S3 E5: What to Expect in Your First Session

In this episode of Health Hope Harmony, we’re breaking down what you can expect during your first counseling session. Whether it’s your first time in therapy or you’re just curious about the process, we’re here to guide you through it. From completing paperwork and assessments to setting goals and establishing trust, we’ll cover it all to help you feel confident and prepared. Join me, Sabrina, as we demystify the intake process and discuss how your first session lays the foundation for a supportive, healing journey.

If you’ve been wondering what to expect in therapy or feel nervous about starting, this episode is for you!

Transcript

Welcome to Health Hope Harmony, the podcast where we redefine health, restore hope, and reach harmony. I’m Sabrina, and I’m so glad you’re here today.

Starting counseling can feel like stepping into the unknown, especially if it’s your first time. Even if you’ve been in counseling before, every counselor and practice does things a little differently. So, today we’re breaking it down: What actually happens in your first counseling session?

We’ll cover everything from paperwork and assessments to goal-setting and how to prepare so you feel ready for that first session. Let’s jump in!

Before You Even Step Into the Office
Let’s start with what happens before your first session. At Health Hope Harmony, we’ve streamlined this process to make things as stress-free as possible.

After scheduling your intake appointment, you’ll receive an email with a link to our secure client portal. Through this portal, you’ll complete your intake forms online. These forms cover important details, including:

• Your basic information, like contact details and insurance, if applicable.
• Policies, including confidentiality and cancellation agreements, using insurance, what to do in an emergency, etc
• Your mental health history and current concerns.
• Any medical history or other factors that may impact your mental health.
• A little background information such as relationship status, housing, children, siblings, religion/spirituality, etc. These things gives us more information about you, while it might seem like some of this isn’t connected to your presenting concerns, in our world everything is connected

Completing these forms ahead of time saves time during your first session and allows your counselor to come prepared. It’s also a chance for you to share what’s been on your mind—what brought you to counseling, and what you’re hoping to work on.

If you’re feeling overwhelmed by the forms, don’t worry. They’re designed to gather helpful information, but there’s no right or wrong way to fill them out. Just share what feels comfortable.

If you are coming in person, we also recommend looking at where our office is located. It helps reduce those first visit jitters if you know where you’re going, how to get there, and where to park. When you schedule you should also be provided this information. If you aren’t or you forget (we get it, there’s a lot going on in that first phone call) please give our office a call and we’ll help remind you. 

Now, let’s talk about what happens on the day of your first session.

Whether you’re meeting in person or virtually, the beginning of your session is about getting settled. If you’re meeting in person, you’ll be welcomed into a private, comfortable space. If your session is virtual, make sure you’re in a quiet, distraction-free area and check your internet connection beforehand.

Your counselor will begin by reviewing some of the logistics. They might go over:

• Confidentiality: Your counselor will explain what they can and cannot keep private, including exceptions like safety concerns.
• Session structure: They’ll give you an idea of what a typical session will look like going forward.
• Any remaining questions about the intake forms: If something was unclear or incomplete, this is a chance to clarify.

The goal here is to make sure you feel informed, comfortable, and ready to begin.

Once the initial logistics are covered, the heart of your first session begins. This is where your counselor starts to understand your story and gather the information they’ll need to support you effectively.

Think of this session as a collaborative conversation, not an interrogation. The goal is to create a foundation for the therapeutic relationship—a space where you feel heard, understood, and safe. Here’s what you can expect during this part of the session

Sharing Your Story

*“Your counselor will likely start by asking an open-ended question like:

• ‘What brought you to therapy?’
• ‘What’s been on your mind lately?’
• ‘What’s one thing you’d like to feel better about?’

These questions are invitations, not demands. You don’t have to spill everything all at once. In fact, counseling often works best when you pace yourself. Share what feels comfortable for you, whether that’s a high-level overview or diving into specific details.

For example, you might say:

• ‘I’ve been feeling overwhelmed at work, and it’s starting to affect my sleep and mood.’
• ‘I’ve struggled with body image for as long as I can remember, and I want to feel more at peace with myself.’

Your counselor is there to listen without judgment and guide the conversation in a way that feels supportive.

Exploring Key Concerns

As you talk, your therapist may gently ask follow-up questions to better understand your experiences. For instance:

• If you mention anxiety, they might ask, ‘Can you tell me more about when you feel most anxious? What does that feel like for you? How often is that happening?’
• If you bring up challenges with relationships, they could ask, ‘What does communication look like with the people closest to you?’

These questions help your counselor get a clearer picture of your situation and identify patterns or themes that might be contributing to your concerns. Remember, there’s no pressure to have all the answers right away—it’s okay to say, ‘I’m not sure’ or ‘I need to think about that.’

At Health Hope Harmony, we approach this exploration with curiosity and compassion, always honoring your pace and comfort level.

Structured Assessments and Questionnaires

Depending on the counselor and practice, your first session may also include a structured assessment. This isn’t always required, but it’s common in practices like ours to gather more detailed information about your mental health history, current symptoms, and lifestyle.

Assessments can include questions like:

• ‘How often do you feel sad, anxious, or overwhelmed?’
• ‘Have you experienced significant trauma or major life changes?’
• ‘What does your support system look like?’

At Health Hope Harmony, these assessments are tailored to your specific needs. For example, if you’re seeking therapy for eating disorders or body image concerns, we may ask questions about your relationship with food, exercise, and self-perception.

This information helps us identify areas to focus on and ensures we’re using the most effective therapeutic approaches for your unique situation.

Throughout the session, your counselor will take notes to capture key insights, but the focus remains on having a conversation. You’re encouraged to ask questions, share thoughts, or even say, ‘I’m not sure how to answer that yet.’

Please keep in mind, the first session isn’t about fixing everything or diving deep into every problem—it’s about laying the groundwork for a supportive, trusting relationship. This is your time to feel seen and start building a connection with someone who’s here to help.”*

If you’re feeling nervous about counseling or unsure if it’s the right fit, your counselor will make space for those feelings, too. They might ask:

• ‘How are you feeling about starting counseling?’
• ‘Is there anything you’re worried about as we begin this process?’
• If a client has been in counseling before, I like to ask about their previous experiences. What they liked, what they didn’t like, if there was anything specific the last counselor did that was really helpful or unhelpful.

At Health Hope Harmony, we understand that counseling is a big commitment, and it’s natural to have questions or hesitations. Your counselor’s role is to meet you where you are and work with you to create a path forward.

Your counselor might also ask about your goals for counseling. This can feel like a big question, especially if you’re not sure what you want yet. And that’s okay! Goals can be as simple as:

• ‘I want to feel less anxious.’
• ‘I want to improve my relationship with food.’
• ‘I want to understand why I feel stuck.’

Counseling is a collaborative process, so you and your counselor will refine these goals together over time. At Health Hope Harmony we usually use the 2nd session to get more information on goals and help develop our counseling treatment plan.

As your first session comes to an end, your counselor will likely summarize what they’ve heard from you and check in to make sure they’re understanding your concerns accurately.

They might also outline a tentative plan for moving forward. For example:

• ‘We’ll spend the next few sessions exploring your anxiety and identifying triggers.’
• ‘I’d like to introduce some grounding techniques that could help with the overwhelm you’ve been feeling.’

Finally, they’ll ask if you have any questions or concerns. This is your chance to ask about things like scheduling future sessions, their therapeutic approach, or anything else on your mind.

Leaving your first session, it’s normal to feel a mix of emotions—relief, hope, or even a bit of nervousness. Starting counseling is a big step, and it’s okay to take time to process.

Before we wrap up, here are a few quick tips to help you prepare for your first session:

1. Be yourself: There’s no need to rehearse or edit your thoughts. Your counselor is here to meet you where you are.
2. Bring questions: If you’re curious about your counselor’s approach or anything else, don’t hesitate to ask.
3. Give yourself grace: It’s okay if you feel a little nervous or unsure. Starting counseling is a courageous step, and it’s all part of the process.

At Health Hope Harmony, we’re here to support you every step of the way. Whether it’s your first session or your hundredth, the goal is always the same: to create a space for healing, growth, and connection.”*

Thank you so much for tuning in to today’s episode of Health Hope Harmony. I hope this conversation has helped demystify what to expect in your first therapy session and given you the confidence to take that step.

If you’re considering therapy and have more questions, feel free to reach out or visit our website for resources. And if you found today’s episode helpful, please share it with someone who might benefit from it, too.

Until next time, be gentle with yourself and take one small step toward healing—you’re worth it.