You’ve finally decided to try therapy, but now you’re sitting in the waiting room or preparing to log in to a virtual session with a question looming in the back of your mind: What will I be asked in my first therapy session? What do I talk about?

If this sounds familiar, you’re not alone. A first therapy appointment, or switching to a new therapist, often comes with a mix of hope, curiosity, and nervous energy.

You may feel excited about getting support while also wondering if you’ll say the “right” things or know where to start.

The truth is, beginning talk therapy is a meaningful act of self-care, and you don’t need to have everything figured out to begin.

In this article, we’ll walk through what you can expect in your first session, how to talk to a therapist, and simple ways to prepare so you feel more confident and less anxious when you arrive.

What to Expect in Your First Therapy Session

The first session with a new therapist is often a combination of conversation and orientation. Think of it as a starting point rather than a deep dive into everything at once. Your therapist’s goal is to get to know you, understand what brought you in, and help you feel comfortable.

Your therapist may also share practical details like session length, explain confidentiality, and answer questions about how therapy works. These questions aren’t a test, and there is no “right” level of detail. You are welcome to share as much or as little as feels comfortable. It’s also important to know that there is no wrong reason to be in talk therapy. You don’t need to be in crisis to benefit. Feeling stuck, overwhelmed, curious about yourself, or wanting better relationships all “count.”

If you’re unsure how to begin, simple statements like “I’ve been feeling off lately” or “I’d like to improve my relationships” are more than enough.

*So, what will I be asked in my first therapy session?*
While every therapist has their own style, most first sessions include questions like:
What’s been going on in your life recently?
What concerns or challenges brought you to therapy?
Would you like to share some background information, such as family history or major life events?
What are your goals for therapy? Or, more simply, what would you like to change or understand better?
Have you tried therapy before? If so, what was helpful or challenging?

How to Prepare for Your First Therapy Appointment

A little preparation can go a long way in helping you feel grounded during your first therapy appointment, especially if you’re worried your mind might go blank.

Here are a few gentle ways to prepare:

Reflect on why you’re seeking therapy. Are you dealing with stress, anxiety, relationship challenges, or a major life transition?
Think about areas of your life that feel hardest right now. This might include work, family, friendships, mood, sleep, or habits.
Write down a few starting points or questions. Many people find it helpful to jot down thoughts like, “I want help managing my anxiety” or “Why do I react this way in relationships?”
Gather basic information. If relevant, note medications, prior mental health experiences, or significant life events. You can also use this opportunity to see if your health insurance may also cover therapy.

Preparation doesn’t mean scripting your session or knowing exactly what to say. Instead, it gives you a place to begin, so if nerves kick in, you have something to lean on. Your therapist will help guide the conversation from there.

What You Can (and Should) Talk About in Talk Therapy

One of the most common worries people have is not knowing **how to talk to a therapist**. The good news? You can talk about almost anything — and it doesn’t have to sound polished. Common and helpful topics in talk therapy include:

Anxiety, sadness, stress, or emotional overwhelm
Patterns or habits that feel hard to break
Past experiences that still affect you today
Your hopes, goals, and what “feeling better” might look like
Even things that feel small, awkward, or hard to explain
If you truly don’t know where to start, you can say that. Opening with *“I’m not sure what to talk about”* or *“This feels a little uncomfortable for me”* is completely okay. A new therapist is trained to meet you where you are and help you find a starting point together.

Finding and Getting to Know Your New Therapist

The early sessions of therapy are about building a foundation. It’s a time to see how it feels to work together and to begin developing trust.

A few things to keep in mind:

Mutual fit matters. You can ask your therapist how they work and what sessions are typically like.
Therapy is collaborative. You and your therapist work as a team to set goals and adjust along the way.
Honesty helps. If something feels confusing, awkward, or unhelpful, it’s okay (and encouraged!) to say so.
Progress takes time. Early sessions often feel exploratory rather than transformational, and that’s normal.

You don’t need a perfect explanation or a fully formed plan. Your willingness to show up and explore is enough.

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