Therapy - What to Expect

If you’re thinking about starting therapy, whether face-to-face, via video, or over the phone, it’s ok to feel uncertain or even anxious about what the experience will be like. Will you have to open up immediately? What if you don’t know what to say? What if you feel overwhelmed or uncomfortable? These are all common questions, and it’s completely understandable to have them before your first session.

Therapy can feel intimidating when you don’t know what to expect, especially if you've never experienced it before. The good news? Regardless of whether you’re sitting in a therapist’s office, connecting via video, or chatting on the phone, the core of the experience is designed to be supportive, non-judgmental, and completely customizable to your needs. So, let’s take a look at what you can expect, and what you absolutely don’t have to do, during your talk therapy session.

1. The Environment is Safe, Supportive, and Non-Judgmental

Whether you’re meeting your therapist in person or logging in through a video call, the space should feel welcoming. If you’re meeting in-person, expect a private office with a calming atmosphere designed to make you feel at ease. If it’s a video call or phone session, your therapist will likely check in with you to ensure you’re in a space where you feel comfortable and can speak freely.

One of the biggest things to keep in mind is that you’re entering a confidential environment. Your therapist is there to listen, support, and help guide you, not to judge or tell you what to do. You have control over the conversation. And if you’re doing online or phone therapy, you may feel an added layer of comfort because you can be in your own space, whether that’s your home, car, or a quiet place where you feel safe.

2. The Paperwork

The first part of therapy usually involves some paperwork, regardless of whether it’s an in-person or virtual session. This paperwork is necessary to establish the logistics of the therapy relationship: it covers things like confidentiality, consent to treatment, and the practical aspects like fees and cancellations.

It’s normal to feel a bit bogged down by paperwork, especially if you're new to therapy, but it’s a standard part of the process. If you’re doing therapy online or over the phone, much of this may be completed electronically before your first session. The most important thing to know here is that you’re not locked into anything rigid or permanent. If anything feels off or uncomfortable, you can always ask questions or adjust.

3. The Initial Conversation: Your Therapist Will Guide, Not Push

At the start of your first session, whether in-person, online, or over the phone, your therapist will likely ask you some open-ended questions to get to know you and understand what brought you to therapy. It’s normal to feel nervous about this, but keep in mind that you’re not obligated to share anything you’re not ready for.

Your therapist may ask things like, “What made you decide to try therapy today?” or “What’s been going on in your life that’s brought you here?” But you’re never required to answer in any specific way. If you feel unsure, you can simply say, “I’m not sure where to begin” or “I’m still figuring out what I want to focus on.” There’s no rush to dive deep right away—therapy is a process, and your therapist is there to help guide you at your own pace.

Here’s a guide to some of the questions therapists might ask, and how to handle moments when things feel uncomfortable, plus how to respectfully end or pause the conversation if needed.

4. Therapists Are Trained to Listen (& Ask the Right Questions)

One of the core aspects of therapy—no matter what form it takes—is that your therapist is there to listen. Their job is not to give advice or “fix” your problems, but to provide a safe, supportive space where you can explore your thoughts, feelings, and behaviors.

They’ll ask thoughtful, probing questions to help you better understand yourself. For example, if you mention feeling overwhelmed, your therapist might ask, “What does overwhelm look like for you?” or “Can you tell me more about what triggers that feeling?” They may reflect back to you things you’ve said, like, “It sounds like you’re feeling stuck between wanting to move forward and fearing what that might mean.”

If you’re doing therapy online or by phone, the therapist will still engage in this reflective process, even though they might not have the benefit of body language to work with. Instead, they’ll focus more on your tone, pacing, and the words you choose. Don’t be surprised if you find yourself feeling heard in a way you hadn’t anticipated—it’s one of the most powerful parts of the therapeutic experience. And if you don't? That's ok too. There's no timer running in the background for when you need to feel better, and you also have the right to find a new therapist if you don't feel heard or supported.

5. You’re Not Obligated to Share Everything Right Away

It’s completely okay if you don’t know exactly what to say in your first session. You don’t have to jump into deep, personal stories if you’re not ready. Some people feel more comfortable sharing small details or even just explaining why they’re unsure about what they’re feeling. You can take your time to ease into more vulnerable topics as you build trust with your therapist.

Your therapist will help you pace the conversation, and if you don’t want to dive deep into a specific topic, it’s okay to say so. You can set boundaries—this is your time, and your therapist should respect your pace and comfort level. You’re not obligated to talk about anything you’re not ready to address.

Here’s a guide to some of the questions therapists might ask, and how to handle moments when things feel uncomfortable, plus how to respectfully end or pause the conversation if needed.

6. Goal-Setting: A Flexible Process

One thing you can expect in your first session is a discussion about what you’d like to accomplish in therapy. This isn’t about setting rigid goals but more about identifying what you hope to get out of the process. Maybe you want to feel less anxious or work through a difficult breakup. Maybe you want to build better coping strategies for work-related stress or explore a deeper sense of self-awareness.

While some people come into therapy with a clear idea of what they want to work on, others don’t have a specific goal in mind, and that’s completely fine. Therapy is flexible, and goals can evolve over time. Your therapist will work with you to set goals that feel meaningful and attainable for you.

7. Note That You Can Ask Questions: Therapy Is a Two-Way Conversation

If you're feeling uncertain about any aspect of the process, don’t hesitate to ask your therapist questions. You’re not expected to just show up and “know what to do.” A good therapist will encourage you to ask about how therapy works, what to expect from the process, and how to make the most of your time together.

Whether you’re curious about the therapeutic techniques they’ll use, how to handle certain emotions, or even how to schedule future sessions, your therapist is there to provide guidance and transparency. If anything feels unclear or uncomfortable, it’s okay to ask questions and express your feelings.

8. Ending the Session: Set Some Time to Reflect

At the end of your first session, your therapist will likely check in with you about how the conversation went. How are you feeling about the process? Was there anything that felt difficult or helpful? This is a chance to reflect on how the session went and if there’s anything you want to adjust for future meetings.

Afterward, you’ll schedule your next session. Some people prefer to schedule right away, while others like to take a little time to reflect. That’s entirely up to you. You might leave your first session feeling a bit lighter or with a lot to think about—and that’s all part of the process.

If you're not ready to commit to the next appointment, here’s how you can politely and assertively communicate your decision.

Therapy Is a Personal Journey, and You Control It

No matter how you choose to engage in therapy—whether face-to-face, online, or over the phone—the goal remains the same: to provide a safe, supportive space for you to understand yourself better, process difficult emotions, and build a healthier relationship with yourself. The first session may feel a little uncomfortable or unfamiliar, and that’s ok.

What’s most important is that you remember that you don’t have to share anything you’re not ready to. Therapy is a process, and it’s okay to take your time. Trust yourself and know that you’re already doing something positive for your well-being.

A Personal Note:

I want to share a bit of my own journey with therapy, in case it resonates with you.

It’s okay to take your time finding someone who makes you feel comfortable. I personally had a rough start with my first therapist, someone who didn’t create the safe, understanding space I needed. Looking back, I wish I’d had the tools to either end the conversation or steer it in a direction I was more comfortable with. After leaving that therapist, it took me years to find the courage to try again. But I’m so glad I did. I went into my new therapist’s office with a few key questions to make sure we were on the same page about my goals and the kind of approach I needed. I also had a list of responses ready in case I felt unsafe. That was a game-changer for me.

If you decide to try therapy (either again or for the first time), I’ve put together some guides on responses you can use if a therapist isn’t respecting your space or comfort levels. You’re not obligated to continue any conversation or keep a therapist who doesn’t feel right for you. Ultimately, therapy is your journey, and you should feel empowered to find the support that works best for you. It might take time, but it’s worth it.

Therapy Q&A

Do I Feel Safe?