You’ve booked your first therapy appointment.
Perhaps you’ve been thinking about it for months. Maybe someone suggested it, or you’ve simply reached a point where you would like to understand yourself or your situation better.
And now that the appointment is approaching, a new concern appears.
What am I supposed to say? Where do I begin? What if I can’t explain what’s wrong?
You might even start preparing a mental presentation of your entire life, complete with background information, important relationships, and a convincing explanation of why you’re there.
You don’t need to have everything figured out
One common concern before starting therapy is not knowing exactly what the problem is.
Some people arrive with a specific difficulty, such as anxiety, relationship conflict, or grief. Others describe a more general feeling of being stuck, overwhelmed, or dissatisfied without knowing precisely why.
Both can be starting points for a conversation.
You don’t need to organise your experiences into a perfectly coherent story. Part of the therapeutic process can involve finding words for experiences that are still confusing.
And if you become emotional, lose your train of thought, or struggle to answer a question, that doesn’t mean you’re doing therapy incorrectly.
What actually happens during the first appointment?
At Therapy Sofa, the first meetings are dedicated to getting to know you and understanding what brings you to therapy.
We may talk about your current difficulties, important relationships, personal history, everyday life, and what you hope might change.
There may also be questions about your wellbeing, previous experiences with psychological support, and circumstances that could be relevant to your care.
The conversation also gives you an opportunity to understand how the psychologist works, ask about confidentiality, and discuss practical arrangements.
You don’t have to share every personal experience immediately. Trust and openness develop gradually.
Therapy is also about the relationship
Research and clinical practice have long recognised the importance of the therapeutic relationship.
Feeling listened to, respected, and able to discuss difficult experiences can contribute to meaningful therapeutic work.
But this doesn’t mean you must feel completely comfortable during the first meeting.
Talking to someone unfamiliar about personal matters can feel unusual. Some people need time before they feel safe enough to speak openly.
From a relational perspective, your expectations about therapy may also be influenced by previous experiences of seeking support.
Perhaps you’re accustomed to handling difficulties independently. Maybe expressing vulnerability has not always been welcomed in your relationships.
These experiences can shape how easy or difficult it feels to ask for help.
What happens after the first session?
Therapy usually begins with a period of exploration rather than immediately moving towards solutions.
At Therapy Sofa, the intake process generally takes one to three sessions. Afterwards, we discuss our understanding of your concerns, possible goals, and whether working together would be appropriate.
You also have a say in this process.
Therapy is not something that simply happens to you. It is a collaborative relationship in which your experiences, preferences, and feedback matter.
You may leave the first appointment feeling relieved, uncertain, thoughtful, or simply tired. There isn’t one correct reaction.
And you don’t need to leave with your entire life figured out.
A question to reflect on
If you didn’t have to explain your difficulties perfectly, what would you most want someone to understand about your experience?
Further exploration
In Maybe You Should Talk to Someone, psychotherapist Lori Gottlieb explores therapy from both the therapist’s and client’s perspectives.
Through personal stories and clinical experiences, the book offers an accessible look at the therapeutic relationship, vulnerability, and the sometimes unexpected process of change.
Anna-Maria Sakellariou is a Psychologist NIP at Therapy Sofa, an English-speaking psychology practice in Maastricht for individuals and couples. Her approach is informed by systemic psychotherapy.