What to Expect From Your First Therapy Session
Welcome to Courageous Counseling Center, where we provide compassionate, inclusive, and effective individual and couples counseling in Marin County, San Francisco, and across California via virtual therapy.
We will walk you through what to expect from your first therapy session, so you feel informed, grounded, and ready to engage in your healing journey.
1. Setting the Tone
Your first therapy session often begins with an intake or consultation phase. At Courageous Counseling Center, whether you attend in-person at one of our centers throughout California or via our Telehealth option, you’ll have the opportunity to meet your therapist, review confidentiality and logistics, and start building a safe therapeutic relationship.
What happens:
You’ll be greeted by a therapist who explains their background, approach (for example, we specialize in Emotionally Focused Therapy (EFT), Accelerated Experiential Dynamic Psychotherapy (AEDP), Attachment-Based Therapy, Somatic Therapy, and Mindfulness).
The therapist explains how your sessions work, session length (typically 50 minutes), how often you might meet, and the expectation of your involvement.
You’ll share what brings you to therapy, your concerns, hopes, and any relevant history or context.
Together, you’ll start to sketch out goals and a treatment plan tailored to you.
Why this matters:
Research shows that clients often struggle to open up in early sessions because they fear vulnerability, feel unsure about their role in the therapeutic relationship, or worry about how the therapist will respond. For example, one study found the overarching theme of holding back and struggling to open up in the initial therapy phase due to multiple factors, including fearing the intensity of their emotions and feeling unworthy of sharing their experiences, among others.
At Courageous Counseling Center, we aim to create a warm, affirming space so you can feel comfortable taking the first step.
2. What Happens During a Typical Session?
Once the connection is established, your sessions focus on exploring your experiences, emotions, thoughts, and behaviors in a relational and holistic way.
Here’s a sample structure:
Check-in & review - You may start with “How have you been since we last saw each other?” or “What’s coming up for you today?”
Exploration of the presenting issue - Together with your therapist, you’ll explore the topic you brought in, what’s happening for you, how you’re feeling, and what’s getting in the way.
Emotional processing or skill-building - Because we use modalities like EFT, AEDP, and somatic therapy, you may be invited to bring awareness to what you feel in your body, what patterns you notice, or how your attachment history plays out in your day-to-day life.
Collaborative goal-setting - You and the therapist may agree on what you want to work on next, e.g., communication skills (for couples), managing anxiety, or strengthening self-identity.
Closure and takeaway - Sessions often end with summarizing what came up, discussing what you might reflect on between sessions (e.g., journaling, noticing patterns, practicing a skill), and scheduling the next appointment.
Here’s what you should know:
You are an active participant, not just a passive recipient of therapy. The best outcomes are seen when clients are engaged.
Conversations might sometimes feel intense, and that’s natural. According to the Mental Health Foundation UK, feelings after a session can range from relief to exhaustion or frustration. This is all a part of the therapeutic process - and your therapist will be there for you every step of the way.
Sessions can occur online (Telehealth) or in-person. Our center offers both. You’ll still experience the same warmth, relational richness, and effective interventions, regardless of the way you show up.
3. What You Can Do to Get the Most Out of Your First Therapy Session
While your therapist brings expertise, the therapy process works best when you engage actively. Here are things you can do:
Be honest and open (even if it’s scary). The research shows many clients initially hold back because they fear the intensity or consequence of emotions.
Ask questions about your therapist’s approach: “What modalities do you use? What is your experience with couples therapy (if applicable)?” It’s okay to “interview” your therapist to ensure it’s a good fit.
Reflect between sessions. Journaling, noting patterns, or practicing a skill can deepen progress.
Set realistic expectations. Therapy isn’t instant magic; it’s a process of change over time.
Prioritize consistency. Regular sessions build momentum; skipping frequently may slow progress.
4. What to Expect From Your First Therapy Session vs. Ongoing Sessions: How They Differ
First session: You may spend more time on intake, background, goals, and building rapport. Less time may be spent on deep work.
Ongoing sessions: Once trust is established, you’ll dive deeper into emotional processing, relationship work (if you’re a couple), somatic awareness, attachment patterns, etc.
Why this matters:
Knowing the difference between what to expect from your first therapy session compared to your ongoing sessions helps you feel less anxious about what should happen and allows you to focus on the healing you’re seeking.
5. Therapy at Courageous Counseling Center: What Makes Us Different
At Courageous Counseling Center, we emphasize:
Accessibility: Serving clients in Marin County, San Francisco, the East Bay, and across California via Telehealth.
Holistic, relational, trauma-informed approach: We integrate how emotional, physical, and social factors affect mental health, and tailor therapy accordingly.
Diversity & inclusion: We celebrate various racial and ethnic identities, gender identities, spiritual traditions, and lived experiences.
Couples & individual work: Whether you’re seeking individual healing or looking to restore connection in your relationship, we have therapists experienced in both types of therapies.
FAQs: Common Questions About What To Expect From Your First Therapy Session
Q: Will I always feel better after a session?
A: Not always. You may feel lighter, but sometimes more aware of difficult material. That’s part of growth.
Q: How long will therapy take?
A: It depends on your goals. Some people work for short-term change, others for deeper exploration. Your therapist will collaborate with you on this.
Q: Is what I say confidential?
A: Yes, with standard exceptions (e.g., risk of harm to yourself or others). Your therapist will explain confidentiality in the first session.
Q: Can I choose online vs in-person?
A: Yes! At Courageous, we offer both virtual and in-person sessions to meet your needs.
Have more questions about what to expect from your therapy sessions? Click here to learn more.
Now that you know what to expect from your first therapy session, it’s time to take the next courageous step
Entering therapy might feel like stepping into the unknown, but at Courageous Counseling Center, you don’t have to go it alone. Expect a space where you are seen, heard, and guided with compassion and skill.
If you’re curious to find out more about how therapy works or are ready to take the next step, explore our other blog posts. And if you’re ready now, please contact us to schedule your free consultation. You’re not alone, and change is within reach.
References
Kleiven, G. S., Hjeltnes, A., Råbu, M., & Moltu, C. (2020). Opening Up: Clients’ Inner Struggles in the Initial Phase of Therapy. Frontiers in Psychology, 11, 1-15. https://doi.org/10.3389/fpsyg.2020.576150 pmc.ncbi.nlm.nih.gov
Sutton, J. (2023, April 20). How To Plan Your (First) Counseling Session: 6 Examples. PositivePsychology.com. https://positivepsychology.com/counseling-session/ PositivePsychology.com
What to Expect from Therapy and Counselling | Help. (n.d.). Mental Health Foundation UK. https://www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/what-to-expect-from-therapy/ mind.org.uk
What to Expect from Therapy. (n.d.). The JED Foundation. https://jedfoundation.org/resource/what-to-expect-from-therapy/ The Jed Foundation
