What happens in the first session?

Justin talks about what new clients can expect from their first session.

Deciding to start psychotherapy can be difficult. But then what?

What happens in the first session?

This sounded like an easy question to answer when I first thought about writing this post, but the answer is ‘quite a lot’. If you have never been in therapy before, it might be an obvious question to wonder about. And even if you have been in therapy before, it is likely to be a different experience coming to see me or anyone else who is not your previous therapist.

Before I risk getting tied up in the details, I want to step back slightly and talk about the purpose of the first session, so I’m going to start at the end. I promise I will try and make that make more sense soon.

What is the purpose?

Primarily, we are there to meet each other, often for the first time in person. We may well have exchanged emails or messages or talked on the telephone, but this will be the first time we actually meet. The goal is to get to a point where you, as the client, can make an informed decision about continuing into therapy with me or not. This process will include at least the following factors:

  • having the opportunity to ask questions about me and of me
  • getting a sense of how it might be to work with me in therapy
  • me getting a better understanding of what it is you are looking for help with
  • us having a shared sense of whether or not psychotherapy has the potential to do what it is you want it to do

How long is the first session?

Your appointments will all be for a ‘standard’ 50 minutes. In reality, the things I have outlined above are likely to take longer than one fifty-minute session to achieve. So more usually, we will have two or three ‘first’ sessions before we formally contract for ongoing psychotherapy.

You can ask questions

It’s really important that you can believe in the potential for psychotherapy to help. As your therapist, I will likely form a big part of that. Maybe you want to know more about my experience, views, beliefs, or understanding of your diagnosis, which might all be relevant to our future work together.

You can get a sense of what it might be like

In general, first appointments are similar to every other appointment, we will sit down together in a room and talk. I will probably talk more than I averagely do in these early sessions, but you will be able to begin to get a feel for what it might be like.

We will talk about what it is you want help with

At first, we will probably try and avoid getting into too much deep or historical detail. But we will talk about how things are for you currently, what you want to do or change by coming to therapy, and how that future change might look. This might include talking about relationships, family, friends, work, sex, alcohol, drugs, feelings, thoughts, and beliefs.

Is psychotherapy part of the answer?

Therapy can not solve every problem. That is not to say that psychotherapy can’t still be helpful. Maybe it can be the thing that helps you make other changes or supports you through difficult times. But we need to be realistic about what we can achieve in our work together.

You might feel nervous

This is totally normal; try not to worry about it. Most people are not used to sitting down with a relative stranger and talking about intimate and personal things. It might even feel like you are doing something ‘wrong’ by talking about these things. This doesn’t mean that you are doing something wrong, just that you are pushing against what you would usually do.

And then it’s all over

Once you begin to settle into the session, it is common for time to feel as though it passes quickly. This will bring us to your first decision point - do you want to come back and continue this conversation?

You do not have to choose right away

I’m not interested in this being a high-pressure sales experience. I want you to deliberately choose, in your own time, so you will not need to make any decisions there and then. We will talk about the options, and usually, I will offer to hold the agreed day and time available for you for the next couple of weeks. You can then let me know in your own time if you want to come back or not.

What if I say no?

Then… I won’t be expecting to see you. You might say no for all kinds of reasons. Maybe I unhelpfully remind you of someone, or you just don’t like me. Perhaps you listened attentively and decided that what I am talking about doesn’t fit with how you see the world. Or maybe I’m not going to offer you some crucial part of what you wanted. It might not be the right time, or what you thought was the question or problem is already changing into something else now that you have started to talk about it. Whatever the reason, please don’t come back if you don’t want to! Or worse, because someone else wants you to. Doing so risks you wasting a lot of time, and money, for little or no benefit.

Can I change my mind?

Of course! Saying no once doesn’t mean you can never return and consider it again. However, you will likely have to wait for another appointment to come available. Equally, you can say no at a later time too. Once we have formally contracted, then things might be a little different, but it’s your therapy; you can leave whenever you want.

And if I say yes?

As I said before, we will probably meet another couple of times before we decide to formally contract for ongoing psychotherapy.

I hope this has given you some insight into what to expect. If you have any questions or would like to book an appointment, then please get in touch. You can also book online, choose from any of our available appointments here.

Justin Clark
Justin Clark
Psychotherapist, Supervisor, and Director of Therapy Nottingham

Psychotherapist and supervisor, interested in personality, self, and identity.