Talk about whatever is weighing on you most, even if it seems small or messy. In a first session, that usually means what made you book, what you have tried already and what you hope will change. After that, the most useful material is often whatever happened since your last session and how you reacted to it. You do not need a prepared topic. Working out what matters is part of what your therapist is there to help with.
First sessions tend to follow a similar shape. Your therapist will ask about:
You can answer as much or as little as you are ready to. If a question feels too personal early on, it is fine to say you are not ready to go there yet.
Blank moments are common, particularly a few sessions in, once the main story has been told. Some starting points:
That last one is often the most useful. If you notice yourself steering around a topic, mention that you are steering around it, even if you do not go further yet.
No topic is too small. Irritation with a coworker, a hobby you have stopped enjoying, a bad week of sleep: these often connect to larger patterns, and they are easier places to start. Therapists hear about everyday frustrations far more often than dramatic events.
Therapists are trained to hear difficult things without judgment, including anger, shame, intrusive thoughts, substance use and sexual concerns. What you say is confidential, with a few legal exceptions your therapist will explain at the start, such as a serious risk of harm to yourself or someone else, suspected abuse of a child, or a court order.
If something feels too hard to say out loud, some people find it easier to write it down and hand it over, or to start with "there is something I find hard to talk about."
If you are unsure the sessions are helping, say so. Good therapists welcome that conversation, and it often leads to a change of focus or approach that makes the work more useful. It is also fine to ask how your therapist sees your progress and what the plan is from here.
If you have been putting off booking because you are not sure what you would say, that is a perfectly good thing to say in a first session. Our clinicians in Calgary, Red Deer and Cold Lake see people for anxiety, depression, relationships, grief, trauma and much more, in person and online. All of our therapists offer a free 15-minute connection call, and no referral is needed.
We direct bill many insurers, including Alberta Blue Cross, Canada Life, Sun Life, Manulife and Greenshield, so you pay only the part your plan does not cover. See direct billing and insurance, or call 1-888-622-8350.
Related reading: How to choose the right therapist, When should you see a psychologist? and Signs of unprocessed trauma.
