What to Expect from Your First Psychotherapy Session
Scheduling your first individual psychotherapy session is a meaningful and courageous decision—and it’s completely normal to feel a bit unsure about what to expect. Whether you’re brand new to therapy or starting over with a new clinician, that first session marks the beginning of something important: a journey inward, toward greater clarity, connection, and healing.
At Midtown Psychotherapy Associates, our goal is to help you feel supported, grounded, and informed—starting from day one. This post offers a guide to what you can generally expect from your first individual psychotherapy session, with a few examples from my own approach (I’m Kaitlin Lowey, therapist at Midtown Psychotherapy Associates) to help you feel more at ease.
Therapy Is Like Beginning a Journey Through Unfamiliar Terrain
Starting therapy is a lot like setting out on a walk through unfamiliar terrain. You may have a general idea of where you want to go—but not exactly how to get there. There might be winding paths, some steep hills, maybe even a few places where you need to pause and catch your breath. You don’t have to know the whole route to begin—you just need the right guide and a willingness to take the first step.
Your therapist is like a trail companion: someone trained in reading the terrain, attuned to the pace that feels right for you, and committed to walking beside you as you find your way forward.
Step One: Meet Your Guide (Your Therapist)
Ideally, before your first session, you would have had the opportunity to read your therapist’s bio and have a phone conversation with them to understand their areas of specialty and approach, ensuring the two of you are a great fit. However, this first session can be a great opportunity for you to ask any questions you didn’t get around to beforehand.
During your first session, your therapist will begin by introducing themselves and setting a tone of curiosity, safety, and care. For instance, in my own practice, I reassure clients that it’s normal to feel a bit nervous the first session, and I invite them to share any questions, concerns, or uncertainties they have about the therapy process. At Midtown Psychotherapy Associates, each of our clinicians brings a unique background and expertise to the work, but we all share a deep commitment to meeting you where you are.
Step Two: Review the Map
Every journey benefits from a bit of orientation. In the first session, your therapist will explain what therapy is and isn’t, what you might expect along the way, and some of the emotional terrain we may encounter.
We’ll also cover some foundational information like:
What confidentiality means (and its legal and ethical limits)
Communication and scheduling policies
What to do if you see your therapist in public
How to contact your therapist between sessions, if needed
In my own work, I always emphasize that therapy is a collaborative process. It’s about getting curious, exploring patterns, and offering space and tools so that you can better understand yourself, heal, develop mental wellness, and make impactful changes that align with your values and goals.
Step Three: Understand What You’re Carrying
Like any journey, it helps to know what you’re bringing with you. In your first session, your therapist will ask questions to learn more about your emotional, physical, and relational history—things like:
What’s bringing you to therapy right now
Your current symptoms or stressors
Past experiences with therapy or support
Family and relationship dynamics
Health and lifestyle factors
Cultural or spiritual influences
I often tell clients that this session will be a little more “question-heavy” than future ones, where they’ll be doing most of the talking. I want to understand what’s weighing on you—and what strengths and supports you already have. We might also explore how early experiences shaped how you respond to stress or relationships today.
Sometimes I’ll suggest using brief assessments to help clarify diagnoses or develop a baseline for tracking progress. But no pressure—you’re always in control of what you share and when.
Step Four: Set an Initial Direction
By the end of the session, we’ll begin identifying initial therapy goals. These don’t have to be perfectly clear or fixed—often, people come in unsure of exactly what they need. That’s okay. Our job is to explore together and refine goals as more clarity emerges.
Your goals might include:
Reducing anxiety or panic
Navigating a big life transition
Healing from trauma or grief
Improving communication in a relationship
Reconnecting with a sense of purpose or identity
Some clients want short-term, focused work. Others are seeking deeper, longer-term exploration. Both are valid, and both begin with a shared understanding of where we’re headed.
We’ll also talk about frequency (I typically recommend starting weekly) and schedule your next session. If it feels right, your therapist may offer a small practice—like reflecting on a theme that emerged during the session, journaling a response to a prompt, or simply noticing emotions or patterns during the week.
A Few Final Words Before You Begin
It’s okay to feel nervous about your first session. Therapy invites honesty, self-reflection, and often discomfort—but also relief, insight, and growth. That first session is less about diving into the deepest pain and more about creating a foundation of trust and understanding.
At Midtown Psychotherapy Associates, we’re committed to walking with you through whatever terrain you’re facing. Whether your path feels overgrown, uncertain, or just hard to walk alone—we’re here to help you navigate it.
If you’re reading this and wondering if now is the right time to begin: you’ve already taken the first step. The rest of the journey? We’ll take it together.
Written by Kaitlin Lowey, therapist at Midtown Psychotherapy Associates. Kaitlin specializes in working with individuals navigating OCD, anxiety, trauma, life transitions like the postpartum period, athletic retirement, and career changes, identity development, and self-worth. She provides in-person therapy in Atlanta and virtual therapy throughout Georgia and Florida.
