What Should You Expect During Your First Session with a Licensed Mental Health Therapist?

Embarking on the journey of therapy can be a significant step towards improving your mental health and overall well-being. The first session with a licensed mental health therapist is crucial as it sets the foundation for your therapeutic relationship and future sessions. Knowing what to expect can help ease any anxiety and make the experience more productive. In this article, we will delve into what typically occurs during the first therapy session and how you can prepare for it.

Introduction and Building Rapport

Initial Greeting and Paperwork

When you arrive for your first session, you’ll typically begin with some administrative tasks. These may include filling out intake forms that cover your medical history, mental health background, and any current issues you’re experiencing. This paperwork is essential for the therapist to understand your background and to tailor their approach to your needs.

Establishing a Comfortable Environment

The therapist will strive to create a welcoming and comfortable environment. They will introduce themselves, explain their background and qualifications, and give you an overview of how the session will proceed. This initial interaction is vital for building rapport and ensuring you feel at ease.

Discussing Your Concerns and Goals

Exploring Your Reasons for Seeking Therapy

One of the primary goals of the first session is to understand why you are seeking therapy. The therapist will ask open-ended questions about your current concerns, such as:

  • What brings you to therapy?
  • What specific issues or challenges are you facing?
  • How long have you been experiencing these issues?

Setting Goals for Therapy

Together, you and the therapist will discuss what you hope to achieve through therapy. Setting clear and realistic goals is important as it provides direction and purpose for your sessions. These goals can be broad, such as “improving overall mental health,” or more specific, like “managing anxiety better.”

Gathering Personal and Medical History

Personal Background

The therapist will ask about your personal history to gain a better understanding of who you are and the context of your current situation. Topics may include:

  • Family background and dynamics
  • Educational and occupational history
  • Significant life events and experiences

Medical and Mental Health History

Understanding your medical and mental health history is crucial for effective treatment. The therapist may inquire about:

  • Previous mental health issues and treatments
  • Any current medications and their effects
  • Physical health conditions that might impact your mental health

Assessing Your Current Situation

Mental Health Assessment

During the first session, the therapist may conduct a brief mental health assessment to gauge your current emotional and psychological state. This can involve discussing your mood, thoughts, and behaviors. The therapist might also use standardized assessment tools to better understand your symptoms.

Immediate Concerns and Needs

If you are experiencing acute distress or a crisis, the therapist will address these immediate concerns. This could include providing strategies to manage anxiety or depression symptoms or discussing safety plans if you have thoughts of self-harm.

Explaining the Therapeutic Process

Therapeutic Approach and Techniques

The therapist will explain their therapeutic approach and the techniques they commonly use. Whether it’s Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), or another modality, understanding the therapist’s methods helps set expectations for how the sessions will unfold.

Confidentiality and Boundaries

Confidentiality is a cornerstone of the therapeutic relationship. The therapist will explain what confidentiality entails, including any legal limits to confidentiality, such as situations involving imminent harm to yourself or others. Understanding these boundaries helps build trust and security in the therapeutic space.

Your Role in the Therapy Process

Active Participation

Therapy is most effective when you actively participate. The therapist will encourage you to be open and honest about your thoughts and feelings. They might suggest activities or exercises to do between sessions to reinforce what you’ve discussed.

Feedback and Communication

Your feedback is crucial for the success of therapy. If certain approaches or techniques resonate with you or if you have any concerns, communicate them to your therapist. This ongoing dialogue ensures that the therapy remains aligned with your needs and goals.

Addressing Any Questions or Concerns

Open Dialogue

The first session is also an opportunity for you to ask questions about the therapy process, the therapist’s qualifications, and what you can expect moving forward. Addressing any concerns or anxieties you have about therapy can help you feel more comfortable and committed to the process.

Next Steps

Towards the end of the session, the therapist will outline the next steps. This might include scheduling future appointments, discussing the frequency of sessions, and any immediate actions you should take based on your initial conversation.


Your first session with a licensed mental health therapist is a foundational step in your therapeutic journey. By establishing a connection, discussing your concerns and goals, and understanding the therapeutic process, you lay the groundwork for a productive and supportive relationship. Remember, therapy is a collaborative effort, and your active participation and honest communication are key to achieving your mental health goals.