Updated on January 26, 2026
You spent 20 minutes sitting in your car before your first therapy session, trying to figure out what to say. Or maybe you walked in with a script, only to have your mind go completely blank the moment you sat down.
If that sounds familiar, you’re in good company. A lot of people arrive at their first therapy appointment wondering if they’re doing it “right” or if their problems are even big enough to warrant being there. The truth? There’s no perfect way to start therapy, and you don’t need to have everything figured out before you walk through the door.
Therapy works when you show up as yourself, even if that means showing up uncertain, scared, or not entirely sure what you need. Whether you’re considering individual therapy for the first time or you’ve tried it before and want to get more from the experience, here’s what actually helps.
Your First Therapy Session
Your first therapy session will probably feel a bit like a structured conversation as you get to know each other. Most therapists start by asking what brought you in and what you’re hoping to get from therapy. Some will have you fill out intake forms or questionnaires beforehand to get basic information about your mental health history.
You might talk about what’s been hard lately, patterns you’ve noticed, or specific situations that feel overwhelming. Your therapist will likely ask follow-up questions to understand your background, relationships, and what you’ve already tried on your own.
Here’s what catches people off guard: you don’t have to tell your whole life story in the first session. If your therapist asks about your childhood and you’re not ready to go there yet, it’s completely fine to say, “I’d rather talk about what’s happening now.” A good therapist will follow your lead.
What About Intake Sessions and Paperwork?
Before your first therapy appointment, you’ll probably receive intake forms asking about your mental health history, current medications, emergency contacts, and what brings you to therapy. These help your clinician understand your background and any immediate concerns.
Some therapists use the first session as a formal intake session focused mainly on gathering information. Others blend the intake process into a regular conversation. Either way, this isn’t wasted time. It’s how your therapist starts building a picture of who you are and what you need.
The Therapeutic Relationship
Research on psychotherapy shows that the therapeutic relationship is one of the strongest predictors of whether therapy works. This means the connection you have with your therapist matters more than the specific type of therapy they practice, at least at the start.
A good fit feels like being understood without having to explain every detail. You leave sessions feeling like someone actually gets what you’re going through. You don’t dread appointments, even when the topics are hard.
A bad fit feels like you’re performing or editing yourself. You leave feeling frustrated, misunderstood, or like you’re not making progress after several sessions.
If something feels off after three or four sessions, trust that feeling. It doesn’t mean you’re failing at therapy or that the therapist is bad at their job. It just means you need a different match. Finding the right therapist sometimes takes a few tries, and that’s completely normal.
What Makes a Good Therapist for You?
A good therapist should have training in evidence-based approaches like Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), or EMDR, depending on what you’re working on. But credentials are just the starting point.
What matters more is whether they:
- Ask questions that help you see things differently
- Make space for your actual feelings instead of rushing to solutions
- Remember the details you mentioned weeks ago
- Adjust their approach when something isn’t working
- Create a space where you can be honest without feeling judged
What Happens Between the First Time and Long-Term Work
After the first few sessions, therapy typically settles into a rhythm. You and your therapist will likely develop a treatment plan, which is really just an agreement about what you’re working on and how you’ll know if it’s helping.
This might look like:
- Specific goals (“I want to feel less anxious in social situations”)
- Skills to practice (“We’ll work on techniques for managing panic attacks”)
- Patterns to explore (“Let’s look at why you shut down during conflict”)
The plan isn’t set in stone. As you learn more about yourself, it will probably shift.
Between Sessions: Where the Real Work Happens
Therapy isn’t just the 50 minutes you spend in the room. What happens between sessions is where much of the personal growth actually occurs.
Your therapist might suggest trying something small during the week, noticing when certain feelings come up, or practicing a skill you discussed. This isn’t homework in the school sense. It’s you taking what you learned and seeing how it applies to your daily life.
Some people keep a journal. Others just pay attention differently. The key is engaging with the process outside the session, even in small ways.
Types of Therapy
Different types of therapy work better for different mental health issues and different people. Here are some common approaches:
Cognitive Behavioral Therapy (CBT) helps you identify thought patterns that aren’t serving you and develop more helpful ways of thinking. It’s one of the most researched and evidence-based approaches, especially for anxiety and depression.
Dialectical Behavior Therapy (DBT) focuses on emotional regulation, distress tolerance, and interpersonal skills. It was originally developed for borderline personality disorder, but it helps with a range of mental health conditions.
EMDR (Eye Movement Desensitization and Reprocessing) is designed to help process trauma and disturbing memories. It uses bilateral stimulation (like eye movements) while you recall difficult experiences.
Talk therapy (also called psychodynamic therapy) explores how past experiences shape current patterns. It’s less structured and more focused on insight and understanding.
Most therapists don’t stick to just one approach. A good psychotherapist will pull from different methods depending on what you need. Some sessions might feel very practical and skill-focused. Others might involve deeper exploration of patterns and emotions.
Making Therapy Work
Be Honest, Even When It’s Uncomfortable
The sessions that feel the most uncomfortable are often the ones where real change happens. If you notice yourself avoiding certain topics, that’s usually a sign that those topics matter.
You don’t have to force yourself before you’re ready, but when you do take the step to talk about the hard stuff, it typically opens something up. Your therapist is trained to handle whatever you bring.
Give Feedback About What’s Working (or Not)
If something your therapist said didn’t sit right, tell them. If an approach they suggested feels wrong for you, speak up. Therapy is collaborative, and your feedback helps shape it into something that actually fits.
You might say: “That exercise you gave me last week didn’t really work. Can we try something different?” or “I appreciate what you’re saying, but I need more direct advice right now.”
A new therapist might not yet know your preferences. Telling them helps them better understand how to support you.
Show Up Even When You Don’t Feel Like It
There will be weeks when you want to cancel because nothing dramatic happened, or because you feel “fine” and don’t think you have anything to talk about. Go anyway.
The sessions where you think you have nothing to say often turn out to be surprisingly useful. Your therapist can help you see patterns you’re missing or ask questions that reveal things you didn’t realize you were carrying.
Let Go of Performing
It’s easy to fall into presenting a polished version of yourself in therapy. You might downplay how bad things are, make jokes to deflect, or spend the whole session talking about other people’s problems instead of your own.
Your therapist isn’t there to judge you. They’re there to understand what’s really happening so they can help. The more honest you can be, the more effective therapy becomes.
What Therapy Can’t Do (And What It Can)
Therapy won’t fix everything instantly. It won’t make difficult relationships suddenly easy or erase painful experiences. It can’t give you a new personality or solve problems that require practical action (like leaving a bad job or ending a toxic relationship).
What therapy can do:
- Help you understand why you respond to situations the way you do
- Teach you skills for managing difficult emotions
- Give you space to process grief, trauma, or major life changes
- Help you recognize patterns that aren’t serving you
- Support you in making decisions that align with who you want to be
- Improve your relationships by helping you communicate more clearly and set boundaries
Therapy supports your well-being and mental health care, but you’re still the one doing the work of living your life.
When Therapy Isn’t Helping
Sometimes therapy stalls. You’ve been going for months, but you’re not sure anything is actually changing. This can happen for a few reasons:
You’re not bringing up what really matters. Maybe you spend every session talking about surface-level stress but avoid the deeper fears or hurts beneath the surface.
The approach isn’t right for your needs. Some mental health conditions respond better to specific types of therapy. If you’ve been doing talk therapy for depression and not seeing improvement, it might be worth trying CBT or exploring whether medication could help.
You and your therapist aren’t a good match. Sometimes the fit just isn’t there, and that’s okay.
You’re ready to take a break. Not everyone needs to be in therapy continuously. It’s fine to step away when you’ve made progress and come back later if you need support again.
If therapy isn’t helping, talk to your therapist about it. A licensed therapist or psychotherapist will want to know if you’re not finding the sessions useful, and they can help you figure out what to adjust or whether a referral to someone else makes sense.
Practical Things That Make Sessions Easier
Come a few minutes early to your first session. This gives you time to settle in, fill out any last-minute paperwork, and not feel rushed.
Think about what you want to focus on before each session. You don’t need a rigid agenda, but having a general sense of “I want to talk about the fight I had with my partner” or “I’ve been really anxious this week” helps you make the most of the time.
Be honest about what you can commit to between sessions. If your therapist suggests something that feels overwhelming, say so. Therapy should stretch you a bit, but it shouldn’t add more stress to your daily life.
Ask questions when you don’t understand something. If your therapist uses jargon or references a concept you’re not familiar with, ask them to explain. Good mental health care should be accessible, not confusing.
Finding the Right Therapist in Austin
If you’re looking for a therapist in Austin, think about what matters most to you. Do you want someone who specializes in trauma, anxiety, or relationship issues? Do you prefer in-person therapy, or are you open to teletherapy?
At Firefly Therapy Austin, our therapists work with anxiety, depression, trauma, relationship challenges, and life transitions. We use evidence-based approaches like CBT, EMDR, and Acceptance and Commitment Therapy, and we tailor our approach to what actually fits for you.
We offer both in-person sessions and online therapy options. If you’re not sure where to start or whether therapy is right for you, we’d be happy to talk through your questions.
You Don’t Have to Have It All Figured Out
The hardest part of therapy is often just starting. You don’t need to know exactly what you want to work on or have a clear treatment plan before you walk in. You just need to be willing to show up and be honest about what’s hard.
Therapy works when you give it space to work. That means showing up consistently, being as honest as you can manage, and trusting that even when sessions feel messy or unclear, something is shifting underneath.
You deserve support. You don’t have to earn your way into therapy with a crisis or wait until things are unbearable. Wanting to feel better, understand yourself more, or navigate life with less struggle is reason enough to start.