There's a version of therapy that exists in people's minds - slightly formal, slightly exposing, possibly tearful - and it isn't always an accurate picture. The uncertainty itself can be enough to keep someone in the thinking-about-it stage for a long time.

So this is a straightforward account of what a first session actually tends to look like.

It isn't an assessment

Some people arrive expecting to be evaluated - to answer a set of questions, to have their situation categorised, to leave with a diagnosis or a treatment plan. That's not generally what happens in therapy, and it's particularly not what happens in integrative therapy.

A first session is more like a conversation with some shape to it. I'll ask about what's brought you here, what's been going on, and what you're hoping for - but not in a way that feels like a form being filled in. The aim is to begin to understand you and your situation, and to give you enough of a sense of how I work that you can decide whether it feels like a reasonable fit.

You won't be expected to disclose everything in a first session. You don't have to go anywhere you're not ready to go. Most people find they say more than they expected to, but that tends to happen naturally rather than through any kind of pressure.

What I'll want to understand

I'll want to know something about what's brought you now - not necessarily why therapy in principle, but why this moment. Sometimes there's a specific thing that happened. Sometimes it's more that things have been building and a threshold has been reached. Sometimes people aren't sure - they just know something isn't right.

I'll also want to know something about you more broadly - your life, your relationships, your history where it feels relevant. Not in an exhaustive way, but enough to begin to see the fuller picture rather than just the presenting concern.

And I'll be interested in what you're hoping for, even if that's hard to articulate. People often come to a first session not entirely sure what they want from therapy. That's fine. Being unclear about it is something we can work with.

What the session feels like

Most people find a first session slightly nerve-wracking beforehand and more manageable than they expected once it begins. The room - or the call, if we're working online - is a contained space. There's no agenda beyond getting to know each other and beginning to understand what's brought you here.

I won't be taking extensive notes while we talk, and I won't be sitting in silence waiting for you to fill it. It's a conversation. Occasionally I'll reflect something back, or ask a question that goes a bit deeper, but it isn't a technique-heavy session. The work proper tends to come later, once there's enough of a foundation.

It's also worth knowing that you can ask questions. About how I work, about what therapy with me typically looks like, about anything that would help you decide whether to continue. A first session is as much for you to assess me as it is for me to begin to understand you.

What happens afterwards

At the end of the session I'll usually check in about how it felt, and whether you'd like to meet again. There's no obligation - you can take time to think about it, or simply decide it isn't the right fit. If you do want to continue, we'll find a regular time that works.

Some people feel relieved after a first session. Some feel a bit stirred up - having spoken about something they don't usually speak about. Both are normal. If you feel more unsettled than you expected, that isn't a sign something has gone wrong. It sometimes just means something has been touched that was ready to be.

On doing it online

If we're meeting online rather than in person, the first session follows the same shape. The main difference is practical - you'll need a private space where you won't be interrupted, and a reasonable connection. Some people find the online format easier to begin with; there's something about being in their own surroundings that makes the first conversation feel slightly less exposing. Others prefer the clearer separation of coming to a room. Both work.

The first session is just a beginning. It doesn't commit you to anything, and it doesn't require you to have anything figured out before you arrive. If you've been thinking about it for a while, it's often enough to simply book and see how it feels. Find out more here.