Tips  on spiritual growth, emotional health, and relational healing.


Starting Therapy? 7 Things You Need To Know Before You Show Up For Your First Session

Apr 11, 2023

“Hi, my name is Scott and I’m in therapy.”

At one time, I thought going to therapy was a cringe-inducing move. 

People who went to therapy had wrecked their life.

Their marriage was hanging by a thread.

They had been really messed up from a troubled childhood.

They didn’t have enough spiritual maturity to handle life. 

During the time when I would have said those words, I worked and lived within a community where it wasn’t safe to go to therapy. It certainly wasn’t safe to be authentic or transparent about your challenges. As a result, I waited about four years after someone said to me “you ever thought about seeing someone?” to actually go and see someone. Even then, it took a relocation and a new job to take that step!

Therapy Has Helped Me & I Want to Help Others

I was introduced to my therapist by a mutual friend and I went in pretty blind. I didn’t know what I didn’t know and I’m not sure how effective my first few sessions were. But, we eventually found a groove. It’s been over five years of sessions every 2-3 weeks ever since that first visit. The ground we’ve covered is incredible, helping me deal with anxiety and challenges at work and home. The work I’ve done with my therapist has positively impacted every relationship and every component of my life.

Recently, in my work as a pastor, I helped a handful of people get connected a therapist for the first time. In the process, I discovered that they were nervous and like me, didn’t know what to expect. It would have been really helpful to have something to share with them in order to prepare them in a way I had been when I started therapy. 

So, I reached out to a handful of therapists I know and trust. I posed the following question to each of them. “If someone was going to counseling/therapy for the very first time, what piece of advice would you give them heading in their first session?”

That question led to a flurry of voice memos, text messages, phone calls, and emails. I was grateful for their input and super pleased to see some common threads across those conversations. I’ve assembled the answers to these questions into this article. I hope following seven things are helpful to you as you prepare for your first visit to see a therapist or counselor. 

7 Things You Need to Know Before You Show Up for Your First Therapy Session

(Even if you’ve been to therapy before, I think these include some helpful reminders. Despite my years of visits, I still learned a couple things I’d never considered before, too.)

1. It is normal to feel A LOT before your first session.

Do you feel nervous or anxious? That’s normal. Do you feel a sense of shame or concern about how you’ll be perceived? That’s normal. If you start rationalizing with yourself – “maybe it’s not so bad and maybe I am over-reacting in doing this”, know that this is very common. 

Something is shifting inside of you. A disruption often drives us to therapy – something changing in our lives or the way we are managing our lives. In taking this step, you are being courageous and vulnerable – so it makes sense that fear is rising up inside of you.

As a pastor, I would tell you that you long for healing and God longs to meet you in that pursuit. It’s normal to feel a lot before your first session. You’re not weird or abnormal. 

2. Bring your honest, vulnerable self

What do you bring to your first therapy session?

One therapist I interviewed said, “you only have to bring two things in the room (to the measure or degree you are able – honesty and vulnerability. If you can simply start with this, that’s enough.”

That’s gotta be a relief. You don’t need to bring a bunch of evidence or justification for what you’re believing or experiencing. You can bring a notebook to write things down if you like, but just show up as you are. Be as vulnerable and honest as you can. 

(When I read that, I took a deep breath! Hope you did too)

3. Look for a good fit

Going to see a professional counselor or therapist has some similarities to meeting a doctor for the first time. You are looking for a good fit, so consider taking an interview mindset with you. 

Ask questions about experiences the therapist has working with others facing similar challenges to the ones you’re facing. It may not be immediately clear if the person is a good fit, so it may be wise to give it a couple sessions to determine if the person is safe and gets you. It’s not a guarantee the first time.

If there are major red flags in the first session or you just aren’t feeling a connection, all five therapists I interviewed for this article told me it is okay to ask for a referral or look for another counselor if you aren’t comfortable. They all said no one therapist is a good fit for every client. 

4. You don’t need to worry about performing here

“What will they think of me when I share _________________? What happens if I just _______________?”

One therapist specifically said, “It’s normal to feel afraid of the floodgates opening and everything you’ve been holding back coming out. It’s normal to worry about what words or emotions might come out.”

A therapist you’ve determined to be a good fit – worthy of your trust – is not judging you or expecting you to perform. They want you to show up honestly and vulnerably, in order to support you and assist you in pursuing health and healing. 

There is no stage in a therapy office, no audience, and no need to worry about performing.

5. Recognize you have a partner in the work you’re starting

I am a pastor and writer. The work I do is a sacred calling – I believe this is what God made me to do, in service to Him and others.

I was surprised when one the of the therapists I interviewed echoed that language. “I would want someone seeking counseling to know that I see it as a profound privilege to provide a safe and sacred space for them.”

You are not alone in your work any longer, once you sit down with a therapist. You now have a resource and guide who can help you go where you never have before now.

6. Be patient with the process

All of the therapists I talked to emphasized patience. In this kind of healing work, there are few quick fixes. So, it might be wise to examine your expectations for your first session. I don’t know anyone who went to therapy once and was “fixed.” The people I know who only went to therapy once did not find a magic shortcut the rest of us missed. They normally were those who found the path ahead daunting and chose not to walk it. 

My therapist regularly reminds me “there’s a difference between going to therapy and doing therapy.” Just going to therapy once per week or a couple times per month can be helpful, very helpful actually. But, if you only do work when you are with your therapist, your results may be more limited in scope. When you do therapy rather than just go to therapy, the bulk of the work and the majority of the breakthroughs happen in between the sessions. You expand the scope of the results because you’re working the process. 

Along that process, remember – your therapist doesn’t have you on a timeline and you might be wise to get rid of yours too. I wrote an article to my email list earlier this year where I reminded my readers that healing doesn’t have a clock and it doesn’t have a calendar, either. 

7. Make a plan for after your first session

It can be normal to feel exhausted or overwhelmed afterwards. One therapist told me, “Many of us are not used to dropping from our head into our heart for such an extended time. Walking out of a therapy session can feel like leaving the gym after a workout – only this time the exhaustion is not merely physical; it’s also mental, emotional, and even spiritual.”

So, in the event your first session (or any session for that matter) takes a lot out of you, consider how you can be kind or compassionate to yourself after your session. 

Can you plan an easy dinner or take out? 

Can you lighten your schedule after your session or clear it entirely?

If you have to go back to work or have your entire work day in front of you, can you plan to drive slower or ease your way back into that reality? 

Can you listen to some music which soothes you or grab a treat for yourself on the way back to something difficult? 

Regardless, be kind of yourself. You’ve just taken a big step, shown up and done some hard work, and you probably have more ahead of you. Plan your rest as intentionally as you are planning your work. 


A Thank You and A Request

I hope these seven things have been helpful to you as you prepare for your first therapy session (or as you prepare like me to go for your 100th).

I want to say thank you to five therapists who helped contribute to this article. You have served me, my family, and my church in the last several years in ways for which I am truly grateful. Thank you Joey and Robyn Coffman at The Coffman Company and 10|10 Ministries, Elizabeth Heinrich, Rob Heinrich, and Dr. Stacie Brown

If you know someone who could use this article, please feel free to pass it on. And if you’d like to read more helpful content like this, please consider to subscribing to my email list. Over 2,000 people receive multiple emails from me each month which provide practical, helpful, and encouraging content. 

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