If you've never been to therapy before, the first session can feel disproportionately large in your mind. People imagine something between a job interview and a confession. It is, in fact, neither. It's mostly a conversation.
Here's what tends to happen, demystified.
Before the session
Most therapists offer a short call — usually around thirty minutes, often free — before any first proper session. It's a chance for you to hear someone's voice, ask anything practical, and notice whether you feel any easier or harder around them. That feeling is information. It's worth listening to.
If you book in after that, you'll usually get an email confirming time, location, and how to arrive. If you're seeing me in Richmond or Fulham, that email tells you which buzzer to press, where the waiting area is, and not to worry if you're a couple of minutes late.
The first ten minutes
The opening is gentle. Most therapists will say something like, "Where would you like to start?" — and then leave space. That space can feel enormous if you weren't expecting it. You don't need to fill it elegantly.
You may want to start with the practical thing — what brought you here this month, this week, today. You may want to start with childhood. You may want to start by saying you don't know how to start. All of these are fine. There is no script you are failing to follow.
The first session is not about telling your story neatly. It's about beginning to find out what your story even is.
What you'll be asked
Different therapists ask different things, but in a first session most of us are quietly trying to understand a few things:
- What's bringing you here now? (Not what's the deepest thing — what tipped you into picking up the phone.)
- What does life look like at the moment — work, relationships, sleep, the daily texture of things?
- Have you been to therapy before, and if so, what helped and what didn't?
- What would feel like a good outcome for you, even loosely?
You don't have to answer any of these completely. "I don't know yet" is a real answer.
What you don't have to share
You don't have to disclose trauma, history, or anything you're not ready to bring. A good therapist will follow your pace, not lead it. If a question feels too much, you can say so. That sentence — "I'm not ready to talk about that yet" — is one of the most therapeutic things you can say in a first session.
How to tell if it's a fit
Forget credentials for a moment. Those matter, but you can check them on a website. The harder, more important question is: does this person feel like someone you could become more honest with over time?
Some signs it might be a fit:
- You feel slightly more, not less, like yourself by the end.
- The therapist seems curious about you in a way that doesn't feel performative.
- You can imagine telling them something difficult, even if you didn't today.
- You want to come back, even if part of you also doesn't.
Afterwards
Give yourself a small buffer after the session if you can. Not because something dramatic will have happened — usually it won't — but because you've spent fifty minutes thinking out loud, and that has a quiet weight to it. A walk home, a coffee, twenty minutes before your next thing. That's often enough.
And then, if you'd like, you book a second one. That's where the work actually begins.