Starting therapy can be overwhelming, especially if it’s your first time. It’s completely okay to feel this way and only natural to feel a bit nervous or unsure about what’s to come. Many people feel the same way about their first therapy sessions, and you’re definitely not alone. With the right support, things can start to feel more manageable.
That’s why we’ve put together this guide: to help calm your nerves and offer clear, kind information about what to expect and how to prepare for your first therapy session. Taking that first step can feel scary, but it’s also a powerful act of self-care and courage. With just a little preparation and the right mindset, your first session can be the start of something truly healing.
CBT demonstrates a 50–75% effectiveness rate for treating anxiety and depression, making it one of the most evidence-based therapeutic approaches
SOURCE: NLM
Cognitive Behavioral Therapy
Why People Start Therapy
People go to therapy for all sorts of reasons—and every single one of them is valid.
You don’t need to be in the middle of a crisis to seek help.
Mental Health Support
For many, it starts with trying to manage anxiety or stress, which might show up as constant worry, trouble sleeping, or just feeling overwhelmed.
Others may be dealing with depression, which can feel like persistent sadness, low energy, or a loss of interest in things that once brought joy. Therapy is also a safe space to work through trauma and PTSD. Past experiences can have a lasting impact, sometimes in ways we don’t fully realize until we begin to unpack them.
Our licensed, trauma-informed therapists are experienced in cognitive-behavioral therapy (CBT) and other evidence-based approaches that help you make sense of those experiences and support your healing journey.
Relationship Concerns
Relationship issues are another common reason people reach out. Whether it’s with a partner, family member, or friend, conflicts and communication problems can be challenging. A therapist experienced in relationship dynamics can guide you in handling these situations in a healthier, more constructive way.
Life Changes
Life transitions, such as moving, starting a new job, or coping with a loss, can stir up a lot of emotions, too. Burnout is also increasingly common, leaving many feeling drained and disconnected from their daily lives. Therapy offers tools and support for navigating all of it.
Whatever’s bringing you to therapy, know that you’re not alone. It’s a chance to explore what’s going on, understand yourself better, and build the tools to face life’s ups and downs with more resilience.
According to the National Institute of Mental Health (NIMH), more than one in five U.S. adults lives with a mental illness.¹
Additionally, according to the CDC, between 2019 and 2023, the number of adults getting mental health treatment grew from 19.2% to 23.9%.²
That’s a clear sign that more people are recognizing the importance of taking care of their mental health.
Approximately 75–80% of individuals who engage in therapy report benefiting from it, experiencing improvements in symptoms and overall well-being.
SOURCE: NLM
The Strength of Alliance in Individual Psychotherapy and Patient's Wellbeing
What to Expect in Your First Therapy Session
Your first session, often referred to as an intake session, is mostly about getting to know each other.
It’s your therapist’s chance to learn more about you and what’s been going on in your life.
Intake Questions
You’ll likely be asked about your personal background, mental health history, and the reasons you decided to come to therapy. These questions aren’t meant to pry—they’re there to help your therapist understand the bigger picture.
You might talk about past experiences, your relationships, or how you’ve been feeling lately. It’s all about creating a foundation for your therapy journey.
Goal Setting
You and your therapist will also discuss what you hope to achieve through therapy. Setting goals can give your sessions direction and help track your progress.
Your goals can be as broad or as specific as you like—maybe you want to manage anxiety better, communicate more clearly, or just feel more like yourself again. Whatever they are, your therapist will work with you to create a plan that fits your needs.
Therapy Structure and Confidentiality
Your therapist will explain how therapy works, including details such as confidentiality, and any exceptions to it.
Knowing your privacy is protected helps create a space where you can speak freely. That trust is a key part of making therapy work.
Getting to Know Your Therapist’s Style
Every therapist has their own style. Some might be more structured while others take a more laid-back approach. The first session gives you a chance to see if their style feels like a good fit.
Don’t be afraid to ask questions and share what you’re looking for. This is your space, and it’s important that you feel comfortable in it.
And remember, you don’t have to have all the answers or know exactly what to say. Your therapist is there to guide you. Simply showing up and being open to talk is already a powerful beginning.
Find Mental Health Support at Cornerstone Today
Explore residential, outpatient, and virtual pathways to addiction treatment and mental health recovery in Arizona.
How to Prepare for Your First Therapy Session
Starting therapy can be a little daunting, but you’re not alone—so many people feel that way at first.
A bit of preparation can help you walk in (or log in) with more confidence and a clearer head.
- Think about why you’re going: You don’t need to have it all figured out. Maybe you’re feeling stuck, overwhelmed, anxious—or maybe you just know something needs to change. That’s more than enough.
- Write down what’s been on your mind: Whatever it is, be it stress, sadness, relationship stuff, sleep issues—just make a quick list. No need to get detailed, just enough to jog your memory.
- Ask yourself what you’d like to get out of therapy: Want to feel more like yourself? Work through something that’s been weighing on you? These don’t have to be big or fancy goals, just real ones.
- Know it’s okay to feel nervous or unsure: Opening up to someone new can feel scary. That’s normal. You’re stepping into something brave, and it’s okay to take your time.
- Bring the basics: If you take medication or have a history of mental health challenges, have that info ready. Also, bring your insurance card if you’re using it.
- Sort out the logistics: Know when your session is and where you’re going. Or, if it’s online, make sure your technology is set up. Reducing those little stressors can make a big difference.
You don’t have to do anything perfectly. Just showing up is a big first step.
Quick Tip: You’re Not Alone—First Therapy Nerves Are Normal!
It’s only natural to feel nervous before your first session. Many people worry about what they’ll say or how they’ll be seen, but your therapist knows this and will help you relax. Just showing up is a huge deal. You don’t have to be perfect, prepared, or even know what you want to talk about. Showing up is the first step toward better mental health.
Tips to Make the Most of Your First Session
The first session is really about testing the waters—getting to know your therapist and seeing how it feels to talk to them.
Here’s what can help:
- Say what’s on your heart, even if it’s messy. You’re not expected to have a script. Just speak from wherever you are right now. That’s where healing starts.
- Let yourself feel things. Tears, long pauses, nervous laughter—it’s all part of the process. It’s okay to feel. You don’t need to hide anything.
- Ask your questions. How does therapy work? How often should I go? Ask. You deserve to understand what you’re signing up for.
- Be kind to yourself. Therapy takes time. One session won’t fix everything, and that’s not its intention. Just showing up is enough for today.
- Write down anything that feels important. After the session, you may want to jot down a few notes or questions for next time. Optional, but it can help you keep track of what’s working for you.
According to research highlighted by the American Psychological Association (APA), about 75% of people who go to therapy report experiencing some improvement.³
That’s a powerful reminder of what’s possible when you commit to the process.
Questions to Ask Your Therapist
You’re allowed to be curious.
This is your time, and it’s okay to ask questions to make sure the vibe feels right:
- What kind of therapy do you practice?
- What’s a typical session like?
- How often should I come in?
- When might I start to feel some changes?
- Do you offer online sessions?
- Does my insurance cover this?
These questions can help you feel more in control and informed, which is a great way to start building trust.
Frequently Asked Questions
What should I expect in my first therapy session?
Think of it as a low-pressure conversation. Your therapist will ask about what’s been going on and what led you to reach out. You don’t need to share everything or have the perfect words—it’s okay to feel nervous. The goal is simply to begin building comfort and trust, one step at a time.
How do I prepare for my first therapy session?
You don’t need to do much. Just take a little time to reflect on what’s been heavy or on your mind lately. If it helps, jot down a few thoughts or questions. But honestly, it’s okay to show up without a plan. Therapy is about showing up as you are, not being “ready.”
What if I don’t feel connected during my first therapy session?
That’s completely normal. Sometimes it takes a few sessions to feel at ease, especially if opening up is hard for you. If it still doesn’t feel right after a while, it’s totally okay to look for someone else. Therapy works best when you feel safe, seen, and like your therapist really gets you.
Can my first therapy session be done online?
Yes, and a lot of people prefer it. It can feel a little less intimidating to talk from the comfort of your own space. As long as you have privacy and decent internet, you’re good. Your therapist will guide you through the setup—it’s just as real and meaningful as in-person therapy.
Key Takeaways
- Key Takeaways
- The first session is just a starting point. You don’t have to spill everything at once.
- Feeling nervous is totally normal—most people do.
- There’s no “right” way to do therapy—just be yourself.
- Therapy is a private, supportive space where you can work through whatever’s going on.
- Virtual sessions are a solid option if that works better for you.
Begin Your Healing Journey with Supportive Therapy at Cornerstone
Deciding to start therapy is a big, brave step, and you don’t have to do it alone. At Cornerstone Healing Center, we offer thoughtful and compassionate therapy that meets you where you are.
Whether you’re working through anxiety, depression, trauma, or just trying to get through a tough season of life, our licensed therapists are here to walk with you. We offer both in-person and online sessions, depending on what feels best for you.
Whenever you’re ready, reach out. We are here to support you.
CBT demonstrates a 50–75% effectiveness rate for treating anxiety and depression, making it one of the most evidence-based therapeutic approaches
SOURCE: NLM
Cognitive Behavioral Therapy
