Beginning talking therapy can seem daunting and overwhelming for some. It is understandable to not know what to expect, and have general feelings of nervousness.

One of the biggest issues as well is the issue of being nervous about whether or not you will get on with your therapist. Having to open up to a stranger is difficult, and arguiably even more so in a therapy session.

In this article, we look at the typical things that will happen at a first therapy session or appointment. This will usually be the same for both NHS and private therapy.

It is normal to be a bi9t nervous ahead of a first therapy session

Introductions and expectations

To begin with, the therapist will likely introduce themselves, talk about their qualifications and their general approach towards therapy. They will also give you a chance to introduce yourself.

The introductions will also involve discussions about session length, the type of therapy used, and the number of sessions that the therapist recommends.

There will then usually be a basic discussion about what you, as the patient, is hoping to get out of therapy. This helps to set the expectations for the sessions ahead.


Therapists are duty bound to read out a confidentiality statement. They will inform you that everything you say will be kept between you and the therapist.

The only exceptions to this is when a therapist needs to explain something or get the opinion of a supervisor. Moreover, if the therapist believes you are at risk of harming yourselves or others, they are legally responsible to notify relevant parties.

They will also give you information about a crisis number, in case you need assistance outside of regular office hours. These numbers can be used if you are in crisis.

Read More: Is Everything I Say in Therapy Confidential?

Initial discussion

After the housekeeping is out of the way, a discussion regarding your symptoms is likely to happen next. The therapist will know some information about yourself, but will want to hear in your own words about how you feel.

They will ask about your emotions, thoughts, feelings – and how they all affect your behaviour. This will give the therapist an idea on what areas they need to discuss and work through.

It is difficult to open up to a stranger, but they will hopefully put you at ease. Through discussion, problems will be identified, as well as the challenges facing you.

Together, you’ll identify the main problems facing you, as well as specific events that may have caused these. A plan will be made for the next few sessions. This allows a structure to be set.


The first session of therapy is an important one – as it will help the patient and therapist to get to know one another, and set up a plan for the rest of the sessions.

Hopefully, a strong bond between patient and therapist will follow, and the patient will find that therapy greatly improves their overall mental health and general wellbeing.



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If you are struggling with your mental health, help is available. With the right support and treatment, you can make a recovery. For information on helplines, or if you are in a state of crisis, please visit our crisis page by clicking on the relevant link for your geographical location (United Kingdom), (United States), (International). You can also see how to get mental health treatment and the process involved by clicking this link.