What to Talk About in Your First Therapy Session

Are you gearing up for your first appointment with a new therapist and don’t know what to expect? The fear of the unknown can be overwhelming, so you might be dealing with some jitters. Well, we’re here to fix that problem by going over what you’ll talk about in your first therapy session.

First, it’s important to understand that your first session is called “intake” and differs from future appointments. Unlike most sessions, your therapist will do a lot of the talking, but you’ll still need to participate.

Man Talking to Therapist

Your therapist will ask a series of questions to learn more about you, the issues you want to overcome, and your goals. Some of the questions just require a “Yes” or “No” answer, while others are more detailed.

Now that you have the basics, it’s time to look at the topics you’ll cover. Remember that all therapists have their own intake styles, meaning these talking points might differ a bit. Still, they provide a general idea of what occurs during intake.

Topics During the First Therapy Session

We’ll go into the topics in greater detail but want to give you a rundown first. You can expect to cover the following during your first therapy session:

  • The trigger that brought you to therapy
  • Your Symptoms
  • Work with previous therapists
  • Current living situation and support system
  • Family history
  • Past trauma
  • Coping strategies
  • Therapy goals 
  • History of suicidal thoughts or self-harm 

Now, let’s dive into each of these talking points.

The Trigger that Brought You to Therapy

Your session will likely begin with a very straightforward question: “What brought you to therapy?”.

Your instincts might be to provide a broad answer, such as, “I’m depressed,” or “I feel anxious all the time.” While that’s a good start, your therapist wants to know the trigger that caused you to schedule the appointment.

For instance, maybe you’ve been depressed for a while but just lost your job, pushing you to take action. By providing those details, your therapist will know if they’re a good fit for you. If so, that information will help your provider create a treatment plan.

Your Symptoms

You’ll also dig into your emotional and physical symptoms during the first appointment. Emotional symptoms like sadness and nervousness are easy to remember, but physical symptoms might trip you up.

For instance, you might have unexplained pains that are symptoms of anxiety or depression. Those aren’t always easy to recall, so we recommend jotting them down before heading to your appointment.

That being said, don’t worry if you leave some symptoms out during intake. It’s an evolving process, and you can add more to the list during future appointments. In fact, your therapist will check in with you during sessions to see if you still have the same symptoms or if you have some extras to add.

Your Work with Previous Therapists

If you’ve attended therapy in the past, your therapist will ask about those experiences. This isn’t to judge a previous therapist’s work. Instead, your counselor will pick your brain to find out what worked in the past – and what you’d rather avoid.

For example, if you were hypnotized in the past and hated it, your therapist won’t recommend that technique. On the other hand, if you had success with mindfulness, your provider might work that into future sessions.

Are you an overachiever? If so, you can also share the therapeutic modality your former provider used. This refers to the type of therapy, such as cognitive behavioral therapy (CBT). If you don’t know it offhand, it’s probably listed on the provider’s website.

But don’t feel bad if you don’t want to go for that gold star. If you provide an overview of your sessions, your therapist can probably nail down the approach used.

Your Current Living Situation and Support System

While you won’t get into much detail in your first session, you’ll need to talk about your living situation and support system. This will help your counselor understand your life outside of therapy and how that will impact your growth.

Don’t stress out if you don’t have good news to share on this front. Your therapist can help you build a support system. It won’t happen overnight, but if you put the work in, you can get support inside and outside of your sessions.

Your Family History

You might have moved out of your parents’ house decades ago, but you still carry those experiences with you. For instance, your formative years impact the way you communicate and see the world. You also might have learned some of your coping strategies when you were growing up.

Because this is an information-gathering session, your therapist will ask some general questions about your family history. This might include who raised you, if you have siblings, and if you’re still in touch. Also, your counselor will ask if you have a family history of mental health conditions.

Traumatic Events You’ve Experienced

Many people go to therapy to work through traumatic events that happened in childhood or when they were adults. Unfortunately, these issues are hard to talk about, and you have to build trust with your therapist before opening up.

Still, your counselor will want to know if you’ve suffered any trauma in your life. While providing that information sounds stressful, your therapist will keep it as painless as possible.

You won’t be expected to provide details, so giving a simple “Yes” or “No” answer will work at this point in therapy. Eventually, you’ll build trust with your therapist and be ready to open up. Then, you’ll start working through those issues.

Your Coping Strategies

You have coping strategies you use, even if you don’t realize it. Sometimes, those coping strategies are negative, such as abusing drugs or alcohol. You also might cope in positive ways, like going on a walk when you feel stressed.

Discuss these strategies with your therapist, including what has and hasn’t worked for you. Then, your therapist can help you use the positive strategies while avoiding the negative ones.

Your Goals

When you made your first appointment, you likely had a goal in mind. Maybe you’re depressed, and your goal is to feel happy, or you’ve lost confidence and want to regain some swagger. Your therapist will discuss these goals with you as part of your therapy plan. Then, your counselor will check in with you later to see how much progress you’ve made.

History of Suicidal Thoughts or Self-Harm

We get that talking about suicidal thoughts and self-harm is difficult, so you might say “No” when your therapist asks about it, even if the answer is “Yes.” Still, it’s important to answer honestly since this information will impact your treatment plan.

Are you worried about being honest because you don’t want to get reported? Your therapist will keep the information confidential as long as you aren’t in immediate danger. If you need more assurance, ask the therapist to go over the confidentiality agreement first. Then, you’ll be more comfortable disclosing the information.

What if You Don’t Have a Therapist Yet?

Are you ready to cover these talking points during a session but don’t have a therapist yet? Starting therapy is easier than ever, thanks to online options. Check out our patient guide for starting online therapy to see if you’re a good fit. Then, look at our online therapy reviews for help selecting an app or website.