Your First Psychology Session: What to Expect (and What Not to Worry About) - Adult Edition

This guide is for adults attending their first psychology appointment. We’ll be sharing a separate guide for parents on what to expect when bringing a child or teen to psychology.

Booking your first psychology appointment can feel like a big step.

Even when you know you want some support, you might still find yourself wondering: What am I actually going to talk about? What will they ask me? Do I need to explain my whole life story? What if I cry? What if I don't cry? What if I have absolutely no idea where to start?

If you've never been to therapy before, not knowing what to expect can make that first appointment feel more daunting than it needs to.

So, here's what a first psychology session at Better Together Therapy might actually look like, and a few things you really don't need to worry about.

Before your first session

Before you come in, you'll usually be asked to complete some intake information. This gives your psychologist some background about you and what has brought you to therapy, so you don't have to start completely from scratch when you walk through the door.

If you're accessing psychology through Medicare, you'll generally have a Mental Health Treatment Plan and referral from your GP. This allows you to claim a Medicare rebate for eligible psychology sessions. If you're attending privately, you don't need a GP referral or Mental Health Treatment Plan to see a psychologist.

You don't need to prepare notes, rehearse what you're going to say or work out exactly what's "wrong".

Some people arrive with a very clear idea of what they want help with. Others arrive knowing that something doesn't feel right, but aren't quite sure how to put it into words.

Both are perfectly good places to start.

First, we'll get to know you

Your first psychology session is usually a little different from the sessions that follow.

Before jumping into strategies or therapy, your psychologist needs to understand you.

At the beginning of your appointment, your psychologist will also talk you through confidentiality and its limits, including the circumstances where information may need to be shared. You can ask questions about this at any point. It's important that you understand how your information is handled and feel comfortable before you begin.

From there, your psychologist may ask about what has brought you in, what's been happening recently, how you've been feeling and how things are affecting different parts of your life.

Depending on why you're seeking support, you might also talk about things like your relationships, family, work or school, physical health, sleep, previous experiences with therapy and some of your history.

But this isn't an interrogation or a checklist you need to get through.

It's a conversation.

And you don't need to squeeze your entire life story into 50 minutes.

You don't have to tell us everything in session one

This one is important.

Coming to therapy doesn't mean you need to immediately talk about the hardest thing that has ever happened to you.

Trust and safety take time.

There may be experiences you're not ready to talk about yet. There may be things you're not sure are relevant. And there may be things you haven't found the words for.

That's okay.

You can let your psychologist know that something feels difficult to discuss, that you'd rather come back to it another time, or simply that you're not ready to go there yet.

Therapy should move at a pace that feels manageable for you.

What if I don't know what to say?

Very normal.

You do not need to walk into your first session and deliver a beautifully organised explanation of your thoughts, feelings and experiences.

You might lose your train of thought. You might jump between topics. You might say "I don't know" a lot.

You might even sit down and realise that the thing you've been thinking about all week has suddenly disappeared from your brain.

Your psychologist is used to this.

Part of our job is helping you slow things down, make connections and find language for experiences that can sometimes be difficult to explain.

Sometimes the starting point really is:

"I don't know where to start."

We can start there.

Do I need to have therapy goals?

Not necessarily.

Some people come to therapy with very specific goals. They might want help managing anxiety or panic attacks, processing trauma, navigating a relationship, reducing OCD symptoms or better understanding themselves.

Others have a much less defined feeling that life has become harder than it should be.

You might want to feel less overwhelmed. Understand yourself better. Stop repeating the same patterns. Feel more like yourself again. Navigate a difficult period in your life. Or simply have somewhere to unpack everything that's been going on.

Your psychologist can help you turn those experiences into meaningful therapy goals.

And those goals aren't set in stone. They can change as you learn more about yourself and therapy progresses.

What actually happens during the session?

There isn't one script that every psychologist follows.

Your first appointment will be shaped by you, what has brought you to therapy and the way your psychologist works.

There will usually be quite a bit of conversation and some questions. Your psychologist may also begin sharing observations, helping you make connections between different experiences, providing some initial psychoeducation or talking with you about approaches that could be helpful.

Depending on your needs, therapy at Better Together Therapy may draw on evidence based approaches such as Cognitive Behaviour Therapy (CBT), Acceptance and Commitment Therapy (ACT), Dialectical Behaviour Therapy (DBT), Schema Therapy or EMDR.

You don't need to know which therapy approach you need before you arrive. That's something you and your psychologist can work out together.

And remember, you can ask questions too.

You can ask why your psychologist is asking something. You can ask why they are suggesting a particular approach. You can tell them about previous therapy experiences that were helpful, or ones that weren't.

Therapy is collaborative. You are allowed to have preferences and a voice in how you work together.

What if I cry?

You can cry.

You can also not cry.

You can laugh while talking about something difficult. Use humour. Need a minute. Fidget throughout the entire session. Sit quietly while you work out what you're trying to say. Lose your train of thought and completely forget the question.

None of these things mean you're doing therapy incorrectly.

Therapy doesn't have to feel serious for every minute of the session to be meaningful.

Our psychology rooms are designed to feel comfortable and welcoming, with different seating options, adjustable lighting and fidgets available if they help you feel more comfortable or regulated.

There is no "perfect therapy client".

What if I've had therapy before?

Tell us.

Knowing what you liked, disliked or found helpful in previous therapy can give your psychologist really useful information.

Maybe you loved having practical strategies between sessions. Maybe you found a particular therapeutic approach helpful. Maybe previous therapy felt too structured, too unstructured or simply wasn't the right fit.

You are allowed to say that.

You don't have to start from zero just because you're seeing someone new.

What happens at the end of the first session?

Towards the end of your appointment, your psychologist will usually begin talking with you about what comes next.

They may share some initial thoughts about what could be contributing to the difficulties you're experiencing and discuss possible areas to work on together.

You might talk about what type of therapy could be helpful, what you'd like to focus on initially and when it would be useful to meet again.

You probably won't walk out with everything figured out, and you're not supposed to.

The first session is a starting point.

What if I don't click with my psychologist?

The relationship you have with your psychologist is an important part of therapy.

That doesn't mean you need to walk out of session one thinking you've found your new best friend. Building trust can take time, particularly if talking about yourself or being vulnerable doesn't come easily.

But you should feel that your psychologist listens to you, takes you seriously and respects you, and that over time you can be increasingly open and honest with them.

If something doesn't feel right, you're allowed to talk about it.

Maybe you need more structure. More practical strategies. More time to process. A different communication style. Or you might simply feel that another psychologist would be a better fit.

Sometimes adjusting the way you work together is all that's needed. At other times, another therapist may simply suit you better.

Finding the right therapeutic relationship is part of finding support that works for you.

The main thing we want you to know

You don't need to prepare the perfect story.

You don't need to know exactly why you feel the way you do.

You don't need perfectly articulated therapy goals.

You don't need to know what to say first.

And you definitely don't need to be "good" at therapy.

Just come as you are.

We'll start there.

Thinking about starting psychology?

Better Together Therapy provides psychology support for children, adolescents and adults from our clinic in Essendon, Melbourne, as well as psychology via telehealth.

Our psychologists support people across a range of areas including anxiety, depression, trauma, OCD, ADHD and autism, eating disorders and body image, grief and loss, perinatal mental health, stress, burnout, relationships and life transitions.

If you're not sure where to start or which psychologist might be the right fit for you, our team can help guide you.