What Happens in Your First Therapy Session: Complete Guide for Beginners

First therapy session

Some of us have been there sitting in the car outside a therapist's office, heart racing, wondering what we've gotten ourselves into. What if we don't know what to say? What if we break down crying? What if they judge us? What if we waste their time with problems that seem too small or too big?

For others, this might be completely new territory. Maybe we've never considered therapy before, or maybe we've been thinking about it for months but haven't known where to start.

Those butterflies in our stomach are completely normal, whether this is our first time or we're trying therapy again after a previous experience. Starting therapy can feel like standing at the edge of something unknown, even when we know we need it.

The truth is, most of us have never been taught what therapy actually looks like. We might have seen it in movies (usually dramatic and unrealistic) or heard fragments from friends, but we rarely get the real picture of what those first moments are actually like.

So let's demystify this together. Let's talk about what really happens when we walk through that door for the first time.

Before We Even Meet

The process actually begins before we sit down together. Most therapists will send intake forms ahead of time, and there's a good reason for this. When we complete these beforehand, it means our entire first session can focus on us not paperwork, not administrative details, but actually connecting and understanding what's brought us to this point.

These forms aren't tests we can pass or fail. They're simply a way to give your therapist a starting point, so when we meet, we can dive straight into what matters most to us.

Think of it like this: instead of spending the first 20 minutes of our precious time together filling out forms, we get to spend those minutes actually being heard.

Walking Into the Space

Here's something that might surprise us: therapy doesn't have to look like what we've seen in movies. We don't have to sit rigidly in a chair, hands folded, speaking in hushed tones about our childhood.

In my practice, I've worked with people who've taken their shoes off, sat on the floor, or even lied down when they needed to. Some clients need to stand and pace while they talk. Others curl up in the chair like they're having a conversation with a close friend.

The space is ours to inhabit however feels most comfortable. We can have coffee, tea, or water. We can move around if we need to. The goal is creating an environment where we can actually be ourselves not some polished version of ourselves, but the real, complicated, human version.

And here's something completely different that many therapists don't offer: if sitting in an office doesn't feel right, we don't have to. Some of our most powerful conversations can happen while walking through a park or along the beach, with our feet in the sand and the sound of waves in the background. There's something about movement and nature that can unlock parts of ourselves that feel stuck in traditional indoor spaces.

This is particularly powerful for men, who often find it easier to open up when they're moving rather than sitting face-to-face in a room. But really, anyone can benefit from having options about where and how they want to engage in this process.

How We Actually Start the Conversation

We won't be thrown into the deep end immediately. The first session is about meeting each other not just me getting to know them, but them getting to know me and how I work.

I usually start by explaining my approach. I believe in something called horizontalization, which simply means that anything someone brings to our session is worthwhile and important. There's no hierarchy of problems whether someone is dealing with relationship struggles, work stress, trauma, or that persistent feeling that something just isn't right in their life, it all matters.

I ask questions, but not in an interrogation way. Some questions help us focus in on what's most pressing right now. Others help broaden our understanding of the bigger picture. I'm curious about how long certain patterns or struggles have been happening, not to judge or analyze, but to help us both understand the context of what we're dealing with.

Many people come to therapy having been "bottled up" for months or years. They've never had a space to actually talk about what's happening for them. For some, our first session is the first time they've spoken these thoughts and feelings out loud to another human being.

That's both an honor and a responsibility I don't take lightly.

The Questions We Explore Together

We're not just talking about feelings in a vacuum. We live in the here and now, and people often come to therapy desperate for direction, answers, and meaning. So while we're exploring the emotional landscape, we're also grounded in the practical reality of our daily lives.

I might ask: What's happening that brought you here today? Not just the surface stuff, but what's really going on underneath.

Or: How is this showing up for you daily? Weekly? This helps us understand the real impact on your life whether these feelings or patterns are affecting your sleep, your relationships, your work, or that general sense of feeling like yourself.

And: How long has this been part of your experience? This helps us understand whether we're dealing with something recent and acute, or patterns that have been with us for a while.

And always: What do you need right now? Sometimes people need immediate practical strategies to get through the week. Sometimes they need help making sense of their experiences. Sometimes they just need to be heard and understood.

The beautiful thing about therapy is that it can be all of these things.

What Makes This Different

Here's what I want people to understand about how I work: I'm not just listening to my clients I'm listening for where they're coming from. There's a difference between hearing someone's words and truly understanding the world they're living in.

Every session builds on the previous one. We're not starting from scratch each week, checking in about the same issues without making progress. Therapy should be one continuous conversation, where each session moves us forward in understanding ourselves and creating the changes we want to see.

We always leave each session with at least one takeaway something concrete that can be helpful between our meetings. This might be a new way of thinking about a situation, a practical strategy for managing stress, or simply a deeper understanding of what's been driving certain patterns in our lives.

This is where the practical grounding comes in. We're not just processing feelings; we're creating pathways forward. We're helping people navigate their actual lives with more clarity, intention, and self-compassion.

Questions for Me

Toward the end of our first session, I always ask if there are questions for me. And there usually are.

People want to know: How long does therapy typically take? What if I don't know what to talk about some weeks? What happens if I need to contact you between sessions? Do you think you can help with what I'm dealing with?

These are important questions, and asking them doesn't make someone needy or demanding. It makes them informed participants in their own healing process.

I also talk about confidentiality, what to expect in terms of session frequency, and how we'll know when we're making progress. The more transparent we can be about the process, the safer and more collaborative it feels.

Creating Safety for What's to Come

That first session is really about setting the stage for a relationship to develop. Not a friendship, but a specific kind of professional relationship where someone can be completely authentic without fear of judgment, manipulation, or having their vulnerabilities used against them.

We're creating what I think of as a safe capsule for both of us, and for whatever someone needs to bring into the room. Some people need to share traumatic experiences. Others need to explore relationship patterns. Some people need to cry, others need to rage, and some need to sit in confused silence while they figure out what they're even feeling.

The space needs to be strong enough to hold all of it.

And here's something particularly important for men, though it applies to anyone: I need to demonstrate that I can handle the intensity of whatever they're carrying. Many people, especially men, have learned to keep their deepest struggles to themselves because they've never encountered someone who could truly hold space for the full weight of their experience.

Creating that sense of trust and safety doesn't happen immediately, but it starts in that first session.

What About the Practical Stuff?

Let's talk logistics for a moment, because these details matter when we're already feeling nervous about trying something new.

Sessions are typically 60-70 minutes, which gives us time to really settle in and go somewhere meaningful together. We're not watching the clock, trying to squeeze important conversations into artificial time constraints.

I offer sessions in person in Caringbah, online via Zoom for those who prefer the comfort of their own space, and yes walking sessions in parks or along the beach for those who find movement helps them process and open up.

The walking sessions are something special. There's research showing that bilateral movement (the natural rhythm of walking) actually helps integrate different parts of our brain, making it easier to process difficult emotions and gain new insights. Plus, there's something about being in nature that reminds us we're part of something bigger than our immediate problems.

When People Leave That First Session

Here's what I hope happens when someone walks out after our first meeting: they feel heard, they have at least one concrete thing they can try or think about differently, and they have a sense that this process might actually be helpful.

They don't need to have all the answers yet. They don't need to have solved everything or even fully understand what therapy will look like going forward. They just need to feel like they've taken a step toward something that could make their life feel more manageable, more meaningful, or more authentically their own.

And if they're still feeling nervous about the second session? That's normal too. This stuff takes time.

What We're Really Building Toward

Ultimately, that first session is the beginning of learning to have a different relationship with ourselves. We're starting to practice being honest about what we're really experiencing, rather than what we think we should be experiencing.

We're learning to be curious about our patterns instead of just frustrated by them. We're discovering that we can talk about difficult things without falling apart, and that being truly seen by another person can be healing in ways we might not have expected.

Most importantly, we're starting to remember that we don't have to figure everything out alone. There's something profoundly relieving about having a space where we can be exactly where we are, without having to perform or pretend or rush toward being "better."

Taking the First Step

If you're reading this and considering therapy, you probably already know you're ready. The fact that you're here, learning about the process, means part of you is already moving toward getting the support you deserve.

That first session might feel scary, but it's also the beginning of potentially the most important relationship you'll develop the one with yourself.

And remember: you don't have to have it all figured out before you start. In fact, not having it figured out is exactly why therapy exists.

If you're ready to take that first step, or if you have questions about what starting therapy might look like for your specific situation, you don't have to wonder about it alone. Sometimes the most important conversations are the ones we have when we're finally ready to be honest about what we need.