What to Expect in Your First Therapy Session

If you've never been to therapy, this is the post I'd want you to read before our first call.

Most people who reach out to me have never done this before. They've thought about it for months, sometimes years. They've opened the booking page and closed it again. And when they finally do book, the question underneath all the other questions is usually the same: what is actually going to happen in that room?

Here's the honest answer, start to finish.

Before we meet

The first step is a free 15-minute consultation, by phone or Google Meet, whichever you pick when you book. It's a short conversation, before any therapy starts, so we can both figure out whether I'm the right person to help you. You tell me a little about what's going on and what you'd like to be different. I tell you how I'd approach it and answer practical questions: scheduling, fees, whether we'd meet in person at my Austin office or by telehealth.

You don't need to prepare anything. You don't need to have the right words for what's wrong. "I don't feel like myself and I can't explain why" is a complete answer. I've heard it many times, and it's a good place to start.

If we decide to move forward, you'll get a few forms to fill out before the first session. They take about fifteen minutes. That's the paperwork part, and then it's done.

The first session

The first full session is fifty minutes, and it has a different shape than the ones that follow. Later sessions are about working on things. The first one is about understanding.

I'll ask what brought you in now, as opposed to six months ago. I'll ask about your history, because the pattern you're stuck in usually makes more sense once we know where it came from. I'll ask what's going well, because that matters too. And I'll ask what would actually make your life feel better, even if it's different from what you think you should want.

You can say "I don't know" to any of those. You can also ask me anything: why I asked a question, what I'm thinking, how confidentiality works. This is a conversation.

By the end, I'll share what I'm noticing and how I'd suggest we work together. I ask clients to meet weekly for the first 8 to 12 weeks, because that's when the momentum builds; after that we usually move to every other week or monthly.

The things people worry about

"What if I cry?" You might. Many people do, often in the first ten minutes, because it's the first time they've said some of this out loud. That's normal, and it doesn't mean something is badly wrong. It often happens when you finally say something you've been carrying alone. I have tissues.

"What if I don't know what to say?" Then you say that, and I'll ask questions. Leading the conversation is my job. You will never be sitting in silence wondering what you're supposed to do.

"What if my problem isn't bad enough?" This one keeps more people out of therapy than anything else. You do not need a diagnosis or a crisis to be here. If something in your life isn't working the way you want it to, that's enough.

"Can I bring my baby?" Yes, please. There are babies in my office most weeks, and they are the highlight of my day. Always feel welcome to bring them, feed them, rock them. If we're meeting by video and the baby is on your lap, that's fine too. And if you're a new mom who doesn't feel like yourself and can't quite explain why, you're in the right place. That's what many of the women I see are describing.

"What if it's weird?" It's a little weird. You're telling a stranger things you haven't told your closest friends. That strangeness fades fast, usually by the second or third session, once you realize nothing you say is going to shock me or change how I see you.

After the first session

People often leave the first session feeling two things at once: lighter, because they finally said it, and tired, because saying it took something. Both are normal.

Over the first two or three sessions, pay attention to one question: do I feel understood here? That matters more than anything else about therapy. If the answer is no, tell me, or find someone else. I won't take it personally, and I'd rather you find the right fit than stay somewhere that isn't working.

If you're on the fence

You don't have to be sure to book the consultation. You just have to be curious enough to have a fifteen-minute conversation. That's the whole first step.

You don't have to be "bad enough" to benefit from support. Many of the moms I work with aren't clinically depressed at all. They're dealing with the everyday stress of becoming a mom, and therapy helps with that just as much as it helps with depression or anxiety.

Book a free consultation