Booking your first therapy session is the hard part. Once it’s on the calendar, most of the fear comes from not knowing what happens next. Here’s the honest version, from the paperwork to the first real conversation.
What Happens in a First Therapy Session?
Mostly, you talk, and your therapist listens. A first therapy session is about getting to know each other and understanding what brought you in. Nothing is demanded of you, and there’s no script you’re supposed to follow.
Before the Session: Paperwork and Practicalities
Every therapy intake session starts with some admin. You’ll usually get intake forms through a client portal before you arrive, covering your history, contact details, and insurance information. Informed consent is part of this too. Your therapist will discuss confidentiality, what stays private, and the few legal exceptions around safety.
It helps to fill these out ahead of time if you can, though it’s not the end of the world if you show up and finish them in the waiting room. Bring your insurance card if you’re using coverage. If you’re paying out of pocket, ask about sliding scale options before your appointment.
| Before You Arrive | Why It Matters |
| Client portal forms | Saves time in session |
| Insurance card or payment info | Confirms your coverage |
| ID or basic contact info | Standard intake requirement |
| A quiet, private space (if virtual) | Protects confidentiality |
What Your Therapist Will Likely Ask
Expect a conversation, not an interrogation. Your therapist will probably ask about your background, what brought you in now, and what you’re hoping changes. They might ask about your support system, your daily routine, or past experiences with therapy if you’ve had any.
None of this needs a polished answer. Therapists are trained to work with whatever you give them, even if it’s just “I’m not sure where to start.”
What You Don’t Have to Do
This is the part most people need to hear. You don’t have to share everything in your first session. You don’t have to cry, and it’s just as normal if you don’t. You don’t need a diagnosis walking in, and you don’t need a clear goal either. Plenty of people start therapy simply because something feels off, and that’s a good enough reason.
Your therapist’s job is to help you figure things out, not to test whether you already have. Go at your own pace. If a question feels too much, you can say so.
How to Prepare, If You Want To
Preparation is optional. If you’re wondering how to prepare for therapy, a few loose notes can help, maybe a short list of what’s been on your mind, or a question or two for your therapist. That’s genuinely enough.
Arriving with nothing prepared works fine too. Some of the most useful first sessions start with “I don’t really know where to begin,” and the conversation builds from there.
What Happens Afterward
After a first counseling session, most people schedule a follow-up, often weekly to start. Your goals for therapy usually take shape over the first few sessions rather than being fixed on day one.
It’s also worth knowing that changing therapists is allowed. Fit matters more than sticking it out, and a good therapist would rather you find the right match than force a connection that isn’t working.
Your First Session at Sequoia Psychotherapy
At Sequoia Psychotherapy in Virginia Beach, first sessions run both in person at our Suite 105 location and virtually through a secure telehealth platform. Most people start with individual therapy, and coverage details are laid out clearly under insurance and rates so there are no surprises. You can also read more about the clinicians here, including Soheila’s background, before your first visit.
Still deciding if now’s the time? We’re working on a companion piece on figuring out if therapy is the right next step, and we’ll link it here once it’s live.
Ready when you are: request an appointment.
Frequently Asked Questions
How long is a first therapy session?
A first session usually runs about 50 minutes, the same length as regular sessions after that. Some intake sessions run a bit longer if there’s more paperwork to cover together.
What should I talk about in my first session?
Start with whatever brought you to therapy right now, even if it’s just a general sense that something’s off. Your therapist will ask follow-up questions and help shape the conversation from there, so you don’t need a plan going in.
Do I have to share everything right away?
No, and most people don’t. You control what you share and when, and it’s normal to open up gradually as trust builds over the first few sessions.
What if I don’t click with my therapist?
That happens sometimes, and it doesn’t mean therapy failed. You can mention it directly, try a few more sessions to see if it shifts, or ask about working with someone else. Fit matters more than sticking with a mismatch.
Is my first session confidential?
Yes. What you share stays private, with a few legal exceptions your therapist will explain upfront, mainly around safety concerns like harm to yourself or others.
If you’re in crisis or thinking about harming yourself, please contact the 988 Suicide & Crisis Lifeline by call, text, or chat, available 24/7. For general guidance on finding mental health support, the National Institute of Mental Health’s page on getting help for mental illness is a solid starting point.