Tips to Manage Anxiety Before Your First Therapy Session

Is it normal to feel anxious before your first therapy session?

It is completely natural to feel anxious or nervous before starting therapy.

A 2022 study found that people typically experience challenging emotions when starting therapy, including fear and shame.

For some people, these feelings may persist through several therapy sessions. You might feel worried about:

• displaying too much or too little emotion
• acting inappropriately during sessions
• not being a “good” client
• talking about relevant experiences
• working through personal issues without being disloyal to loved ones

You might also feel anxious before a first therapy session because you’re unsure what to expect from the process.

Some of these concerns may resolve when you start therapy and begin to build a trusting relationship with your therapist. Others, you may be able to prepare for in advance.

The benefits of a consultation session

Knowing what to expect during your first therapy session may help you feel less anxious when you attend.

The exact contents of a first session may vary from person to person, depending on factors like:

• your therapist
• the type of therapy, such as talk therapy or cognitive behavioral therapy (CBT)
• the location of therapy — in-person or online
• why you’re attending therapy

Before officially starting therapy, you may need to attend one or more consultation sessions. These can allow you to learn the best type of therapy for you and determine whether a specific therapist is right for you.

These consultation sessions may also be a good opportunity to find out from your therapist what a first session with them may involve. If you’re feeling nervous about starting therapy, you can ask outright what to expect.

Medical Perspective

“Consultation sessions are opportunities for a potential client to ask questions of the potential therapist in order to gather enough information to decide whether or not to proceed in working with that particular individual. Both the client and therapist have a brief encounter to determine if they might be a good fit to work together. This contrasts with the typical nature of a first therapy session, in which the focus will be more on the therapist gathering diagnostic information about the client in order to begin creating a treatment plan.”

— Bethany Juby, PsyD

Learn more: How to Find the Right Therapist for You

_{Quotes represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.}

Tips to minimize anxiety before your first therapy session

The tips below may help you manage feelings of anxiety before your first official therapy session.

Prepare for the practicalities of your appointment

Before your first therapy session, it may relieve your anxiety to prepare for the practical elements of the appointment. This may include things like:

• driving the route to your therapist’s office or double-checking you have any video links for online therapy
• checking your insurance coverage for therapy, including details like your copay and deductibles
• understanding how you will pay for the session
• filling out any paperwork that your therapist requires you to bring to the session
• obtaining your health records from other healthcare professionals, if they are relevant
• writing a list of questions you want to ask or topics you’d like to cover

In some cases, your therapist may ask you to arrive slightly early for your first session to fill out paperwork.

Consider what you want to discuss

Your first therapy session is likely to involve your therapist getting to know you and understanding your goals in taking therapy. In some cases, this may take several sessions to establish.

Your therapist may ask open questions to better understand what you hope to get out of therapy. Open questions are those that require a detailed answer instead of a simple “yes” or “no” response.

Considering your therapy goals before your first session may help you feel more prepared for this conversation.

Get to know your therapist

Consultation therapy sessions and early therapy sessions are important to understand if your therapist is well suited for your needs.

A trusting, respectful relationship between you and your therapist is vital for you to develop and achieve your therapy goals. Part of this may involve finding a culturally competent and sensitive therapist.

If you don’t think you will have a productive relationship with your therapist, it may be beneficial to consider a different practitioner.

Be honest about your feelings

If you’re feeling anxious before your first therapy session, it may be helpful to take some time to acknowledge your emotions.

For some people, even naming the negative emotions you’re feeling can help relieve them.

These feelings may or may not be something you feel happy talking about in your first therapy session.

Try some stress-relieving practices

The following practices may help reduce feelings of stress or anxiety:

• exercise
• socialize with friends or loved ones
• practice some self-care, such as a warm bath or time on a hobby you enjoy
• practice gratitude

It may also be helpful to avoid substances such as alcohol and caffeine.

The bottom line

It’s natural to feel anxious before your first therapy session, but that doesn’t mean there aren’t ways you can manage and reduce that feeling.

Consultation sessions are a good opportunity to understand if your therapist is suitable for your needs and to ask exactly what you can expect from the first few therapy sessions.

Beyond this, it may also be helpful to prepare for the practicalities of therapy, consider what you want to discuss with your therapist, and try relaxation strategies.