What Do I Talk About in My First Therapy Session?

You’ve taken the leap and, after an introductory call/email, you've booked your first therapy session. This may have come after weeks (or months) of thinking about it. And now the worry kicks in:

What am I supposed to say? Do I need to prepare? What if I go blank?

These thoughts before your first session are completely normal. As a therapist who specialises in working with socially anxious adults, I want to gently reassure you: your first therapy session isn’t a test. There’s no script. And you don’t have to say anything perfectly.

In this blog, I’ll walk you through what to expect in a first session, what you might talk about, and why it’s okay to just show up as you are.

First of All: You Don’t Need to Prepare

Let’s get this out of the way: you don’t need to come to your first therapy session with a perfectly organised list of 'problems'. You’re not expected to explain your life story in 50 minutes or figure everything out right away.

Your job is simply to be there. My job as your therapist is to create a space that feels safe enough for you to begin exploring, at your pace.

What Can I Talk About in My First Therapy Session?

The short answer? Whatever feels most present for you.

Here are some things that many people bring into a first session - especially those struggling with social anxiety, low self-esteem or self-doubt:

• “I overthink everything I say.”

• “I struggle to make or keep friends.”

• “I avoid social situations but feel lonely.”

• “I feel like everyone’s judging me.”

• “I don’t feel like I’m enough.”

• “I want to feel more confident—but I don’t know how.”

  
  

You might not have clear “goals”, and that’s okay. You don’t need to know exactly what you want from therapy on day one (or ever to be honest!). Often, one of the first things we work on is helping you feel more comfortable being seen and heard, especially if that’s something you’ve been avoiding for years.

Silence Is Okay and Welcomed

You can talk as little or as much as you want. Silence is okay. Rambling is okay. Emotion is okay. Avoidance is okay, too.

It's likely that at some point in the first session, you don't know what to say. And you may notice that your therapist doesn't 'rescue' you from the discomfort of the silence. They may stay silent too. What comes up for you in silences is often very meaningful, it's important to allow it - even if it feels awkward! (Your therapist won't feel awkward by the way so you don't need to 'rescue' them either!!)

What If I Feel Awkward or Embarrassed?

It’s completely normal to feel awkward in your first session. Therapy is a very rare and unfamiliar experience.

Therapy asks you to do something we’re not usually taught how to do: be emotionally honest in front of another person, without having to perform, explain, or apologise.

It's also all about you, and you're probably used to trying your best to avoid that at all costs.

So yes, it might feel exposing or strange at first. That’s not a sign you’re doing it wrong - it’s a sign you’re doing something new.

My role is to help you feel less alone in that awkwardness. To create a space where you can start saying the things you’ve never had the words-or safety- to say.

Therapy Is a Space, Not a Performance

If you’ve spent your life trying not to take up space, or fearing you’ll say the wrong thing, therapy can feel like a big shift.

But it can also be one of the few places where you don’t have to overthink everything. Where you don’t have to be interesting or put together or “easy to like.” You can just be.

And gradually, that permission can begin to ripple into the rest of your life.

So, what do you talk about in your first therapy session?

Whatever’s on your mind. However it comes out. However unsure or messy or guarded it feels.

You don’t have to impress me. You don’t have to be brave in a big way. Just being there is enough.

Ready to Begin?

If you’re feeling socially anxious, uncertain, or stuck, I offer therapy designed with sensitivity and gentleness in mind.

• Video therapy - from the comfort of your own space but still with real-time interaction

• Email therapy - for those who feel safer processing through writing and maybe want longer to respond and gather your thoughts.

  
  

📩 If you’re ready to explore what therapy might look like for you, get in touch. There’s space for all of you- the quiet parts, the uncertain parts, and the parts that don’t know where to begin.

Warmly,

Laura