Your First Therapy Session: What Actually Happens (and How to Prepare)
Deciding to start therapy is a big step. For a lot of people, the hardest part is simply not knowing what to expect. What will they ask? What if I don't know what to say? What if I cry?
Here's what starting therapy at Third Culture Counseling looks like, so you can log on knowing what's ahead.
A free 15-minute consultation
Before committing to anything, you can book a free 15-minute consultation. It's a short, relaxed call where you can share a little about what's bringing you in, ask how the therapist works, talk through scheduling and payment, and get a sense of whether it feels like a good fit.
You don't need to prepare anything or tell your whole story. Fit matters a lot. Research consistently finds that the strength of the working relationship between you and your therapist is one of the most reliable predictors of how helpful therapy will be. A review of nearly 300 studies found this held across many types of therapy, both in person and online. The consult is a low-pressure way to check.
Paperwork and payment
If you decide to move forward, you'll receive intake forms to complete before your first session. These usually include basic information, a consent form explaining how therapy and confidentiality work, and a few questions about what you'd like help with.
You'll also confirm how you'd like to pay. If you're using insurance, the Fees & insurance page lists the plans we're currently in network with, and it's a good idea to call your insurer about your specific coverage, deductible and copay.
You can also choose to pay privately. Nothing is billed to an insurer unless you decide to submit a superbill, a detailed receipt that includes a diagnosis code, for possible out-of-network reimbursement. How much you get back, if anything, depends on your plan's out-of-network benefits. If you're uninsured or choose not to use insurance, you have the right to a Good Faith Estimate of expected costs before your first session, and if your bill comes in at least $400 above that estimate, you can dispute it. There's more on the private pay page.
Both options are equally welcome. It's simply a matter of what works best for you.
The first session
Sessions take place over secure video, so you can join from home, a parked car, or anywhere private, as long as you're physically in Illinois at the time of your session.
A first session is a bit different from the ones that follow. It's mostly about getting to know you. Your therapist will probably ask what's bringing you to therapy now, how things have been affecting your daily life, relationships and work, and a bit about your background: family, culture, where you've lived, experiences that shaped you. They'll also ask what you'd like to be different.
You don't need polished answers. "I'm not sure, I just know something feels off" is a perfectly good place to start. You also don't have to share anything you're not ready to. You set the pace.
Toward the end, you'll talk about next steps: how often to meet, what to focus on first, and any questions you still have.
A few things that help
Find a private, comfortable spot where you won't be overheard. Headphones help.
Jot down a few notes beforehand about what's been on your mind or what you want your therapist to know. Even a couple of bullet points can help if you tend to go blank.
Bring your questions. It's completely fine to ask about a therapist's approach, their experience, or how they'll know whether therapy is working. Research suggests therapy tends to go better when therapists check in on progress regularly, so it's a good question to ask.
Expect some feelings. Nervousness, tears, relief and even laughter are all normal in a first session.
And give it a few sessions. Trust usually takes a little time to build.
If it isn't a fit
If it doesn't feel like a fit, it's worth saying so. About one in five adults stop therapy early, often without telling their therapist why. Naming it gives you a better chance of getting what you need. A good therapist won't take it personally and can help you find someone better suited to you.
Related reading: The Same Fight on Repeat: What Couples Are Really Arguing About and "Where Are You From?" Why a Simple Question Feels Complicated for Third Culture Kids.
Starting therapy is an act of care for yourself. When you're ready, book your free 15-minute consultation, or browse the FAQ for more details.
Third Culture Counseling offers online therapy for adults and couples across Illinois. This article is for general education and isn't a substitute for professional care. Third Culture Counseling is not a crisis service. If you're in crisis, call or text 988 (Suicide & Crisis Lifeline) or call 911. More options are on our crisis resources page.
