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Most people arrive at a first session with an opening rehearsed in the car. Most of them drop it in the first two minutes, and that is exactly how it should go.
In this article
A first session is fifty minutes long, and nobody expects you to fill them alone. Your therapist has done hundreds of first sessions; you have done none. Leading is our job.
You do not need a diagnosis, a clear goal or a story told in order. "Things have not felt right for a while" is a complete reason to come. So is "my doctor suggested it".
About half my clients begin with "I'm not sure this is a big enough problem." It is always big enough to talk about.
Maya Ortiz, LPC, from the room
If the first minute feels hard, borrow one of these. Each one gives your therapist something useful to work with.
"I don't really know where to start."
It tells me to lead for a while, and I will.
"It's been building for about six months."
A rough timeline helps more than a label.
"I'm here because my partner asked me to come."
An honest reason is a useful reason.
"There's something I'm not ready to talk about yet."
You can say it exists without saying what it is.
Expect a mix of practical and open questions. You can skip any of them, and you can come back to them later.
Before any of that, your therapist explains how privacy works: what you say stays in the room, with a few exceptions, such as a risk to someone's safety, that they name in the first ten minutes.
A first session is not a test you can fail. It is two people finding out whether they can work together.
Seeing us online? Test your camera the day before and find a room with a door.
It is normal to feel tired, light or a little raw afterwards. Plan something gentle for the next hour: a walk, a meal, a quiet drive home.
If it did not feel right, tell us. Changing therapists after a first session is common, and nobody takes it personally. Finding the right fit is part of the work.
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