August 7, 2025.
Written by General Psychologist, James Blaze

Men’s Mental Health – The First Therapy Session Unpacked

Have you been struggling with a particular issue for a long time? Maybe someone has brought to light a problem you have not noticed affecting your life for some time now? Or perhaps someone close to you has recently decided to seek help, and you are thinking about whether you should too? These can all be reasons to seek therapy. However, stigma around being judged, finding it hard to open up, worrying about not connecting with your psychologist or negative experiences with therapy in the past may make it harder for you to start or stay in therapy. So, it could be expected that you feel confused, uncertain, sceptical or even hopeless when connecting with a psychologist.

This article will explore what it can be like in the first session and what to expect from the first contact with a psychologist. It will aim to help you feel confident and informed going into your first session for the first time or if you are returning to therapy.

If you have not had therapy before, it can feel daunting and vulnerable to speak about your personal issues with a stranger. Some of us have not had good experiences of seeking or even receiving support from people they are close to. It is understandable to feel this way, and a good psychologist should not only know this but accommodate for it by doing their best to make the session feel natural, like a conversation. Your psychologist might invite you to share past experiences of mental health support to explore what they could do to make the process better for you.

The first few sessions typically focus on getting to know what your life looks like and what has been going on that has triggered you to come to the session. Think about someone close to you and the kinds of things you hope they would know about you. For example, what your family relationships and friendships are like, what activities you normally do, how you are finding your work, what romantic relationships look like for you and whether you enjoy a drink? If any of those areas align with why you have come to therapy, you may be invited to share in more detail about that part of your life. Of course, your psychologist will likely ask you about your mental health, but in a way that is easy for you to understand. It might be useful to reflect on what it is about your life that you are finding difficult. There is no pressure to have all the answers; it is your psychologist’s task to piece together the information you share. If you have a rough idea of what you would like to speak about, that may be enough for them to lead the way.

Some people worry about whether the things they say are going to be told to anyone else, especially if they have had their trust broken before. Psychologists are generally held to high ethical standards that protect your confidentiality, unless in rare situations (typically involving imminent harm to someone), your information will remain between you and them. Your psychologist should explain to you the limitations of confidentiality clearly and in detail so you will feel at ease opening up. This is also a good time to ask any specific questions you have about confidentiality.

In the first few sessions, you will likely be asked about your goals for therapy. Think about what in your life you would like to change. What would your daily activities and experiences look like in a world free of your issues? You should be guided to explore and clarify these in session so that there is an ideal outcome to keep therapy on track.

At the conclusion of the beginning sessions, you will be explained some ways of working together to achieve your therapy goals. These will reflect your preferences for therapy, which might include time, money, past therapy experiences and your strengths, in combination with what your psychologist thinks might work best for you. Don’t forget that you are involved in collaborating with your psychologist on how to work together, so be sure to let them know what you think best suits you. Do not forget to ask your psychologist questions about how therapy works. You may decide to clear up how often you should attend, for how long and what exactly the therapy involves.

Sometimes the first session can leave you feeling heard and relieved that you have opened up and taken a step to seek help. However, the first sessions could also make you feel as if you have spoken about many pressing issues but received minimal solutions. It is important to trust in the process and that support and guidance can come once a connection is formed with your psychologist and they have understood you well.

Starting therapy is a courageous decision as it involves vulnerability to confront challenging issues in your life and trusting someone else to help you with those. Regardless of how you feel after the first session, you have taken a meaningful step towards caring for your mental health that will hopefully pay off in the coming sessions.