What Happens During a First Session With a Psychologist

Booking in with a psychologist is one thing. But what will you actually talk about?

You might wonder: What should you tell them? Will they ask certain questions? What if you cry or don’t know how to explain yourself?

These are all fair questions. Even finding the motivation to get an appointment can be difficult. According to the Australian Bureau of Statistics in 2024-25, 38.8% of people who needed to see a psychologist for mental health delayed or did not see one when needed.

Everyone’s first session will be slightly different but here are some things that will usually happen.

How to Prepare Without Overpreparing

There’s no need to have everything memorised about your life or why you’re attending the appointment. If you’re concerned you may forget something, you can always write some notes down.

Think about why you wanted to book in, one recent event that has made you feel this way and what you hope to improve on. Maybe it’s affecting your sleep, work or relationships, write that down too. These can all help guide what you want to speak about.

There may be some intake forms and consent that you’ll need to fill out prior to your first session. This may include your contact details, any medical history you want them to be aware of and what information can be collected from you. You may need to bring these to your session or some psychologists allow you to complete them at home.

Make sure you know where and when your appointment is. If you’re having an online session, find a comfortable place where you can talk privately. You can also let your psychologist know if you require an interpreter or other accessibility services.

Feel free to bring your notes with you, you can always reference them if you need a prompt.

What Happens When You Sit Down

Your psychologist will likely ask you what you would like to discuss today or what brought you in for an appointment. You can explain that work meetings are causing you stress, you don’t need to go into too much detail at first.

Someone who wants to learn more about social phobia therapy may not feel comfortable answering this question either. Solace Psychology explains that some people who have social anxiety are afraid of others judging them, think about things after they have had a conversation with someone or avoid certain situations. You may relate to one of these, which can help explain your experience.

Your psychologist may ask you when these problems started, what situations bring it on or make it worse and how it affects your life. They may also ask about your general health, feelings, past experiences or how you have coped with it. All of this can help give them a better understanding of your issue.

Some psychologists will have you fill out a short questionnaire to identify certain symptoms. This can be helpful if there are things you didn’t think of while you were speaking to your psychologist.

If you don’t understand a question or want to know why they’re asking, you can always ask your psychologist. You should feel comfortable asking questions at your first appointment.

If Talking to Someone New Feels Hard

If you suffer from social anxiety, it can be intimidating to see a psychologist. You may feel your heart pounding, not make eye contact or obsess over the conversation you just had with your psychologist.

Your psychologist may want to know what you experience when in a situation that causes you anxiety. For example, when you have to speak at work, you may think that people will judge you, you have trouble focusing and after the meeting you may think about it for the rest of the day.

They may also ask you what you do when these situations arise. Maybe you rehearse what you’re going to say, try not to speak or leave the situation as soon as you can. While these can help you in the moment, they may be preventing you from learning what will happen if you don’t.

You don’t have to push yourself at your first appointment if you’re not ready. You can always take a moment or tell your psychologist if you need some time.

Will You Get a Diagnosis or Start Treatment?

Maybe, but your first appointment is unlikely to give you that answer. Your psychologist will probably assess what you told them and may want another session to gather more information.

They can tell you what they’ve noticed and maybe suggest a treatment plan to help with your concerns. If they think a diagnosis may apply, they should be able to explain what it means and answer any questions you may have.

CBT is commonly used for social anxiety, this can help people recognise and manage patterns in thoughts and behaviours. Your psychologist may want you to face some of your fears, with gradual steps to what you want to achieve.

If you’re afraid to answer your phone, you may learn about your thought process of not wanting to pick up because you think you’ll sound stupid. A future goal may be calling someone with less preparation than you normally would. You don’t need to face your biggest fear at the first session; talk with the psychologist about a manageable starting point.

Privacy and Questions Worth Asking

Knowing what happens to the information you provide can make it easier to open up to your psychologist. They will have certain guidelines to follow when collecting and storing your information, however there are some circumstances that information can be disclosed.

You can ask your psychologist about how your information is collected, if anyone else will have access and under what circumstances. If your doctor sent you a referral, you can ask if your psychologist will share any information with them as well. You should know what your psychologist can collect from you and what information you consent to sharing with others.

You may also want to know what your psychologist believes will be helpful for your problem, how they will measure your improvement and if there are any topics you can’t discuss with them. Do they offer online appointments?

Always ask about the cost of an appointment and what happens if you cancel, before you book more sessions. 

How the First Appointment Ends

Your psychologist may reiterate what you’ve told them and ask if they have a correct understanding of your problem. If they haven’t, let them know and they can gather more information at your next session.

You can decide if you want to book another assessment, discuss goals and how often you’d like to see them. They may give you a small assignment to complete before your next session, such as becoming aware of when your problem occurs. Or you may want to continue your conversation at your next appointment.

You can always ask your psychologist what they recommend, or decide that you don’t want to book another session. Just know that you felt comfortable enough to ask questions and express what was making you unhappy.

Wrapping It Up

There’s a lot that can happen at your first appointment with a psychologist. You may not have everything you want to tell them, and they may need more time to understand what you’ve shared with them.

But now you know what to expect, you can decide if you want to proceed with further appointments.