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What to expect in your first therapy session

Nervous about starting therapy? Here is what usually happens, and how to make the most of it.

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The Mind ProjectClinically reviewed by [Reviewer name, credentials]Last reviewed: June 20265 min read

Starting therapy can feel daunting, especially if you do not know what to expect. This guide walks through what usually happens in a first session, so you can go in feeling more prepared.

What usually happens

The first session is mostly about getting to know each other. The therapist will ask what brought you in, what has been difficult, and what you hope for. They may ask about your background, your health, your sleep, and the people in your life. This is not an exam, and there are no wrong answers. You can share at your own pace, and it is fine to say if something feels too hard to talk about yet.

Confidentiality, and its limits

What you say in therapy is private. A good therapist will explain this early on, and will also explain the few limits to it, which usually involve serious risk of harm to you or to someone else. If anything about privacy worries you, it is completely reasonable to ask the therapist to explain how they handle it.

How to prepare

You do not need to prepare much. It can help to think beforehand about what you want to change and any questions you have. Some people find it useful to note down a few points so they do not forget them. Arrive a little early if you can, and know that feeling nervous is normal and very common.

Questions you can ask

Therapy works best as a partnership, so it is fine to ask questions. You might ask how the therapist usually works, what kind of therapy they offer, how long sessions and treatment tend to last, and what the cost is. Asking these things is sensible, not rude.

Finding the right fit

The relationship between you and your therapist matters a great deal, and research shows it is one of the strongest predictors of whether therapy helps. If after a few sessions it does not feel right, it is okay to say so, or to look for a different therapist. Wanting a good fit is not being difficult; it is part of getting good help.

A note for our context

Seeking therapy still carries stigma in many communities here, and you may feel you have to keep it private. That is your choice to make. It can help to remember that going to therapy is a step toward health, much like seeing a doctor for any other condition, and not a sign of weakness or madness. Cost and distance are real barriers, so it is worth asking about fees and about lower-cost or community options. Our Get Support and find a therapist pages can help.

Sources

  1. Norcross, J. C., & Lambert, M. J. (2018). Psychotherapy relationships that work III. Psychotherapy, 55(4), 303-315.
  2. World Health Organization. (2016). mhGAP Intervention Guide for mental, neurological and substance use disorders in non-specialized health settings (version 2.0).
This guide follows The Mind Project's editorial policy. It is general information, not a diagnosis or a substitute for professional care; only a trained clinician can diagnose. If you are in crisis, you can call Befrienders Kenya on +254 722 178 177.