Making the Most of Your Early Therapy Sessions

1Bring everyday examples

General descriptions are a natural place to start: “I’ve been stressed,” or “My relationship has been hard lately.” Specific moments help your therapist see what that looks like in your life.

You might describe a recent conversation that stayed with you, a morning that felt especially heavy, or a time you reacted more strongly than you expected. Small details can be useful: where you were, what you noticed in your body, what you were thinking, and what you did next. Moments that went better than usual are worth sharing too, because they can show what already helps.

You do not need to arrive with the perfect example. Some people jot a few notes on their phone during the week; others simply start with “Something happened on Tuesday.” If nothing comes to mind, you can say so. Your therapist can help you find a starting point.

2Develop goals together

In the early sessions, you and your therapist will usually begin to shape goals together. Goals give therapy a direction and help you both notice progress. They are agreed on together, reviewed over time, and can change as you learn more (APA, 2023).

Goals do not need to be clear or impressive at the start. “I want to feel less on edge” or “I want to stop dreading Sunday nights” is a reasonable beginning. Your therapist can help turn a broad hope into something more concrete, such as noticing what tends to set off worry or practicing one new way to respond.

It can also help to think about what would be different in daily life if things improved. What would you be doing more of, or less of? Who would notice? These questions can make a goal feel more personal and easier to recognize when it starts to happen.

If a goal no longer fits, say so. Changing direction is a normal part of the process, not a sign that something has gone wrong.

3Ask questions

Questions are welcome throughout therapy, not only at the first appointment. Understanding why your therapist suggests something can make it easier to try, and it helps you take an active part in your own care.

You might ask:

• Why do you think this approach might help me?
• What should I notice between sessions?
• How will we know whether this is working?
• Can you explain that in a different way?

It is also fine to ask about the therapist’s thinking. For example: “What stood out to you from what I shared today?” Hearing your therapist’s perspective can help you see patterns you may not have noticed.

4Speak up when something feels unclear or unhelpful

It can feel awkward to tell a therapist that something is not working. Many people worry about seeming ungrateful or difficult. Yet this kind of feedback is one of the most useful things you can offer. The quality of the working relationship between client and therapist is consistently linked with how much people benefit from therapy (Flückiger et al., 2018), and honest conversations help strengthen that relationship.

You might say:

• “I’m not sure I understood what you meant last week.”
• “That exercise didn’t feel right for me. Can we talk about why?”
• “I feel like we keep coming back to the same thing without getting anywhere.”
• “Something you said last time stayed with me, and I want to talk about it.”

Your therapist should take your feedback seriously and be willing to discuss it respectfully. Together, you can adjust the pace, try a different approach, or clarify what you need. If you are unsure how to raise something, you can start with “This is a bit hard to say.”

Speaking up also includes positive feedback. Letting your therapist know what feels helpful shows you both what to build on.

5Notice changes and review progress

Much of therapy’s value shows up in the days between appointments. Your therapist may suggest something to notice, reflect on, or practice. If a suggestion does not fit your life, or you did not get to it, bring that back to the next session. What got in the way is often useful information.

Progress is rarely a straight line. Some people feel relief and hope early on, while others notice mixed or difficult emotions as they begin talking about painful experiences (APA, 2019). Some weeks may feel productive and others may feel stuck. Feeling worse is not, by itself, evidence that therapy is working. If distress persists, intensifies, or begins to interfere with daily life, let your therapist know so you can discuss what needs to change.

Early signs of progress can be small: noticing a pattern sooner, recovering more quickly after a hard day, or feeling more able to say what you need. These changes count.

Therapy takes different amounts of time for different people (APA, 2023), but you do not have to wait silently if you are unsure it is helping. Ask to review your goals and progress together. If your needs are not being met, you can discuss changes to the approach or consider another provider.

6Find what helps together

You do not need to arrive knowing how to make therapy work. The early sessions give you and your therapist an opportunity to build a shared understanding of what you need and how to move toward it.

This article provides general education about individual therapy for adults. It is not a substitute for individualized professional advice. If you are in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline) or call 911.