Why Starting Therapy Feels So Intimidating

Taking the step to begin therapy is one of the bravest decisions you can make — and yet, it’s also one of the most intimidating. Many new clients tell me they worried for weeks (sometimes months) before reaching out.

Questions like:

• “What if I don’t know what to say?”
• “Will my therapist judge me?”
• “What actually happens in a therapy session?”

…are completely normal. If you’ve ever felt this way, you’re not alone. Therapy is a deeply personal process, and walking into your first session with a stranger can feel vulnerable.

This guide is designed to help ease those fears by walking you through what to expect in your first therapy session. My hope is that by the end, you’ll feel more confident, prepared, and reassured about taking this important step.

Normalizing First-Time Therapy Nerves

It’s completely natural to feel nervous before your first therapy appointment. After all, you’re about to share personal details of your life with someone new. Some clients describe it as a mix of excitement, hope, and anxiety.

Here’s what I remind every new client:

• You don’t need to have it all figured out before you start.
• Therapy isn’t a test — there are no right or wrong answers.
• Feeling unsure or guarded in the beginning is normal, and we’ll go at a pace that feels right for you.

Acknowledging these nerves helps take the pressure off. Remember, just showing up is already a huge step forward.

What Happens Before the First Session

Often, your therapy journey begins before you even walk through the door or log on for a telehealth session.

1. Intake paperwork
You’ll typically complete some initial forms, which may include basic personal information, insurance/payment details, and sometimes a brief history of your concerns. This helps me prepare for our time together.

2. Confidentiality explained
One of the most important things to know is that therapy is confidential. I’ll explain the limits of confidentiality (such as safety concerns), but overall, you can trust that what you share will stay private.

3. Setting up telehealth
If you’re meeting online, I’ll provide a secure video link. Telehealth is just as confidential and effective as in-person sessions, and many clients appreciate the convenience.

The First Session Step by Step

Here’s what usually happens during our first session together:

1. Welcome and introductions
We’ll start by getting comfortable. I’ll introduce myself, explain my role, and invite you to share what brings you to therapy.

2. Talking through your history
I may ask some background questions:

• What challenges are you experiencing right now?
• Have you been in therapy before?
• Are there specific goals you’d like to focus on?

This isn’t about prying — it’s about understanding your story so I can better support you.

3. Exploring your concerns
You don’t have to know exactly what to say. Some clients share openly from the start, while others need more time. Both are okay. I’ll guide the conversation gently, based on what feels right for you.

4. Collaborating on goals
Therapy is most effective when it’s a partnership. Together, we’ll begin shaping a plan: what you’d like to get out of therapy and how we can work toward it.

5. Answering your questions
I encourage every client to ask questions about therapy itself — the process, techniques, or even my approach. The first session is as much about you getting to know me as it is about me understanding you.

How You Might Feel After the First Session

Clients often leave their first session with a mix of feelings: relief from finally sharing, hope about moving forward, and sometimes even emotional fatigue.

It’s important to remember:

• Feeling emotional afterward is normal — therapy is deep work.
• Progress doesn’t happen overnight, but beginning the journey is powerful.
• With each session, the process usually feels more comfortable and natural.

Tips to Make the Most of Your First Session

If you’re preparing for therapy, here are a few things that can help:

• Write down your concerns beforehand so you don’t feel pressured to remember everything in the moment.
• Be honest, even about being nervous. Saying “I don’t know where to start” is a perfectly fine place to begin.
• Set realistic expectations. Therapy is a process — the first session won’t solve everything, but it lays the foundation for growth.
• Remember you’re in control. You decide what you’re comfortable sharing and how quickly to move forward.

Why Therapy Is Worth It

Starting therapy may feel overwhelming, but the rewards are life-changing. Over time, therapy can help you:

• Reduce anxiety and depressive symptoms
• Develop healthier coping skills
• Improve relationships and communication
• Gain clarity during life transitions
• Build self-confidence and resilience

Your first session is simply the beginning of this journey — a step toward the support, insight, and healing you deserve.

Beginning therapy takes courage, but you don’t have to do it alone. As a therapist, my role is to create a safe, supportive space where you feel understood and empowered.

If you’ve been considering therapy, I encourage you to take that first step today. I offer in-person sessions in Kentfield, CA and telehealth sessions across CT, NY, MA, and FL.

Request a Consultation Today