What to Expect at Your First Therapy Appointment

For nearly four years, I’ve been in and out of therapy. I’ve seen ten different therapists, which is way more than I would have liked. Some moved away. Others didn’t work out or weren’t available for more than 12 sessions (looking at you university counseling centers).

While it’s taken a while to find consistency with therapists, I’ve become somewhat of a regular with first sessions. Each therapist has had a different approach to the first appointment, but there have been some similarities.

If you’re anxious about your first appointment, here are a few things you can do and expect to feel more prepared:


Like any doctor’s office, you’ll have paperwork to fill out. Some places also request you print off the intake forms before your first appointment. I’ve seen a wide variety of paperwork and forms at each therapist’s office I’ve been to.

Some take 25 minutes to fill out. Others take five. You’ll give your general information such as your insurance details and address.

They may ask about your relationships and other social factors of your life. They might ask about your family history. You’ll also list any diagnoses you may already have, and if you’ve been to therapy before.

Some offices may provide you a checklist of concerns that may have brought you in. They may give you an open-ended question of “What brings you in today?”

Some places may give you questionnaires like the PHQ-9 where you rate the frequency of your symptoms. On a scale of “not at all” to “nearly every day,” you’ll rate your experience of nine signs of depression.

When it comes to paperwork, each office varies widely in what they want. The best approach is to be as honest and thorough as possible. It may feel weird to write down vulnerable information, especially if it’s your first time. Though I’d recommend still writing everything down, you will get a chance to bring it up during your first appointment.

You’ll also fill out confidentiality agreements. What you discuss with your therapist is confidential, but there are a few caveats to that. A therapist can break confidentiality if they believe you may harm yourself or others. They can also break it if they suspect ongoing child abuse.

Common Questions You’ll Hear

Even though you have spent time filling out paperwork, be prepared to answer some of the same questions in person. Your therapist needs to get an idea of why you decided to come in, and it’ll give you a chance to elaborate on what you wrote.

Your first appointment won’t really be a therapy session. It’ll be more of a “get to know you” session.

They’ll ask why you came in. For some people, it’s a vague question. You might not be able to put a lot of what you’re going through into words. Try your best, and if needed, write down your concerns/symptoms before coming in.

For others, the question may seem like there’s too much to put into a succinct answer. That’s OK. Therapy is your time, so feel free to say as much as you can.

A therapist may refer to your paperwork to get an idea of what needs to be assessed. They may ask you to elaborate on something in particular. This isn’t a time to clam up about something. If it’s hard to discuss, especially before establishing a rapport with the therapist, feel free to answer as much as possible and then let the therapist know it might be a topic to discuss later down the road when you feel more ready.

Another question you’ll probably hear is, “What do you want to get out of therapy?” When I first started therapy, I hated this question. How was I supposed to know when I’d never been through therapy before?

The question is not meant to be that serious. You’re not expected to come up with a treatment plan. Your therapist just needs to know what you’re expecting. In the beginning, my answer was a vague “to feel better.”

Maybe you’re looking for better coping skills for stress or depression. Maybe you’re wanting help regulating anger. Maybe you’re interested in building better relationships. It doesn’t need to be specific. Your therapist will work with you over time to establish the best treatment plan.

Questions to Ask a Therapist

You can ask your therapist what type of therapy they see using with you. Every therapist is different, and there are many approaches to therapy. In my experience, many therapists work with a combination of approaches. A therapist may use a cognitive-behavioral approach but could also utilize aspects of dialectical behavior therapy.

You can also ask what you can expect from therapy. Ask if your therapist assigns homework. I prefer therapy with more structure and homework. I feel like I get more out of it, but not everyone feels that way.

Ask about the frequency of therapy. They may ask you what you think would work, but they may recommend coming in once a week or every other week. Ask what’s the best way to contact them. Some therapists will prefer you email or call them directly. Others may prefer you to work with the front desk depending on how large the practice is.

The Intake Therapist May Not Be Your Actual Therapist

A couple of the practices I’ve been to have had “intake” therapists. It’s typically another therapist who works in the office. Their job is to figure out which therapist in the office may be the best fit for you. The rapport between a therapist and a client is a key component of successful therapy.

You may end up working with your intake therapist if it seems like a good fit. There’s also scheduling to consider. This setup usually happens in larger practices.

Seeking therapy can be nerve-wracking, but having an idea of what to expect may help you. You may not find a therapist that’s a good fit right away, but that’s OK. It takes strength to reach out, but scheduling your first appointment is a great first step.