First Therapy Session Questions: Your Complete Guide to What to Expect

Starting therapy for many people feels like stepping into completely unknown territory. Will you know what to say? What if you cry? What if nothing changes?

It feels vulnerable to get started, especially when you don’t know what to expect in therapy or even what will come up for you. Many people worry about first therapy session questions they might be asked or wonder what they should ask their therapist.

Let’s talk about what actually happens in therapy and hopefully make getting started with therapy a little less nerve-wracking. 

Anxiety About Therapy (And Why It Makes Perfect Sense)

Feeling anxious about starting therapy? Of course you are!

You’re about to sit in a room with a stranger and potentially talk about some pretty personal stuff. Naturally, that feels scary! Some of the most common worries we hear include:

• Will they judge me?
• What if I cry?
• What if I don’t know what to say?
• What if they think I’m crazy?
• What if it doesn’t help?

Here’s the reality: Be Seen therapists have heard it all, and nothing you say will shock us. We’re trained to create a safe, non-judgmental space and want to help you work through the “therapy jitters.”Most importantly, we will go at your pace to do the deeper work to ultimately give you some relief and clarity.

Additionally, crying is totally normal and actually often helpful. P.S. We have tissues throughout the office just in case 😘

What to Talk About in Therapy When You Have “Nothing” to Talk About

Many clients come in at one point or another saying “I don’t have anything to talk about.”

Interestingly, many of our clients often feel surprised at how deep and meaningful a session can be on the days they “have nothing to talk about.”

Be Seen therapists will help guide you and navigate your sessions to steer you in a direction that provides relief and healing.

If the “unknowing” makes you feel stressed and wondering what to expect in therapy,  here are some ideas of topics you could explore:

• How you’ve been feeling lately (even if it’s “fine”)
• Relationships in your life
• Work or school stress
• Sleep and energy levels
• Things that have been on your mind
• Patterns you’ve noticed about yourself
• Goals you have (big or small)
• What brought you to therapy in the first place

Remember, your therapist is trained to help guide conversations, make connections, and revisit things that have meaning to you. You don’t need to come in with a presentation. Sometimes the most meaningful sessions start with “I don’t even know what to say today.”

First Therapy Session Questions: 7 Tips to Prepare Before Your First Session

Knowing what to expect in therapy starts with asking yourself some questions and preparing first therapy session questions you might want to ask. Here are seven tips to guide you:

1. Clarify your goals – What do you want to get out of therapy?
2.  Write down your concerns – You might forget in the moment
3.  Consider your history – Major life events, family background, previous therapy
4.  Prepare for paperwork – Be as honest as you feel comfortable when filling out forms
5. Bring questions – About the therapist’s approach, experience, what to expect
6. Set realistic expectations – Change takes time and commitment to the process
7. Remember it’s okay to be nervous – Your therapist gets it and even expects you to be nervous!

Common First Therapy Session Questions Your Therapist Might Ask

While every therapist has their own style, here are some typical first therapy session questions you can expect:

• What brought you to therapy today?
• How are you feeling about being here?
• What are your goals for therapy?
• Can you tell me about your support system?
• How do you typically cope with stress?
• What does a typical day look like for you?
• Have you been in therapy before?
• Is there anything specific you’d like me to know about you?

Dreading Therapy? Here’s What Might Be Going On

Many of our clients at one point or another in their therapy journey will come into session saying “I really did not want to come to therapy today.”

Of course they don’t. Most people don’t “want” to dredge up stuff that’s painful. Therapy can be really hard at times, and it makes sense that you might have moments where you don’t want to come. Yet… you keep showing up because even though it’s painful, you also know that you are growing and healing.

If you’re already in therapy but finding yourself dreading sessions, pay attention to that feeling. It could indicate:

• The therapist fit isn’t quite right yet (this is common and okay!)
• You’re hitting some uncomfortable but important growing edges
• The approach isn’t working for you
• You need to address something specific that’s making you uncomfortable

Don’t suffer in silence. Talk to your therapist about these feelings – they can help you work through them or help you explore what is coming up for you, or if goodness of fit is the problem, they will help you find someone to meet your needs. 

How Can I Tell if Therapy Is Working?

Good question! Progress in therapy doesn’t always feel dramatic. Instead, look for:

• Small shifts in how you handle situations
• Increased self-awareness
• Better relationships
• Improved coping skills
• Feeling more like yourself
• Less intense reactions to triggers
• More clarity about your values and goals

Sometimes progress feels like taking one step back and two steps forward. That’s normal and part of the process.

5 Signs Therapy Isn’t Working (And 5 Tips to Help)

Signs it might not be working:

• You don’t feel heard or understood
• You’re not seeing any progress after several months
• You don’t feel safe or comfortable
• Your therapist seems distracted or disengaged
• The approach doesn’t match your needs or learning style

Tips to help:

• Communicate openly – Tell your therapist what’s not working
• Give it time – Real change often takes longer than we’d like
• Be specific about your goals – Help your therapist understand what you want to achieve
• Try a different approach – There are many types of therapy
• Consider a different therapist – Sometimes it’s just not the right match

Why Isn’t Therapy Making Me Feel Better?

If you’ve been in therapy for a while and not seeing the progress you hoped for, there could be several reasons:

Therapist compatibility issues – Chemistry matters in therapeutic relationships

Approach mismatch – Different methods work for different people

Honesty barriers – Hard to make progress if you’re holding back

Unrealistic expectations – Change takes time and patience

External factors – Sometimes life circumstances make progress slower

Additional support needs – Sometimes therapy plus medication is more effective

Don’t give up. Talk to your therapist about your concerns, or consider trying someone new.

The Bottom Line

Starting therapy is brave. Continuing when it feels hard is even braver. Remember that finding the right fit might take time, and that’s completely normal.

Your willingness to invest in your mental health is something to be proud of, not something to second-guess. Whether you’re preparing first therapy session questions or you’ve been in therapy for months, trust the process and be patient with yourself.

Keep Going Deeper: What to Read Next

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4 Things That May Happen During Therapy Sessions (And Why They’re Actually Good Signs)

Robyn Krugman, LCSW, specializes in somatic therapy and anxiety treatment in New Jersey. With over 20 years of experience and training in AEDP Level 2 and Complex Trauma II, she helps clients understand the mind-body connection and find lasting relief from anxiety, depression and self esteem issues.