What to Expect From a First Therapy Appointment

By Lauren Presutti

If you scheduled a first therapy appointment, congratulations! This means you are committed to your wellness and are taking steps to improve your quality of life, heal from emotional pain, strengthen your relationships, develop better coping skills, and feel more empowered. Therapy is the one space in your life where the focus and energy is 100% on you, your happiness, your life fulfillment, and your journey through whatever challenges you face. There’s problem-solving, deep reflections, self-understanding, skill-building, empowerment, and a thousand other little moments that can be transformative for becoming be a better version of yourself. There are numerous benefits of therapy and we truly want you to look forward to this process.

We also acknowledge that starting therapy can be nerve-racking and you might have some feelings of nervousness or anxiety about the first appointment. This is completely normal and your feelings are valid. It’s important to normalize your apprehension but also remind yourself that working through a little bit of discomfort in the beginning is worth the positive outcomes you will gain from therapy. To help ease your worries, let’s talk about what to expect from a first appointment.

At River Oaks Psychology, you can expect to be warmly welcomed by your therapist. We pride ourselves on going above and beyond to help people feel like they truly belong here. We urge our patients to be themselves – their full selves – without holding back, because the only way that we can help is if you show up authentically and let us into your world. We deeply want to understand every individual who works with us, and that means that it is our job to build a sacred space where healing and trust can be guaranteed.

In the first appointment, you’ll be able to express what brought you to therapy, how you’re feeling, your expectations, and any questions or concerns about the treatment process. You don’t need to “prepare” anything and it is perfectly okay if you’re feeling unsure how to express yourself. It is our job to guide you and answer any questions you have about therapy. We don’t expect you to perfectly articulate what’s on your mind and we don’t want you to recall a rehearsed narrative. Instead, we simply want you to be yourself! We are extremely non-judgmental and down-to-earth. However you show up in session – however you feel, however you act, however you choose to express yourself – we’re paying attention and we care about you. We are accepting you. We’re honoring your experience.

Beyond expressing whatever is on your mind, the first appointment usually involves your therapist asking a series of questions to better understand your needs. For example, your therapist might ask about your mental health history, your family relationships, how you feel about your school/job experiences, or any trauma you have experienced. These questions might feel boring, but they help your therapist better understand you so they can make the therapeutic experience as beneficial as possible for you.

In addition, your therapist may ask you about any counseling from your past. If you’ve had past treatment, it will be helpful for you to share what you liked and disliked about your past experiences. Please feel encouraged to express what was helpful vs. unhelpful so that we can appropriately tailor your therapy sessions with us. We want you to get the most out of therapy with us – so please speak up and tell us what works best for you! Therapy is largely controlled by you – it is your time, your space, your session, and your opportunity to use the support from your therapist in whatever way feels most helpful.

Goal setting is also an important part of the first appointment. What do you hope to gain from therapy? If you’re not sure, don’t worry! Your therapist will help you clarify your goals and you can expect to leave the first session with a plan for future sessions. Maybe you want to work on stress-management and developing stronger coping skills. Maybe you want to work on trauma recovery, emotional regulation, finding balance in life, building stronger relationships, discovering your life purpose, overcoming schools/job challenges, or resolving family conflicts. You might be in therapy to process difficult experiences after a significant life change or loss. Maybe you want to address problems related to eating, sleeping, self-care, parenting, anger, obsessive-compulsive problems, perfectionism, self-worth, or negative thinking patterns. Or maybe you are starting therapy to establish a safe outlet to vent about day-to-day frustrations or for general processing of who you are and how you relate to the world around you.

Together, you and your therapist will collaboratively determine your therapy goals and create a plan for how to move forward successfully. If – at any point – you feel unhappy with your goals or feel like a change is needed, we highly encourage you to speak up because we are here for YOU! Your happiness in therapy is our top priority and we are committed to modifying your goals however needed as things progress.

The first appointment should also be an opportunity to decide if this is the right therapist for you. It’s extremely important that you feel completely comfortable and connected to your therapist. Sometimes you just don’t click with a person, so we understand if you need to try a different option. Therapy can only be productive and successful if you are able to connect deeply and form a strong alliance with your therapist. If you decide at any point – for any reason – that you would prefer a different therapist, please let us know. You will not hurt your therapist’s feelings. We want you to speak up (asserting your feelings is a part of healthy communication!). You always have the right to request transferring to a different therapist at River Oaks Psychology and we are happy to help you with the process so that a smooth transition occurs.

Finally, you can expect the first appointment to help you feel better about starting therapy. The first time that we do anything in life can be a bit of an adjustment. But after the ice breaks during the first session, you should leave feeling confident and hopeful. To help break the ice, remember to be honest and open. You and your therapist may even use some humor to build rapport right from the start or you might bond over things you have in common. Most people experience the first session to be much more relaxing than they anticipated.

Whether you are starting therapy for the first time in your life – or whether you have had past treatment but are starting therapy at River Oaks Psychology – it’s completely normal to feel nervous, but we hope you’ll find that starting therapy with can be highly empowering. We truly commend you on your decision to work with us and we want you to feel wholeheartedly honored and authentic here. We hope that is evident right from the start.

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We’re here for YOU. Please don’t hesitate to call or text us at (248) 717-1232 or email lauren@riveroakspsychology.com to schedule an online counseling appointment. Your mental health matters.