What to Expect at Your First Psychologist Session

It’s normal to feel nervous before your first therapy session. What will happen? What should you say? The good news is a visit to a psychologist is a simple, supportive conversation – you set the pace. In this post, we explain what to expect when seeing a psychologist (especially via telehealth) so you can feel prepared and at ease.

Taking the Step to See a Psychologist

Taking the step to see a psychologist is courageous, and knowing what to expect can help ease any anxiety about your first session. Psychologists understand that you might be nervous or unsure, and they will do their best to make you feel comfortable. Here’s an overview of how the process usually works, from the first session onward.

Before Your Session: Setting Up for Telehealth

If you’re meeting your psychologist via telehealth (video call), you’ll want to set up a quiet, private space for your session. Find a room where you won’t be interrupted or overheard, so you can speak freely. Make sure you have a reliable internet connection and a device (computer, tablet, or phone) ready for the video call. It can help to have a glass of water and maybe a notepad and pen handy, in case you want to jot down any points or homework from the session. Then, simply click the secure link your psychologist provides at the appointment time – and you’re ready to go. Telehealth is basically like having your psychologist come to you, in the comfort of your own home. Many people find it easier to open up when they’re in a familiar environment instead of an office.

Tech tip: Test your microphone and camera briefly before the session if you can, to avoid any hiccups. And don’t worry – if something goes wrong with the connection, psychologists are used to it and will help you troubleshoot or reschedule if needed.

During the First Session

Introductions

In your first session, the psychologist will typically start by introducing themselves and chatting a bit to break the ice. They know it’s important to build trust and make sure you feel safe. Don’t worry, you won’t be expected to spill your deepest secrets right away! This first part is about getting comfortable.

Talking About Your Situation

The conversation will likely turn to what brought you to therapy. You can share as much or as little as you want in that first meeting. Some people dive straight into their biggest issues; others prefer to keep it light initially and get to know the psychologist first. There’s no “right” way to begin – the pace depends on what you’re comfortable with. Your psychologist might ask a few gentle questions to understand your situation, such as “How have you been feeling lately?” or “What would you like help with?” You can take your time answering. Remember, they are there to listen, not judge, and they will follow your lead on how deep to go.

Background and History

To get a full picture, the psychologist may ask a bit about your background. This could include questions about your work, family, or any relevant medical history. It’s not an interrogation – it’s just so they understand the context of your life. If there are topics you’re not ready to discuss, that’s okay – you can let your psychologist know, and you can revisit them when you feel ready. You’re in control of what you share and when.

Goal Setting and Plan

Early on, you and the psychologist might discuss what you hope to get out of therapy. For example, do you want to feel less anxious? Improve your mood? Work through a trauma or big change? It’s okay if you’re not 100% sure yet – goals can become clearer over time. The psychologist might outline how they typically work and what the coming sessions might look like. This is also a good time to ask any questions about therapy itself (“How often should I come?” “How do you handle confidentiality?” etc. — though they will likely explain confidentiality without you even having to ask: everything is private and stays between you and them, with rare safety exceptions).

Wrapping Up the First Session

First sessions often go by quickly. Towards the end, the psychologist may summarize what you’ve talked about and check how you’re feeling about the session. They might give a small suggestion or coping tip to try between sessions, but they won’t overwhelm you with homework on day one. If you haven’t already discussed it, you’ll also talk about scheduling the next appointment (if you decide to continue). There’s no pressure to book more sessions if you feel it’s not a good fit – the choice is always yours. Psychologists understand that finding the right therapist is personal, and you have the freedom to decide.

One important thing to note: You set the pace. As Erin says, “The first session really depends on you.”

Working Through Challenges

Throughout all of this, confidentiality remains in place. You can trust that what you share isn’t leaving the (virtual) room. Over time, as trust builds, many people start to really value having this consistent, private outlet for their thoughts and feelings. It can become a safe haven to express things you might not talk about elsewhere.

Lastly, let’s touch on telehealth specifically: Many clients are pleasantly surprised at how personal and connected telehealth sessions can feel. Erin often notes that telehealth is like the psychologist is coming to you, into your world. You can have a session on your sofa with a cup of tea, even in your pajamas if you want! Being in your own comfortable space can actually help you relax more during therapy. And research has found that online therapy is just as effective as in-person for most issues, so you aren’t losing any benefit by being on a screen.

If you’re about to see a psychologist for the first time, congratulate yourself on taking this big step. It’s okay to have butterflies in your stomach. Hopefully, knowing what to expect takes away some of the mystery. A therapy session is basically a conversation with someone who cares and is trained to help. You should leave that first session feeling heard and understood, and perhaps a bit hopeful about next steps. Each session after that is another step on the path you and your psychologist are walking together toward better mental health.