Preparing for a first psychotherapy appointment

Deciding to see a psychotherapist can take a long time, and the first appointment can feel like a big step. It helps to remember that a first session is mostly about getting to know each other. You do not need to arrive with a clear story or a list of goals.

Before the appointment

If it helps, spend a few minutes jotting down some thoughts. You might consider:

• What made you decide to reach out now?
• What would you like to be different in a few months’ time?
• Is there anything you are worried about saying, or being asked?
• For couples: what does each of you hope therapy might help with?

It is also worth checking the practical details in advance: the time and length of the session, the location or online link, fees and cancellation arrangements, and whether any referral is relevant to you. Practices will usually explain these when you book.

What usually happens in a first session

Every therapist works a little differently, but a first session often includes:

• an explanation of confidentiality and its limits
• some questions about what brings you, and about your current situation
• a little background, such as relationships, health and supports
• a chance to talk about how you might work together

You can choose how much to share. It is fine to say “I’m not ready to talk about that yet.”

A good first session is not one where everything is said. It is one where you begin to feel heard.

Questions you are welcome to ask

• How do you work, and what approaches do you draw on?
• What experience and training do you have with concerns like mine?
• How often would we meet, and how will we review progress?
• What happens if I need to cancel or take a break?

Looking after yourself on the day

Talking about personal things can leave you tired or stirred up, even when the session goes well. If you can, leave a little unhurried time afterwards, perhaps a short walk or a quiet cup of tea, rather than going straight into something demanding.

Afterwards

Notice how you felt during and after the session. Did you feel listened to and respected? Some unease is normal when talking about difficult things, but over time you should feel that the relationship with your therapist is a safe enough place to do that work. If the fit does not feel right, it is reasonable to say so, or to look for someone else.

If you are considering couples therapy, you may also find it useful to read about repeating patterns in couple communication.