Seven things to know before your first therapy session

Deciding to start therapy often takes months. Some of my clients tell me they opened my website on and off for a year, filled in the appointment form halfway and stopped. That hesitation makes sense: not knowing what is behind the door makes it harder to go there.

Here are the questions I hear most before a first session, and seven things I think are worth knowing before you come.

1. You don’t need to know what to say

Arriving at the first session saying “I don’t know where to start” is very common and completely normal. You do not need to prepare, bring notes or describe your problem neatly. We go step by step with questions, and you are never pushed to talk about anything. If there is something you are not ready for, saying “I don’t want to talk about that now” is enough.

2. The first session is an assessment

The aim of the first session is to get to know you and what you bring. We usually talk about what you are going through now, how long it has lasted and how it affects daily life. I ask a few questions about sleep, work, relationships and the people who support you. At the end we name what you hope for from therapy and decide how to continue.

3. We talk openly about confidentiality and limits

What is said in sessions is confidential. I do not record sessions; I keep only brief notes. No one can get information without your written permission. There are two exceptions: a clear and serious risk to your life or someone else’s, and a legal obligation. We discuss these openly and read an information form together.

4. Crying, silence or anger are fine

There is a box of tissues in the room for a reason: feelings have a place here. Long silences, not knowing what to say or feeling angry are also normal. My job is to hold these feelings with you without judgement.

5. You have the right not to “click” with your therapist

Research shows the working relationship between client and therapist is one of the most important factors in therapy. If you do not feel safe or understood, or my way of working does not suit you, saying so is valuable. Sometimes that conversation moves the work forward; sometimes we decide together that another therapist would suit you better, and I can suggest colleagues. That is not a failure, it is part of finding the right place.

6. Therapy is not magic; it is work done together

For something to change, things often need to happen between sessions too. In CBT these are short tasks: a thought record, a small experiment, an observation. Change rarely moves in a straight line; a hard week does not mean therapy is not working. I cannot promise you a result, but I can explain how the process works and how we will review what helps.

7. Practical matters are part of the work

Talking openly about fees, cancellation, frequency and length from the start makes the work easier. My sessions last 50 minutes; we usually begin weekly. You can cancel or reschedule free of charge up to 24 hours before. For online sessions, all you need is a closed room, headphones and a stable connection.

Three questions to ask yourself before you come

• What tires me most these days?
• What would I like to be different in my life after therapy?
• What have I already tried; what helped and what didn’t?

And there is the intro call

If you would rather not come straight to a first session, we can start with a free 15-minute intro call by phone or online. It is not a session, but it lets you see a little of what is behind the door.

Starting therapy takes courage. If you are reading this, you have already shown some of it.