What to Expect in Your First Therapy Session


 Your first therapy session is mostly a conversation. You and your clinician get to know each other, talk through what brought you in, and start to shape early goals. There is no test to pass and nothing you have to perform.

It is normal to feel nervous before you start. Most people do. Knowing what the first session looks like takes some of the unknown out of it.

Here is what to expect, from the intake call to what happens after session one.

Before the Appointment

A few things happen before you sit down with your clinician.

The intake call. When you reach out to AACA, you speak with our intake coordinator. They learn what brings you in, answer practical questions, check your insurance, and match you with a clinician whose focus fits your needs.

Paperwork. Before the first appointment you will complete intake forms. These cover basic history, contact details, insurance, and consent. Filling them out in advance leaves more of session one for conversation.

Logistics. You will get clear instructions for either visiting our office at 2002 Hogback Rd, Suite 17, in Ann Arbor, or joining by telehealth. If you are meeting online, test your connection a few minutes early.

None of this needs to be perfect. If you have a question about a form, ask. Our intake coordinator is there to help.

What Session One Is Actually Like

The first session is an introduction, not deep work.

Your clinician will spend the hour getting to know you. Expect questions about what brought you in, what has been going on recently, and some background: family, health, work or school, past experiences with therapy. You share what you are ready to share. You are never required to go into more than you want to in a first meeting.

Toward the end, you and your clinician will start to name early goals. These can be broad at first, like feeling less anxious or communicating better at home. The plan gets more specific as you go.

You can explore the kinds of care we offer, for adults, teens, children, couples, and families, on our counseling overview page.

How to Prepare

You do not need to prepare much. A little reflection helps.

  • Think about why you are reaching out now and what you hope changes.
  • Note any specific moments or patterns you want to mention.
  • Jot down questions for your clinician about how they work.
  • Arrive a few minutes early, in person or online, so you can settle in.

If you draw a blank in the moment, that is fine. Your clinician will guide the conversation. You do not have to walk in with a script.

Nerves Are Normal

Feeling anxious before a first session is common, even for people who are sure they want to be there. Talking about personal things with someone new takes courage.

A few things help:

  • Remember the clinician’s job is to make the space feel safe, not to judge you.
  • You set the pace. You can say when a topic feels like too much for now.
  • It is okay to name your nerves out loud. Clinicians hear this often and welcome it.

AACA is an inclusive, welcoming practice. We want the first session to feel manageable, not intimidating. You can read about our clinicians in advance on our team page, which can make the first meeting feel less unfamiliar.

What Happens After Session One

After the first session, you and your clinician decide on next steps together.

Most people meet weekly or every other week at first, especially early in care. This rhythm helps build momentum. As things progress, sessions may space out. Your clinician will talk through frequency with you rather than setting it without input.

You will also keep refining your treatment plan and goals. Therapy is collaborative. Follow-up sessions build on what came before, and you and your clinician adjust the plan as you learn what helps.

If something about the fit does not feel right, say so. We would rather make an adjustment early than have you continue with a match that is not working.

Contact us

Location: Ann Arbor, MI, USA

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