The First Step: What to Expect from Your First Psychotherapy Session
Have you wondered what psychotherapy would be like?
For many, the decision to seek psychotherapy is accompanied by a mix of curiosity, hope, and apprehension. Expectations can vary widely: some believe therapy will serve as a quick-fix solution, while others fear it might involve some form of mind control. So, what actually happens when you step into a therapist's office for the first time?
Let’s delve into common concerns people have before starting therapy and shed light on what you can expect during those initial steps toward better mental health.
This article is adapted from the transcript of Season 2, Episode 2 of our podcast Mindful Dialogues “Psychotherapy for First Timers” with guest Nastasia Tang , an associate psychologist, and host Noora Juma’at, a former peer support specialist.
What Happens in the First Session?
Noora:
I have clients who come to me and ask “I don't know if my problems are big enough for a therapist to help me through them,” or “What's going to happen during therapy sessions? Do I have to talk all the time? What if I don't want to speak or I'm not comfortable speaking?”
How do you assess and differentiate whether a person needs or would benefit from therapy?
Nastasia:
Whether someone would benefit from therapy depends on the problems they’re currently facing and their underlying causes. For instance, if stress or anxiety stems from practical concerns like financial difficulties or lack of housing, addressing these issues—such as providing financial aid or shelter—may reduce their distress more effectively than psychotherapy. Similarly, someone experiencing a temporary life challenge might find counselling more helpful for navigating that period.
At IMH, there’s a process called Psychotherapy Review. When referred to Psychology Services, individuals meet a triage psychologist who helps identify their goals and determines which services best suit their needs.
Your therapist will likely focus on understanding your concerns, history, and goals. Think of this as laying the groundwork—a time to explore your reasons for seeking help and to set expectations for the therapeutic journey ahead. The first session often includes:
Addressing the Fear of Vulnerability
Noora:
Stigma around therapy is very real. I’ve experienced it myself—early on, I would attend sessions wearing a black cap, mask, and jacket to avoid being recognised. Overcoming societal stigma was a personal journey. Many clients have shared with me about similar fears of being seen entering clinics. Others also face practical barriers, such as inflexible work schedules that make attending in-person sessions difficult. What common barriers have you observed among your clients?
Nastasia:
You're absolutely right. In fact, when going through the psychotherapy reviews, there are a lot of clients that bring out concerns about their fear about being seen by others when going to the clinic for therapy. We offer various services to address different client needs. For those who might prefer remote learning, we have an Internet-Based Cognitive Behavioral Therapy (iCBT) program. This platform provides module-based programs to teach therapy skills and coping strategies. While clients complete the modules at their own pace, a psychologist provides guidance through scheduled calls, offering support without requiring in-person sessions. This flexibility is ideal for clients with busy schedules, as they can engage with the program during weekends or evenings.
Opening up to a stranger can feel intimidating. It’s normal to wonder, “What if I’m judged?” Rest assured, therapists are trained to create a nonjudgmental space. They aim to meet you where you are and help you feel comfortable sharing at your own pace. Remember, it’s okay to take your time.
Realistic Goals and Independence in Therapy
Nastasia:
Common unrealistic expectations in therapy include wanting to go to therapy to change the behaviour of others. Therapy focuses on individual change—understanding and controlling our actions, thoughts, and interpretations. While improving self-awareness and communication can influence relationships, how others respond remains beyond our control. For persistent family conflicts, systemic or family therapy may be more appropriate, allowing loved ones to work together to build healthier relationships.
Another unrealistic expectation is viewing therapy as lifelong professional emotional support. While it may feel convenient, therapy aims to equip clients with coping skills to manage independently and build organic emotional support systems. The goal is to help clients achieve independence and eventually "graduate" from therapy. They can always return if new challenges arise, but relying on therapy indefinitely can hinder self-confidence and growth. Supporting clients in becoming independent is a core part of the process, helping them stand on their own over time.
Key Takeaways About Your First Psychotherapy Session
Taking the first step toward therapy is a powerful act of self-investment. While concerns and misconceptions are natural, understanding what to expect can help ease the transition. Remember, therapy is not about achieving perfection but about fostering growth, resilience, and self-awareness.
So, if you’re considering therapy but have hesitated due to uncertainty, know this: the first session is just the beginning of a journey—one that holds the potential for profound personal transformation. Ready to take that step?
Join the conversation: What were your expectations before starting therapy? Share your thoughts with us in the comments below.
About Nastasia Tang :
For the past eight years, Nastasia has helped patients through volunteering, case management and psychotherapy. Her hope is to impact lives, inspire hope and cultivate resilience in persons with mental health conditions.
About Noora Juma'at:
Drawing from her personal experience with bipolar disorder, Former IMH Peer Support Specialist Noora Juma’at championed mental health recovery, uplifting both herself and others through peer-to-peer sessions.
Attachment and trauma therapist. The only therapist in Singapore trained in Integrative Attachment Therapy, featuring the Ideal Parent Figure protocol. Also helping clients process trauma with MEMI and Brain-Switch 2.0.
2 个月In addition, for clients seeking therapy for a traumatic memory and worried about having to relive the painful experience, modern techniques like #MEMI (Multichannel Eye Movement Integration) and Brain-Switch 2.0 generally work in one session and don’t require the client to give details about what they went through. These can be useful options for clients who are looking for something quick, effective and value for money, while maintaining their privacy and dignity.