What to expect in your first therapy session

Before you come in

Walking into a first therapy session can feel a little like showing up to a test you didn't study for. The good news is there's nothing to study, and you don't have to arrive with a polished story or a list of symptoms. Most of the people I see show up with something pretty vague — "I just feel off," "things have been heavier than usual," "my wife thinks I should talk to someone" — and that is a perfectly good place to start. You don't have to know what's wrong to come in. That's part of what we figure out together.

What the hour looks like

The first ten minutes or so are mostly logistical. We'll handle a little paperwork, talk through how confidentiality works and where its limits are, and I'll ask what brought you in. There is no wrong answer to that question. Some people have a clear inciting event — a loss, a fight, a diagnosis. Others just sense that something has been quietly off for a long time. Either way is fine. From there, I'll mostly listen. I might ask about your family growing up, what your week actually looks like, what's been heavy lately, what's been good, how you sleep, how you fight, what you do when you're angry. We're not trying to fix anything in a single hour. We're getting a feel for each other and starting to map the territory.

Leaving the session

By the end of the session you should have a sense of whether this feels like a room you can come back to. If it does, we'll talk about a rhythm — usually weekly to start — and what you'd like the next few months to be about. If it doesn't feel like a fit, that's useful information too, and I'd rather you find the right person than stay with the first one you tried. Finding a therapist you actually trust matters more than any single technique or credential, and the only way to know is to sit in the room.