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What to Expect from Your First Few Therapy Sessions

What to Expect from Your First Few Therapy Sessions

Here at OpenCounseling, we've created a lot of content designed to help you choose the right therapist. After all, getting that crucial first step right can make the difference between having a good experience in therapy or having a bad one. Finding a therapist who's a good match is a tricky process that's a lot like dating. The stakes are high, but the rewards can be life-changing.


When you find the right therapist, you connect more easily, trust and open up to them more, and get more out of the time you spend with them. You feel better just being with them, so it's easier to stick around and do the work therapy requires. But while finding a therapist who's a good match is an important first step, it's not all you need to be successful in therapy.


Research shows that 20 percent of therapy clients quit before they complete treatment and that the majority who drop out do so after only two sessions. We want to make sure that doesn't happen to you and that you stick around long enough to give therapy—and yourself—a chance.


Why do so many people give up on therapy so quickly? Of course, one reason a person might quit therapy early is that they didn't connect with their therapist, but it's not the only reason. Far too many people who don't know what to expect in their first few therapy sessions get confused, disappointed, or overwhelmed, and drop out.


This is why we stress the importance of learning about how therapy works before you begin. By knowing what to expect in your first few sessions, you'll be more likely to stick it out and get to the point that therapy really starts to get good.



Well, This Is Awkward


If your first few sessions feel awkward, you're not alone. Starting therapy can be especially awkward if you've not been in therapy before, but it's almost impossible for it not to be awkward. The early phase nearly always is. If you feel weird at first when you're talking to your therapist, it might just be because it takes a while to get used to therapy. It's also important to understand that your first therapy sessions will be different from the sessions you'll have later.


While you might expect your first therapy sessions to be full of life-changing insights, or to feel like a warm hug from the awesome friend you've always wanted to have, they probably won't feel like that. What those first sessions are more likely to actually feel like is an extremely awkward, overly personal job interview as your therapist collects lots of information about you.


It can help to understand that, surprisingly, the purpose of your first few sessions isn't therapy, but assessment. By learning some very specific things about your life, including your background, symptoms, relationships, work, health, and goals, your therapist can more accurately determine how to help you and start off on the right track. So, that's where your therapist will begin.


Collecting the Dots


While you might have told your therapist a lot about yourself on the phone or online when you were setting up your first session, you probably didn't tell them enough for them to know where to begin your work together. Almost every therapist has to spend those first sessions asking a bunch of questions so they can understand you and what you want to accomplish in therapy.


Good therapists use intuition, but they need to have enough dots before they can start connecting them. And collecting dots is boring. This can make your first therapy sessions feel stilted. Your therapist may spend a lot of time looking at a computer screen or piece of paper as they take lots of notes. They might not give you a whole lot of feedback during this process. It might make you feel more like you're at the DMV than in therapy.


If you're with a good therapist, they should be able to talk you through the process and make you feel more comfortable. Even in an assessment session, you might laugh, or be moved, or have an insight about yourself right away. But that doesn't always happen, and even the best therapist can't get around the fact that they need to take in a lot of information. Inevitably, this takes away some of the immediacy or warmth of the connection you might otherwise experience with them.


Many therapists complete that initial assessment in one session. Others might take two, or even three sessions to finish. But however long it takes, we encourage you to hang out long enough to get to your first real therapy sessions. This is where you'll start to build your relationship with your therapist and when exciting insights and emotional catharsis can start to occur.


Getting to Know You


The assessment is undoubtedly the most awkward part of therapy. But you might not be out of the awkward woods yet just because you got through it. Just like when you're dating, or making a new friend, or starting a new job and getting to know your co-workers, it can take some time for you and your therapist to really start to "get" each other and to find your rhythm together.


While good therapists are skilled in the arts of empathy and communication, they're also human. It might take them a little while to learn how to tell when you're joking or to understand what certain subjects mean to you. In the same way, it will probably take you a while to get to know your therapist's quirks, sense of humor, and way of working with you.


In your first sessions, expect to have jokes that misfire and to have to explain yourself more than you will later. For example, if lettuce makes you really sad, your therapist isn't going to instantly understand why. But once you tell your story to them, they'll be more sympathetic—probably more sympathetic than other people in your life—and will understand the next time you bring it up. They might even be able to help you figure out the deeper meaning behind the sadness of lettuce. But they'll have to know your story—the dots that connect lettuce and sadness for you—first.


So give your therapist a chance to get to know you—and a chance for you to get to know them—before you decide that therapy isn't working. You might be surprised how quickly things start to progress once you both get to know each other a little better.


Expectation Versus Reality


How you learn about therapy can have a huge effect on how you experience your first sessions. It's easy to get unrealistic ideas about how quickly and easily therapy works from other people's stories, whether you've seen them in the media or heard them from people you know.


People often connect dots more clearly and quickly in stories than they connect them in real life. A short article you can read in five minutes might be summarizing fifteen years of therapy. This can make it seem like a person hopped right from one insight to another in therapy, when there were actually a lot of dull, stuck, and confused times, too.


The opposite can also be true—storytelling conventions can make therapy seem more difficult than it actually is. If you learned about therapy from movies or television, just forget about it. The way therapy is depicted in fiction has more to do with how the writer wants to reveal the character than anything else. By watching Tony Soprano in therapy, for example, we learn how unmotivated he is to confront the truth about himself. If you're going to therapy voluntarily, you're probably going to be a lot more successful than Tony was.


Hollywood and Barnes and Noble aren't the only places we find stories. We learn a lot from the stories our loved ones tell us. If your mother, friend, or partner had an awesome experience in therapy, you might have great expectations when you go. Conversely, if someone had a bad experience, or if therapy didn't do much for them, you might assume therapy won't work for you, either. But everyone is different. Don't assume that what worked for someone else will work for you or that what didn't work for them won't work for you.


The best way to check your preconceptions and not quit prematurely is to talk to your therapist about your concerns. Tell them when you're confused, upset, or disappointed. A good therapist will be happy to talk to you and even alter their approach without getting defensive. Part of the way you get good therapy is to keep working with your therapist and tweaking what you're doing until it really starts working for you.




Therapists usually choose the profession because they already have certain strengths, including empathy and an intuitive understanding of how people work. They then complete a lot of study and training that helps them refine their knowledge and their skills. This means that talking to a therapist isn't the same as talking to a friend. But in the end, therapists are human, too, and they need time to build a good relationship with you just like anyone else would.


We don't want anyone to keep going to a bad therapist, and we strongly encourage you to walk away if you start seeing red flags. But we don't want you to give up on a new therapist too quickly, either. Give your new therapist enough time to complete their initial assessment sessions, and to get at least a few sessions beyond that, before you decide you're not clicking with them or that therapy isn't working for you. It's the only way you'll ever get to where it does work.


Therapy is awesome. That belief is at the heart of what we do at OpenCounseling. We think that people should be able to experience the healing power of therapy regardless of their income or their life circumstances. But we know that affording therapy is only half of the story. Far too many people give up on therapy too quickly and miss the chance to experience something life-changing. We want to help you avoid the same fate, so please, trust us—you might be surprised by just how amazing therapy will feel after you get through those awkward first sessions.

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Stephanie Hairston, MSW
Posted on 01/25/2021 by Stephanie Hairston, MSW

Stephanie Hairston is a freelance mental health writer who spent several years in the field of adult mental health before transitioning to professional writing and editing. As a masters-level clinical social worker, she provided group and individual therapy, crisis intervention services, and psychological assessments. She has also worked as a technical writer for a medical software company and as an editor for a company that appeals denials of insurance coverage for behavioral health treatment. As a writer, she is motivated by the same desire to help others that brought her into the field of social work and believes that knowledge is one of the most essential recovery tools. She strongly believes in the mission of OpenCounseling and in making therapy accessible for everyone.