Getting the most out of your first therapy session in Hillsborough, NJ

Whether you’re starting therapy for the first time, switching to a new therapist, or returning after a break, meeting and getting to know a new therapist can be nerve wracking. While some people feel a huge sense of relief after scheduling a therapy session, for many, their anxiety goes through the roof as their appointment day approaches. You may feel uncomfortable about sharing your story and struggles with someone you don’t know, wondering if your therapist is going to “get” you, or if this is even going to help. Sometimes it can feel like your thoughts are all over the place! So what can you do about your therapy worries? Knowing what to expect and preparing for your first session are a good place to start.

Before your first session…


Many therapists have secure, confidential online systems for completing paperwork ahead of time. They send you a link, you go to the site, fill in your information, electronically sign it and you’re done. If they don’t have this option, your therapist will generally either mail you the paperwork, or ask you to come in early on your appointment day to complete it. Getting the forms out of the way ASAP not only takes them off of your “to-do” list, it also gives you more time to focus on you during your session. Your therapist won’t have to spend precious minutes getting basic information, having you sign documents, or gathering insurance information because you’ll have already done that.


If you plan to use your insurance for therapy, and are not sure about your behavioral (mental) health coverage, I recommend that you contact your insurance company to verify your benefits. They can tell you who’s in-network, who isn’t, how much you will have to pay for your in-network provider co-pay, and if you have coverage for out of network providers. Your insurance company can also tell you if you have to meet a deductible before they begin paying for your sessions. Having all of this information ahead of time will help you to avoid surprises about fees later on. Insurance coverage can be confusing, so I’ll be writing a blog on this topic in the next few weeks. Be sure to check back!

What do you want to talk about?

During the first session, or even the first few sessions, the main goal is for you and your therapist to get to know each other. Your therapist will want to learn about you, your life, your struggles, why you’re there, and what you want to work on. That can be a lot to talk about! Rather than trying to cover everything from your past, what’s happening now, and what you’re worried about for the future, think about narrowing that down—for now anyway. There will be plenty of time to get into things in detail as you continue with therapy. So, really think about what the major issues are, and what you want to get out of therapy right now. Your counseling goals will keep changing as you work through things. You can make this an ongoing practice by writing down thoughts or issues in between sessions as they pop up, and then bringing those with you to talk about. It’s a great way to make sure that you and your therapist are focusing on what’s important to you and that you’re getting what you want from sessions.

On the day of your first session…

Insurance and getting started paperwork

Bring your completed paperwork (if needed), your insurance card and payment or co-payment. Ideally, your therapist will have gone over their billing practices and types of payment they accept, which is usually cash, check, and sometimes, credit cards. If you are using a Flexible Spending Account (FSA) or other medical reimbursement card through your employer, be sure to ask the provider if they can process payments directly. Many payment systems used by therapists are not able to directly process FSA payments. You may have to pay for the session and then submit the receipt provided by your therapist for reimbursement.

I also find that it’s helpful to get the business stuff out of the way first. Taking care of any paperwork, scheduling, insurance issues or payments at the start of session means that once things get into a groove, you can keep going until your time is up without having to be interrupted to take care of this stuff.

Plan ahead to keep stress levels down

On appointment day, try to arrive at least 5 minutes early. Give yourself extra time to find the office, park, and then get into the office building. Having to rush around at the last minute, and arriving to your appointment late can just amp up that anxiety and make it harder to jump into your session.

While you’re waiting to go into the office, take a few deep breaths. Especially if you notice your heart is racing, your breath is quick and shallow, and/or you’re feeling panicky, antsy or sweaty. While you’re breathing, look out the window or around the room and just notice what you see. This won’t get rid of the anxiety completely, but can calm things down so that you feel at least a little bit of relief before you get started.

Sharing your story during the session—what you need to know

So you’ve already thought about which issues you want to talk about and work on with your therapist before you got to your session, but now that you’re there you may be hesitant to bring these things up. Maybe you’re uncomfortable with new people or it feels weird talking about yourself. Maybe you just need more time to get to know your therapist better. It’s always ok to go at your own pace as you get to know the therapist!

First sessions can also bring up lots of emotions. You’ve been dealing with all of this anxiety and stress, relationship issues, your past, or whatever you’ve been dealing with all on your own, and it’s been a lot to manage. Letting that out can feel overwhelming, scary, and sometimes, even relieving. No matter what comes up for you, it’s ok!

Finally, keep in mind that what you say in therapy, stays in therapy. We have to keep your information confidential. So for example, if your partner calls to see if you were at therapy today, your mom wants to know what you said at your session last night, or your doctor asks your therapist how you are doing—without your permission we can’t say a word! There are only a few instances where therapists can share information about you to other people. Firstly, if you sign a release of information saying it’s ok to talk to a certain person, then we can do that. Secondly, if you tell your therapist that you are going to hurt yourself or someone else, or, that you know of a child, older adult, or disabled person that is being abused or neglected, we have to take action. Your therapist will go over this with you in detail, and if you have questions about confidentiality, be sure to ask. Knowing that what you say in sessions is going to be kept under wraps means you can talk about your history, your feelings, and your thoughts, knowing that it won’t be shared.

I hope this blog has given you a few tips that you can use to get the most out of your first therapy session in Hillsborough, NJ.

Still looking for a therapist or have more questions about therapy? You can schedule your free 15 minute phone consultation by calling me at (732) 649-8112, sending me an email, or by clicking here to fill out a contact form. Joan is a psychotherapist in Hillsborough, NJ offering therapy for issues related to anxiety and stress, trauma, and relationship issues.