What to Expect in Therapy: From Consultation Call to Your First Few Sessions

Starting therapy can feel overwhelming—especially if you’re not sure what to expect. Many people I work with ask questions or wonder: What happens in the first therapy session? Will it feel awkward? How do I even start?

If you’re feeling anxious about beginning counseling, you’re not alone. This guide will walk you through an example of what therapy with me may look like.

If you’re specifically looking for support with anxiety, you can also learn more about my approach to therapy for anxiety.

The Consultation Call: Your First Step into Therapy

We begin with a 15–20 minute consultation call.

This is a relaxed, no-pressure conversation where you can share what’s been going on and what kind of support you’re looking for. You don’t need to have everything figured out—just come as you are.

During this call, we’re both deciding if we’re a good fit. Therapy is most effective when you feel comfortable and understood, so this step is important.

If we decide to move forward, we’ll:

• Schedule your first therapy session

• Review insurance or payment details

• I’ll send intake paperwork for you to complete before we meet

If you’re ready to take that step, you can schedule a consultation call here.

Intake Paperwork: Preparing for Your First Therapy Session

Before your first session, you’ll complete intake forms—similar to what you’d fill out at a doctor’s office.

These forms help me understand:

• Your mental health and medical history

• Current symptoms and how long they’ve been present

• Sleep, exercise, and daily habits

• Your relationships and support system

This allows us to use your first session more effectively, without starting from scratch.

Your First Therapy Session: Getting to Know You

Your first therapy session focuses on understanding your story.

We’ll review your intake information and talk more in-depth about your experiences. I may ask follow-up questions to better understand what you’re going through, but this is always a collaborative and supportive conversation.

We’ll also begin identifying your goals for therapy, such as:

• Reducing anxiety or overthinking

• Improving mood or motivation

• Building confidence or boundaries

• Adjusting to life transitions

Your Second Therapy Session: Building Awareness and Learning Skills

In your second session, we begin building direction and introducing tools.

We may:

• Review and refine your therapy goals

• Explore patterns in your thoughts and emotions

• Identify triggers for things like anxiety or stress

If anxiety is something you’re experiencing, we may introduce the concept of cognitive distortions—patterns of thinking that can make situations feel more overwhelming or negative.

Here’s a helpful, easy-to-understand explanation from Harvard Medical School.

You may also leave this session with a small practice or “homework,” like tracking thoughts or noticing triggers. This helps build awareness between sessions—but it’s always flexible and tailored to you.

Your Third Therapy Session: Connecting Patterns and Creating Change

By your third therapy session, we start connecting the dots.

We’ll:

• Review what you noticed between sessions

• Identify patterns in your thoughts, emotions, and behaviors

• Focus on what feels most distressing or important to address

From there, we begin working more directly on change. This may include:

• Learning how to respond differently to anxious thoughts

• Building coping strategies for situations you can’t control

• Continuing to challenge unhelpful thinking patterns

Is This What Therapy Always Looks Like?

Not exactly.

Every therapy experience is unique. This is one example of what therapy for anxiety using a cognitive behavioral approach can look like, especially in the beginning.

Your sessions will always be tailored to your specific needs, goals, and comfort level.

Ready to Start Therapy?

If you’ve been thinking about starting therapy but feel unsure what to expect, that’s completely normal.

You don’t have to figure everything out on your own.

If you’re ready to take the next step, you can reach out here to get started.