What to Expect During Your First Therapy Session

Posted: July 8, 2025

Starting therapy is a big step — and for many, it comes with questions and uncertainty. At Asheville Counseling and Wellness Center, we want you to feel informed, supported, and comfortable from the very beginning. Knowing what to expect during your first session can help reduce anxiety and make the process feel more manageable.

Whether you are seeking support for anxiety, depression, life transitions, or trauma, here is what typically happens during your intake session:

1. A Warm Welcome

The first session is all about beginning to build a trusting, collaborative relationship. You will be welcomed into a safe, nonjudgmental space—whether in-person or via telehealth. Your therapist’s goal is to help you feel heard, respected, and at ease.

2. Paperwork and Consent

Before the session, you must complete intake paperwork, which usually includes:

Professional Disclosure
HIPPA/Notice of Privacy Practices
Telehealth Consent (if applicable)
Clinical Information/Medical Hx/Symptom Checklist
Authorization to Release Information for Insurance, Primary Care Physician, and Emergency Contact
Client Information Form
Credit Card Authorization Form (if applicable)
Financial Policy

These forms ensure we understand your background and can provide ethical, personalized care.

3. Getting to Know You

Much of the first session is a conversation about what brings you to therapy. Your therapist may ask:

What concerns are you hoping to address?
Have you experienced therapy before?
What goals do you have for your mental health?

This is your space, and you set the pace. There is no pressure to share everything at once.

4. Exploring Your History

To gain a fuller picture of your experience, your therapist may ask about:

Family background
Work or school life
Relationships
Medical and psychiatric history
Past experiences that may impact your well-being

This biopsychosocial approach helps identify patterns and strengths to guide treatment.

5. Clinical Impressions & Co-Creating a Treatment Plan

Toward the end of the session, your therapist will share initial clinical impressions and collaborate with you to create a treatment plan. This typically includes:

A tentative diagnosis (if appropriate)
Recommended session frequency
Goals tailored to your unique needs
Next steps in your care

You will have time to ask questions, express preferences, and share any concerns. Your voice matters. This is your journey, and we want to ensure the process feels right for you.

6. What Happens Next

If you and your therapist feel like it is a good fit, you will schedule your next session. Most clients begin with weekly therapy to build momentum and deepen the therapeutic relationship—an essential foundation for change. Over time, frequency can be adjusted based on your progress and needs.

You may leave your first session feeling hopeful, relieved, reflective, or even a bit emotionally drained — all of that is completely normal. Beginning therapy can stir up emotions, and that is okay. Healing begins with awareness and connection.

Final Thoughts

It is normal to feel nervous about your first therapy session. You are meeting someone new, opening up about personal experiences, and stepping into vulnerability. But it is also a powerful move toward healing, growth, and self-understanding. At Asheville Counseling and Wellness Center, we are honored to walk alongside you on your journey.

Ready to Get Started?