Going to therapy for the first time? Know what to expect, what to talk about and how to know if your therapist is right fit for you

Ahead of World Mental Health Day, give therapy a shot and learn what all you can expect and talk about in the sessions.

For a first-timer, a therapy session may seem unsettling. They wonder how to open up to the mental health professional; after all, opening up about your feelings and thoughts is not an easy thing to do. Doubts about whether you will be judged are common and hold people back.

Identifying what to expect and how to proceed aids in getting the necessary clarity. Ahead of World Mental Health Day 2026 on October 10, let's answer some common doubts. In an interview with HT Lifestyle, Devyani Todi, senior psychologist at Amaha, discusses expectations for the first therapy session.

Why do people struggle to talk about their problems in therapy?

We first asked, why do people struggle to report their mental health problems in a therapy session, when they can do so easily with a physician regarding their physiological symptoms? Simplifying this, the psychologist attributed it to the nature of emotions, which feel much more vulnerable than objectively recalling physical symptoms.

Therapy is built on collaboration and mutual understanding.

How to start talking in your first therapy session?

If you are intimidated by how emotionally scrambled you become when you recount any incident or talk about your feelings, then that is valid. The expert reminded us that you do not need to be ‘polished.' You don't need to be articulate and well-spoken in a therapy session. Devyani assured that therapists are actually trained to work with ‘uncertainty and fragments.’

Describing what she believes to be the useful starting point, she said, “Therapists are trained to work with uncertainty and fragments. A useful starting point is simply describing what has changed in your everyday life. For example: 'I'm not sure where to start. I've been snapping at people at home, and I don't enjoy things I used to. I don't know why.' This gives the therapist a starting point to explore your mood, behaviour, and timeline.”

Sometimes, you may be feeling low, and you, yourself, cannot identify the potential source. So if you are struggling to locate the trigger, you can begin by mentioning the major aspects of your life.

The psychologist added, "You can also mention when the difficulty began, what makes it better or worse, and how it is affecting your sleep, work, relationships, or daily functioning. If something feels particularly difficult to say, you can simply tell your therapist that: 'I'm finding it hard to talk about this.' That itself is a useful starting point."

Now, how much do you cover in the first session? Sometimes mental health concerns are part of a bigger picture, and uncovering it may take time. Not everything can be covered in the first session. Devyani noted, “You don't have to disclose everything in the first session. Therapy is a collaborative process, and you can work at a pace that feels manageable. It can also help to note down beforehand why you decided to seek help now and what you would like to be different with therapy.”

What to expect from first session, and what questions to ask the therapist to identify if they are a good fit?

Devyani believed in the value of the first session firmly, calling it the ‘beginning of the therapeutic relationship.’

Now, what kind of questions does a therapist ask you, and what kind should you ask them to understand the right fit:

Here are some questions the therapist can ask you:

• What brought you in?
• When did the difficulties begin?
• How are they affecting your life?
• Any previous history or treatment ?
• What you hope to achieve?

Now, the psychologist also gave a reality check: after the first session, despite talking a lot, you may not feel like ‘you have solved anything.’ Sometimes, because of this unresolved aftermath, many end up quitting therapy right after the first session. But, there's much more to the story than this. Devyani said, "The initial goal is usually to develop a shared understanding of the problem and decide on a direction for treatment."

Now, therapy is a collaboration and the questioning is not only one-directional. To check if your therapist is the right fit or not, you can ask them some questions.

The expert recommended these questions:

1. What approach do you use, and why would it suit my concerns?
2. How will we know if therapy is working?
3. How frequently would you recommend sessions?
4. What happens if I feel the approach isn't working?
5. How is confidentiality handled?

How do you identify if your therapist is the right fit for you? Is it someone who has all the answers? Devyani disagreed and instead highlighted what actually matters: “You don't have to immediately 'click' with a therapist. Instead, notice whether you feel heard, respected, and able to be honest. A good therapist should be able to explain their approach, involve you in decisions, and respond constructively if something isn't working.”

In the end, therapy is built on collaboration, so the right therapist is someone who collaborates actively with you.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.