Your first session with a psychologist: what happens and how to prepare

Booking a first session is often the hardest step. People worry about what they will be asked, whether they will find the words, whether they will be judged. I would like to show you what usually happens, so that it all feels a little less unknown.

How to prepare

You do not need to prepare anything special. But a few minutes of thought before the session can help:

• Write down in a few lines what is troubling you and since when.
• Think about what you would like to change. “I want to sleep at night” or “I want to argue less at home” is enough. If you do not know yet, that is fine too: we can work it out together.
• Note any medication you take and whether you have seen a psychologist or psychiatrist before.
• Write down your own questions for the psychologist: about the method, how often you would meet, the fee, cancellations.
• For an online session, find a quiet place where no one can overhear you, check your internet connection and headphones, and keep water and tissues nearby.

What happens at the first session

The first session is above all a chance to get to know each other. Most of the time you talk, and I listen and ask questions. At the start I explain the terms: how long the session lasts, the fee, the cancellation and confidentiality rules. Then we talk about what brought you. Towards the end I share how I see the situation, what we might work on and how, and we agree whether to meet again and how often. Sometimes a single session is enough to see what to do next.

What the psychologist usually asks

Every specialist asks in their own way, but the questions are usually similar:

• Why did you decide to come now?
• How long has this been going on, and how does it affect your work, sleep and relationships?
• What have you already tried, and what has helped even a little?
• Who is around you: family, friends, people you can rely on?
• How are your health, sleep and appetite? Do you take any medication, alcohol or other substances?
• Have there been hard events in your life that still hurt?
• Do you sometimes have thoughts of harming yourself? This is asked of everyone, calmly and gently, because it matters for your safety.
• What would you like to be different a few months from now?

You do not have to answer everything at once. You can say “It is still hard for me to talk about this”, and that is a perfectly good answer. We go at a pace that feels safe for you.

Confidentiality and its limits

What you say in a session stays between us. I do not pass it on to your family, your employer or anyone else without your consent. I discuss difficult cases in supervision, but without names or details that could identify you.

Confidentiality has limits, and an honest psychologist names them at the start. The ethics code of the American Psychological Association, for example, asks psychologists to discuss the limits of confidentiality at the outset, and allows disclosure without consent only in narrow cases, such as protecting someone from serious harm. In practice this means that if there is a real threat to your life or someone else’s, or a child is in danger, I may need to act to keep people safe. In some cases the law may also require disclosure. If you have questions about this, ask them before we begin: you have every right to.

If a client is under 18, a parent or guardian takes part in the arrangements and gives consent, and we agree together on what stays between the young person and me.

How to tell if the psychologist is right for you

Research shows again and again that a trusting working relationship between client and therapist is linked to better results in therapy. So listen to yourself after the first one or two sessions:

• Did you feel listened to, rather than judged or rushed?
• Could you speak honestly, even about uncomfortable things?
• Did the psychologist explain clearly how they work and what to expect?
• Were the terms and boundaries clear?
• Did you leave with at least a little more clarity, even if it was hard?

Feeling tired or stirred up after a first session is normal. But if you felt unsafe or ashamed during the session, that is worth paying attention to. If something does not feel right, you can say so directly: a good psychologist will take it calmly. And if the connection is not there, it is perfectly fine to look for another specialist.

Online or in person

Studies comparing therapy by video with therapy in the same room find similar results for many common difficulties. So the choice is yours:

• Online saves travel time, works from any country and suits people who find it easier to open up at home. You need a quiet space where you are alone.
• In person suits people who find it easier to talk face to face, or who have no private space at home. Some people also prefer it for body-oriented work.

You can start in one format and switch later.

If you would like to get a feel for things first, book a free 15-minute intro video call with me. It is not yet a session: we get to know each other, you tell me briefly what is happening, ask your questions and decide whether you want to go on. My sessions are held in Armenian or Russian only, online from any country or in person in Yerevan. And if you would like to check in with yourself before we talk, the free WHO-5 wellbeing test on this site takes only a couple of minutes.