What Happens in a First Therapy Session

If you've never been to therapy before, the thought of that first session can feel quite daunting. What are you supposed to say? What if you cry? What if your mind goes blank and you can't think of anything to talk about?

I hear these worries all the time, and they're completely normal. Most people feel nervous before their first appointment. So I wanted to write something that might take some of the mystery out of it.

Before you arrive

My practice is at Manor Drive Medical Centre in Worcester Park. It's a familiar, professional setting, which some people find reassuring. There's parking nearby, and the centre is easy to find.

When you arrive, I'll come and meet you. There's no reception desk to check in at, no forms to fill in on the spot. We just head to the room and get started.

The first few minutes

The most important thing to know is that there's no right way to start. Some people arrive with a clear idea of what they want to talk about. Others aren't sure where to begin. Both are absolutely fine.

I usually start by asking what's brought you to therapy. Not in a formal, clinical way, but simply to understand what's going on for you right now. You can share as much or as little as you feel comfortable with. There's no expectation to tell me everything in the first session.

If you feel nervous or awkward, you can say that too. Most people do, and naming it often helps it settle.

What I'll want to understand

During this first meeting, I'm trying to get a sense of a few things. What's brought you here now, rather than six months ago or a year ago. What you're hoping therapy might help with. And a bit about your background, not a full life history, but enough context to understand where you're coming from.

I might ask about your family, your relationships, your work, how you've been feeling recently. These aren't test questions. There are no right answers. I'm just trying to build a picture so that I can be as helpful as possible.

What I won't do

I won't diagnose you. I won't give you homework. I won't sit in silence and stare at you while you try to figure out what to say. And I won't push you to go deeper than feels right for a first meeting.

This session is as much about you getting a sense of me as it is about me getting a sense of you. You're allowed to be sizing me up. In fact, I'd encourage it. The relationship between therapist and client matters enormously, and it's important that it feels right.

You might feel emotional, and that's OK

Some people worry that they'll cry in their first session and find that embarrassing. I can promise you that if you do cry, it won't be the first time it's happened in that room, and it certainly won't be the last.

Feelings have a way of surfacing when you finally give them space. That's not a sign of weakness. It's actually a sign that something important is there, ready to be looked at.

Equally, if you don't feel emotional at all, that's fine too. Everyone responds differently. There's no right way to do this.

Practical things

Sessions last 50 minutes. The fee is £70, payable on the day. I usually suggest meeting weekly, at least to begin with, as that gives the work enough momentum to be useful. But we can talk about what works for you.

If after the first session you decide therapy isn't for you, or that I'm not the right fit, there's absolutely no obligation to continue. No awkwardness, no hard feelings.

What happens after

If we both feel it's a good fit, we'll arrange a regular time to meet. There's no fixed number of sessions. Some people come for a few months, others for longer. It depends on what you're working through and what feels right.

The most important thing is that you've taken the step. That first phone call or email is usually the hardest part. Everything after that tends to feel a bit easier.

Getting in touch

If you'd like to book a first session, or if you just want to ask a question before deciding, you can email me at help@counsellingwithclaire.uk. I always respond personally, and I'm happy to have a brief chat before you commit to anything.

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Claire Smith is a BACP accredited psychodynamic therapist (216379) based at Manor Drive Medical Centre, Worcester Park, KT4 7LG. She offers in-person sessions for adults.