to Find Out & Who May Help!” on choosing the right therapist could be a helpful resource.
Reviewing different therapists’ profiles and reading about their speciality and therapeutic modality can also help determine who may be the right fit to help you with the goals you would want to work on in therapy.
When reading a therapist’s profile, you may even consider reaching out to them to set up a free 15-minute consultation via phone or video call to have a chance to explore if their personality and approach fits with what you’re looking for.
Whether you're seeking therapy for anxiety or depression, grief counselling, therapy for new mothers, or a wide range of other concerns to explore in therapy, Niilo Wellness therapists in Guelph are here to offer in-person therapy sessions, or online counselling appointments in Ontario, to help you find your way through the challenges impacting your emotional, relational, and mental wellness.
For a full listing of the Niilo Wellness Therapist accepting new clients, and to explore their profiles, visit our Guelph Therapist listing here
What Will Your First Therapy Session Be Like?
We will break this down in more detail below, but you can expect your Therapist to explore these four main aspects in your first counselling session:
Administrative information & Confidentiality
Getting to know you
Your goals in therapy
Final thoughts & future sessions
Read on to learn how Niilo Wellness Therapist Andra Gemmell, and most other therapists, structure a clients first session, for insights that may help ease any worries or anticipation anxiety you may have about attending your first therapy session.
Once you have done the hard work of deciding on a therapist, and now that your first session is coming up, you may be wondering,
What is even going to happen in the first session?
What do I even say?
How do I even talk for almost an hour straight to someone?
Having thoughts like this is incredibly common but rest assured your Therapist will be prepared to guide you through any of these concerns as well as a few essential topics that need to be discussed.
4 Main Topics Your Therapist May Ask You About In The First Therapy Session
Your experience may not be in this specific order, but here are four things that you can expect to be discussed in the first session, regardless if you are attending in-person or online therapy:
1. Administrative Information
While you might be worried about what to say and how to talk for 50 minutes straight, the first session might be one of the few sessions where the therapist will actually have a lot to say. There is some logistical admin information that therapists will want to ensure you understand before leaving the first session. Things like:
Confidentiality and its limits, such as in the case of risk of harm to yourself or others
Session length and fees
Payment (and how you can submit the receipt to your insurance)
Cancellation policy and late cancellation fees
Risks and benefits of psychotherapy
Therapist’s approach and modalities used – they may discuss if they use Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy (DBT), Somatic Therapy, Solution Focused Therapy, etc
Opportunity for you to ask the therapist any questions you may have either about them or therapy
Some of this information can also be found on the Nillo Wellness FAQ page
2. Getting To Know You
While the therapist will likely have a lot of information to share with you, they will also want to get to know you because after all, the sessions are about you! It may be hard to open up to someone you have just met, and it is okay if you do not want to go into depth right away and would rather wait until you feel like you have developed more trust and rapport with your therapist. Some therapists may keep the session more open-ended and let you guide what you would like to share about your background, and others may have specific questions they would like to ask.
Here are some of the topics that may be helpful for your therapist to know about for treatment planning:
Mental health history
Family dynamics
Past therapy experiences (what has and hasn’t worked)
Current life circumstances (work, school, living situation, etc)
Current concerns with mood, thoughts, behaviours, health, etc
3. Setting Goals
After the therapist has a bit of your background information and current concerns, together you will work on making some goals for your therapeutic journey. Some people may come to therapy with a specific goal such as setting boundaries with their boss to have a healthy work-life balance before the end of the year, while others may come to therapy with a more general goal such as improving coping skills for managing anxiety. A therapist will help you explore what goals you would like to set while also prioritizing what to work on first. Some things to consider when setting goals:
What would I like to see differently in my life? (improved self-esteem, less relationship conflict, making peace with life changes, drink less, etc)
How can I accomplish this? (learn coping skills for emotional regulation, improving communication, set boundaries, process past trauma, etc)
Do I have a timeline for these goals? (short term goals vs long term goals)
How will I know I am meeting these goals?
Which therapeutic modalities does my therapist recommend for addressing these issues? (Cognitive Behavioural Therapy [CBT] for addressing unhelpful thinking patterns such as catastrophizing or black and white thinking, or maybe Dialectical Behavioural Therapy [DBT] for emotional regulation or distress tolerance skills)
How often would you meet to try to meet these goals? (weekly, biweekly, or monthly sessions)
Are you willing and able to complete “homework” outside of sessions? (some may choose to keep the therapeutic work within session while others like formal homework through worksheets or simply practicing a new coping skill)
4. Wrapping Up
At the end of the session, there will likely be a discussion about your final thoughts and if you would like to schedule your next appointment based on the frequency that you had decided upon. You may also take the time to reflect whether or not you would like to schedule your next appointment and reach out after the session. This is the time when you wrap up your session and prepare for the next steps.
Remember, at the end of the day the therapy sessions are for you. While the holidays can often feel overwhelming due to financial pressures, time constraints, and the weight of expectations of what the holidays “should” look like, it’s important to remember that managing expectations, getting creative, and setting boundaries could help to navigate the season with more ease.
What if You Don't Like Your Therapy Session?
While there are times in therapy that you may feel uncomfortable as you explore emotions that may be difficult, it is important to feel like you have the right fit with your therapist and feel comfortable with them. You may be guided in session, but you have control over what you do and do not want to share.
It is okay to give your therapist feedback.
If something did not feel quite right in session, and if after the first session you felt like this therapist may not have been the right one for you – that’s okay! Sometimes it may take some time to not only get used to attending therapy, but also finding the right therapist for you. You may find when attending your first session that not all of the information mentioned here will be touched upon since it can vary by therapist’s style and also how much information can be shared in a 50-minute session, but over time, more information can be shared in session. Therapy can be a helpful tool for improving your well-being and the first session is just one of the many steps in beginning that process.
Now that you have an idea of what the first session looks like, hopefully you feel more confident to reach out and take that first step to healing!
Guelph Therapist Andra Gemmell is a Registered Psychotherapist at Niilo Wellness and provides in-person therapy in Guelph and online counselling sessions across Ontario. Andra provides counselling using various therapy models such as Cognitive Behavioural Therapy, Dialectical Behavioural Therapy, Solution Focused Therapy, Person-Centred Therapy, Gottman Method, & Trauma-Informed.
To explore working with Andra browse through her Bio and see her availability here!
You deserve to be heard, understood, and supported - At Niilo Wellness, we aim to do that!
The information provided in this article is for educational purposes only and is not a substitute for professional advice, diagnosis, or treatment. The author is not liable for any misuse or misinterpretation of the information in this article.
Your mental well-being is important. Always seek the advice of a qualified mental health provider with any questions or concerns you may have regarding your mental health.
If you or someone you know is experiencing a mental health emergency, please reach out to a professional immediately. In Ontario, you can contact the Talk Suicide Canada Service at 9-8-8 or 1-833-456-4566 for support 24/7, or ConnexOntario at 1-866-531-2600 for mental health and addiction services.
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