What Happens in the First Therapy Session?

Every therapist is slightly different in how they conduct a first session of therapy, just as they would be with any session. Some therapists offer a free phone call before booking the first session, whereas others don’t, and this may impact how the first session goes.

 Initial Phone Call

If a therapist offers an initial phone call before you decide to book with them, this will be an opportunity for you to ask questions about how the therapy will be, about their qualifications and experience, or about whether they think they can work with what you’re bringing.

It is also a time when the therapist will want to learn more about what has brought you to seeking out therapy and what you are hoping to gain from the therapy sessions.

They might also ask you whether you’ve had any therapy in the past and, if so, what your previous experience(s) of therapy were like. This will help to inform them of how comfortable you are with the therapy process or whether they might need to explain more how therapy works, what you found helpful with previous therapists, and what you found unhelpful.

Mostly, this initial phone call is free and lasts about 15 minutes. It is not about going into the detail of why you’re seeking therapy – it is not a therapy session in itself. If your therapist doesn’t offer an initial phone call, it is likely that everything that would be covered during the phone call will be covered in the first counselling session.

Contracting

One of the first things that a therapist will go through with you in the first session is their therapeutic contract. They might do this verbally, or they might have a contract written out for you to sign.

Some therapists might now send out their contracts in advance of the first session (since a lot of therapists are still partly working with clients online), some might ask you to sign it in the first session, and others might give it to you in the first session, talk through the contents of the contracts, but then allow you to take it away with you and bring back a signed copy the following week.

The contract should cover a few basic things such as confidentiality. Confidentiality within a counselling relationship means that everything you discuss in the session is confidential but that there are a few exceptions such as them seeing a supervisor, them possibly being subpoenaed, you discussing certain illegal activities, or you or someone else being in danger.

Another aspect that the contract should cover is data storage. It should detail how your information and notes about each session are stored, and how long they are kept for.

The contract should cover the fees of each session and how they are to be paid. They should also cover the cancellation policy that the counsellor works by, the length of each session and the frequency of sessions.

This is the bare minimum of what a counselling contract (sometimes called a counselling agreement) should include. Different counsellors may also include additional things such as provisions for working online, your responsibilities as a client, their responsibilities as a therapist, what happens if you bump into your therapist in public, social media, and so on.

Assessment

Whether your client informs you or not, a first session is slightly different from following sessions as they are trying to get a good knowledge of who you are, what your background is, and who else is in your life, so that when you later dive deeper into the reasons you’re coming to therapy, they have a better knowledge of you as a person and can understand what is happening better.

What this can mean is that in a first therapy session, your therapist might be more directive, i.e. they might steer the conversation more than they would in future sessions and they might be asking more questions.

For example, in my own first sessions with clients, I tend to cover; the reasons they’re seeking out therapy (although I’ve usually already gathered this in the initial phone call), how long it’s been going on for, what their living situation is like right now (i.e. housemates, partner, parents, etc), what their family was like growing up, what their experience of school and/or university was like, what their most important previous relationship was, what (if any) their current relationship is like, and what their social support is currently like.

I will also try to gather information about their level of risk to themselves and their ability to keep themselves safe. If this isn’t immediately obvious, then I will ask about it outright as this is very important.

It differs from client to client, but this can take anywhere from 20 minutes to the whole session. It depends because some clients want to give short, sharp answers to each question whereas others like to share more about each area of their lives. Either is absolutely fine.

In the final few minutes of the session, you might find that your counsellor talks to you about how you found the first session and whether you feel comfortable continuing to work with them on an ongoing basis.

If you have any questions about therapy that you’d like us to answer, please get in contact with us or leave a comment below.

If you would like to get started on your therapeutic journey, head to our Therapist Profile page to find someone who can support you.