Beginning therapy can be an intimidating experience. Opening up about things that are bothering you – especially to a complete stranger – can feel very vulnerable. It’s a brave choice to pursue therapy! 
Understanding what to expect from therapy sessions can help ease your nerves. Whether you are just starting out on your journey to mental health or continuing therapy with a new provider, it is important to know what to expect from your therapy sessions.

First session introduces the expectations for therapy

What to Expect from Therapy Sessions? - Gayle Weill

In the first session, the therapist will start by talking to you about the limits of confidentiality – what information they can and cannot share with others. For example, legally, what is said in the therapy session stays in the therapy session. 

This is true unless one reveals that they are planning to harm themselves or others, or abuse of elder or minor children is revealed to the therapist. The therapist is a mandated reporter, which means that they are required to report cases of abuse and neglect to the local authorities. 

The therapist may ask you how you heard about them, and whether you’ve been in therapy before. This is so that they can get an understanding of what works and what doesn’t work for their practice. You’ll get a chance to talk about why you decided to come to therapy, ask any questions about the therapy process, and discuss any goals or expectations you have for the sessions. 

This initial conversation will help the therapist get to know you and get an understanding of how to best tailor your therapy sessions to best meet your needs.

Therapist will ask questions about your history

During the first session or two, your therapist will conduct a biopsychosocial assessment. This is an in-depth look into your past, present and future to better understand you and provide the most effective treatment. Your therapist will ask you questions about your history such as where you grew up, your relationships, family dynamics, lifestyle habits, mental health, and physical health. 

These questions are important in forming a complete picture of who you are and how the therapist can best help you. Your answers will provide information for the development of personalized treatment goals and a treatment plan that best fits your individualized needs. The therapist will make sure to ask questions in a way that is respectful of your privacy. You don’t have to answer any questions you are not comfortable with. 

The goal is to build trust between you and the therapist. Knowing more about your history can help guide the therapist in providing the most beneficial treatment possible.

Some therapists accept insurance for session payment. If you are paying for your therapy sessions with your insurance, your therapist is also required to diagnose you in order to receive payment. Getting more information about your history and current symptoms will help your therapist formulate an accurate diagnosis.

Assessing therapeutic fit

Therapeutic fit is one of the most important factors when seeking therapy. It’s the relationship between the therapist and the client and is necessary for the successful progress of the treatment plan. A good therapeutic fit is when both parties feel comfortable with each other, and can collaborate to achieve the desired goals. It’s essential for both you and the therapist to feel comfortable to get the most out of the therapy sessions. 

It’s also important for you to feel as though your therapist respects you, understands your unique situation, is attentive to your needs, and has the expertise you are looking for in therapy sessions. For example, if you are looking for a therapist that specializes in addictions, it wouldn’t make sense to seek out a therapist who instead specializes in eating disorders because the therapist wouldn’t be experienced in what you are seeking treatment for.

A therapist may make some initial assumptions about a client based on what they discuss in their first sessions, but this will change over time as the relationship grows and develops. Therefore, it’s important to be open and honest with your therapist about how you are feeling throughout the process. Similarly, a therapist should also be open and honest with their clients about their expectations and what they can offer in terms of guidance and support.

Clients and therapists should also feel like their personalities are a good match. In the real world, you click with certain people, but not with others. This is because as human beings we connect with different personality styles. This is also true with the therapeutic relationship. The therapist and client both need to feel like they connect with the other’s personality so that the therapeutic relationship could develop and both parties can feel comfortable.

In short, the therapeutic fit is key when seeking therapy. It’s important to find a therapist that you trust and are comfortable with, as this will enable you to make meaningful progress toward your treatment plan. If at any point during your sessions you do not feel as though you are getting the best out of the therapeutic relationship, it’s important to speak up and let your therapist know how you feel.

You will talk about your current situation and how you’re feeling

In the first few therapy sessions, you need to be open and honest about why you are seeking help and how you have been feeling. It is important to tell your therapist about your current situation, both emotionally and physically. This will help the therapist gain an understanding of your circumstances and collaborate with you to come up with the most suitable treatment plan for you.

It is also important to talk about what emotions you have been experiencing. Whether you’re feeling overwhelmed, anxious, depressed, or some other emotion, your therapist needs to know what is going on with you to assess therapeutic fit and to collaborate with you on goals for sessions. Be sure to mention any specific situations that caused certain emotions and share any details that will help the therapist understand what kind of treatment plan would be best suited for you.

Therapist will give some feedback

Different therapists have different approaches. Some therapists provide the space for you to do all the talking and don’t give much solid feedback. Talking and feeling heard by someone can be very therapeutic.

In my sessions with people, I too listen and provide space for my clients to talk, but my approach is different in that I want to collaborate and discuss with you so that we can get to the root of the issues that bring you to therapy. While talking is a key part of therapy, I also want to be an active participant and give feedback and guidance.

This helps us to develop an effective treatment plan together and to figure out what progress in therapy will look like for you specifically, as each person is different. I strive to create an atmosphere in which we can explore your thoughts and feelings, uncover any underlying issues, and create a plan that works for you.

Subsequent sessions will build on this foundation

Once the treatment plan is developed and therapeutic fit is established, subsequent sessions will work towards reaching the goals outlined in the plan. These can include working on identifying and understanding underlying issues, exploring possible solutions to problems, and gaining insight into thoughts and behavior patterns. These sessions may also involve activities or exercises designed to help you understand your current situation, explore alternatives, and practice new behaviors.

There are many types of therapeutic techniques that a therapist could utilize in sessions. The type of therapeutic approach used will be decided based on what will best help you reach your goals. Examples of different therapeutic techniques include Cognitive Behavioral Therapy (CBT), mindfulness, hypnosis, and EMDR.

The therapist may also assign homework for you to complete between sessions to help you make progress toward goals. The therapist will also provide feedback and guidance as you work on the issues that brought you to therapy. As progress is made, the therapist may modify or adjust the treatment plan as needed. Ultimately, the purpose of subsequent sessions is to help you identify and overcome obstacles so that you can reach your desired outcome.


During our first few sessions we’ll discuss the issues that prompted you to seek counseling, review your history, and assess your current needs. With your assistance, I will then develop a comprehensive treatment plan tailored to you – this includes creating specific goals to focus on throughout our time together. We’ll establish how we’ll measure your progress and ensure that each session moves us closer to your therapeutic objectives.

Throughout our sessions, I’ll use various evidence-based therapeutic approaches to assist us in meeting these therapeutic objectives. I’m committed to providing a safe space where you feel heard, respected, and understood – all of which are essential for cultivating a trusting therapeutic relationship and fostering long-term success. For any remaining questions about what to expect from therapy sessions, or to schedule a free 15 minute intro call to learn about how I can help you specifically, please contact me today.

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