Most people sit in their car in the parking lot for a few minutes first.
Not everyone, but enough that I want to say it out loud. The first session is the hardest one to show up for. Not because of what happens inside but because of everything that happens between deciding to make the appointment and actually walking through the door.
You have been thinking about this for a while, probably. Maybe a long while. Something shifted recently, or something finally broke, or you just got tired of telling yourself you would deal with it later. And now here you are, about to sit across from someone you have never met and talk about something you have never quite been able to put into words.
That is a lot. I want you to know I am aware of it.
Here is what the first session actually looks like - not knowing is part of what makes it so hard to get here.
Do I need to know what to say in my first therapy session?
The number one thing I hear from people in first sessions is some version of: I do not even know where to start.
Good. We will figure that out together. That is what the first session is for.
You do not need a clear explanation of what is wrong. You do not need a diagnosis, a timeline, or a neat summary of your history. You do not need to have thought through what you want to get out of therapy or how long you think you need it or whether what you are dealing with is serious enough to be here. None of that is a requirement for walking through the door.
The first session is a conversation. I am going to ask you questions and listen carefully, and I am going to follow up because I am genuinely curious about what is going on for you, not because I am filling out a form in my head.
You can say you do not know. You can say it is complicated. You can say you have been trying to explain this to people for years and none of them have quite gotten it. We have time.
What does a therapist actually want to know in a first session?
I am trying to understand a few things, none of which require preparation on your part.
What has been going on. Not your whole history - just what is present right now, what brought you to make the appointment, and what it has been like to carry it.
What you have already tried. If you have done therapy before, I want to know what was useful and what was not. If you have been on medication, I want to know how that has felt. Not to evaluate your previous treatment but to understand what has already been attempted.
What you are hoping for. Most people do not have a clear answer to this, and that is fine. Something like I want to stop doing the thing I keep doing or I just want to feel more like myself is a completely sufficient answer.
Whether this feels like the right fit - that matters to me. Not every therapist is right for every person. You are allowed to come in and decide this is not quite right for you. You are allowed to ask me questions. The first session is as much you evaluating me as it is me understanding your situation.
Do I have to talk about everything in the first session?
No. And you will not be asked to.
You will not walk through every significant event of your life in chronological order. You will not be asked to rate your mood on a scale or describe your symptoms in clinical terms. You will not be pushed into material you are not ready for.
Before any processing work starts, whether that is EMDR, somatic work, or anything else, we spend time building trust and making sure you have the grounding to handle what comes up. We do not skip that part. The first session almost never goes into the deepest material. That is by design.
You also do not need to know what kind of therapy you need. Plenty of people come in having heard about EMDR or IFS and wanting to explore it. Plenty of people come in with no idea what any of those terms mean. Both are completely fine starting points. Figuring out what makes the most sense for you is my job.
How does the first therapy session actually feel?
Most people leave feeling lighter than they expected.
Not because anything has been resolved - nothing has been. But there is something that happens when you say out loud the thing you have been carrying quietly to someone who is actually paying attention. It does not have to be dramatic. Sometimes it is just a small amount of relief that someone else now knows - that the room held it and nothing fell apart.
Some people feel a little tired after, which is a normal processing, even the low-level kind that happens in a first conversation takes something out of you. If that happens, let yourself rest.
Some people feel nothing in particular and wonder if they did something wrong. You did not. The first session plants something. What it produces usually shows up later.
How long is a first therapy session and what are the logistics?
Sessions are 50 minutes. The first session occasionally runs a few minutes longer while we sort out any logistics.
I see clients in person in Breckenridge at my office on North French Street. If you are coming from Frisco, Silverthorne, Dillon, or anywhere else in Summit County, you are looking at a short drive. I also see clients throughout Colorado via telehealth.
You do not need to bring anything. No notes, no prepared list, no paperwork you have filled out in advance. Just yourself. If there is something specific you want to make sure we cover, you can say so at the start and I will make room for it.
What if I have tried therapy before and it did not help?
This comes up a lot. And it is a fair concern.
If therapy has not worked for you before, I want to know that. It is useful information, not a warning sign. There are a lot of reasons therapy can fall short: the wrong approach for what you are dealing with, a therapist who was not the right fit, a method that worked with thoughts but did not reach whatever is underneath them.
A lot of people who find their way to this practice have already done a version of this. They are self-aware, they have done the reading, and the talking has only gotten them so far. That is actually a very specific thing, and there are approaches, including EMDR, IFS, and somatic therapy, that work at a different level than the one most traditional talk therapy reaches.
If that sounds familiar, you are probably in the right place. The first session is a good time to say so.
How do I know if I am ready for therapy?
There is rarely a right time. There is usually just a moment where you get tired enough of waiting that you do something.
Reaching out is harder than the actual session for most people. The gap between thinking about therapy and making the appointment is where most people stay the longest. Not because of cost or logistics or finding the right person - because making the call means admitting, even just to yourself, that you want help with something.
That is not weakness - it's courage.
If something in this post felt familiar; the first conversation is just a conversation. And if you sat in your car for a few minutes before coming in, that is fine. I will be in there when you are ready.
Frequently Asked Questions
What should I say in my first therapy session?
Whatever feels most present for you. You do not need a prepared answer. Most people start with something like what has been going on lately or why they finally made the appointment. That is enough.
How long is the first therapy session?
Sessions at Nurturing Wellness in Frisco are 50 minutes. The first session may run slightly longer.
Do I need to fill out paperwork before my first therapy session?
You will complete basic intake paperwork before your first appointment. The session itself is a conversation, not a clinical assessment.
What if I do not know what kind of therapy I need?
You do not need to know. Figuring out what approach makes sense for your situation is the therapist's job.
Is it normal to feel nervous before the first therapy session?
Very. The anticipation is almost always harder than the actual session.
Where is Nurturing Wellness located?
610 E Main Street, Frisco, Colorado 80443. Telehealth available throughout Colorado and Mississippi.
Crisis Resources
If you are in crisis or need immediate support, please reach out.
988 Suicide and Crisis Lifeline: Call or text 988
Colorado Crisis Services: Call 1-844-493-8255 or text TALK to 38255
Paragon Behavioral Health Connections: Call (303) 691-6095 or email contact@paragonbhc.org — paragonbhc.org
Crisis Text Line: Text HOME to 741741
About the Author
Laura Landrum, LCSW, LAC is a certified EMDR therapist and licensed clinical social worker based in Summit County, Colorado. Before becoming a therapist she spent years as a backcountry guide, which is a longer story than it sounds. She works with adults, adolescents, and children in Breckenridge and throughout Colorado via telehealth. She is direct, she does not flinch at hard things, and there is nothing you can bring into the room that is going to send her running
