What Happens in a First Therapy Session?

What Brings You to Therapy?

People come to therapy for many different reasons. You may be struggling with anxiety, stress, low mood, grief, fertility-related challenges, health issues, identity or cultural concerns, relationship difficulties, or simply feeling overwhelmed and emotionally exhausted. Perhaps things are going okay for you, but you have some personal development goals you’d like to work on. Sometimes people come with a very clear issue they would like support with, while others arrive with a sense that something just does not feel right. Whatever brings you to therapy, you are welcome.

Starting Therapy

Beginning therapy for the first time can feel like a big step. It’s completely natural to feel nervous, uncertain, or even unsure about what to expect. Many people worry that they won’t know what to say, that they’ll become emotional, or that they’ll somehow “do therapy wrong.” Even if you’ve previously had therapy, these feelings and concerns can still arise, and are completely valid. It can be daunting to start a new therapeutic relationship and to tell your story again.

The reality is that a first therapy session is simply the beginning of a conversation. It is an opportunity for us to meet, explore what has brought you to therapy, and begin building a safe and trusting therapeutic relationship at a pace that feels comfortable for you.

As an integrative psychotherapist, I work in a client-led way. This means I endeavour to meet you where you are at, and to work at your pace. There’s no expectation that you arrive knowing exactly what you need. The first session is often a gentle exploration of your experiences, concerns, and hopes for therapy. The session is guided by what feels important and manageable for you. There is no pressure to share everything immediately, though sometimes clients want to get as much off their chest as possible, and that’s okay too! You are always in control of what you choose to share. It’s your space, your time, you can use it however you feel is best for you.

Building Safety and Trust

My aim for our first session is that together we will create a space where you feel emotionally safe, heard, and respected. Therapy works best when there is trust within the therapeutic relationship, and building that trust takes time.

Part of this process involves discussing how we will work together. This is sometimes referred to as “contracting.” I will explain practical aspects of therapy such as session times, fees, cancellations, confidentiality and safeguarding. Following our session, I will also send you a written copy of our therapy agreement for your reference.

Having clear agreements in place helps create consistency, safety, and transparency within the therapeutic relationship.

Confidentiality in Therapy

One of the most important aspects of therapy is confidentiality. What you share in therapy is treated with privacy and respect. As an accredited member of the Irish Association for Counselling and Psychotherapy (IACP), I work within professional ethical guidelines designed to protect clients and support safe therapeutic practice.

There are, however, some important legal and ethical limits to confidentiality which I will explain during our first session. These situations are rare, but may include circumstances where there is a serious risk of harm to yourself or another person, concerns relating to child protection and welfare, or other legal obligations requiring disclosure. Where possible, I would always aim to discuss any concerns with you first. However, in urgent safeguarding situations, confidentiality may need to be broken in order to protect safety and wellbeing. I also attend regular clinical supervision, as required by IACP ethical guidelines. Supervision is a professional support process that helps therapists work safely and ethically. Any discussion of client work within supervision is done anonymously and confidentially. Your personal information and clinical notes are stored securely in line with GDPR requirements.

There Is No “Right Way” to Do Therapy

Many people arrive to therapy worried that they may say the wrong' thing, become emotional, or not know where to begin. But I want to reassure you that therapy is not about performing or having everything figured out.

Some people cry in the first session, others may feel numb. Some feel relieved at feeling able to talk openly. Others may feel anxious or uncertain at first. All of these responses are normal and completely valid.

Therapy is a collaborative process, and the first session is simply the beginning of getting to know one another. It is also an opportunity for you to get a sense of whether you feel comfortable working with me, and to ask me any questions you may have about the process.

You do not need to prepare anything perfectly before attending therapy. Often, just showing up is enough.

Taking the First Step

Reaching out for support can feel vulnerable, particularly when you have been carrying difficult feelings alone for a long time. Whether you are experiencing anxiety, grief, stress, low mood, fertility-related challenges, identity concerns, or simply feeling overwhelmed, therapy can offer a compassionate space to pause, reflect, and feel supported.

If you are considering therapy and would like to learn more about what therapy with me might be like, you are welcome to book a free consultation here