Starting therapy is a huge and brave move. You might have questions like:

• Will it benefit you?
• Will it be uncomfortable in the start?
• And what do you do when you can’t really think of anything to say?

Such type of a combination of curiosity, hope, and nervousness affects a lot of people before their very first session.
Your first month in therapy lays the groundwork for everything ahead. It’s a time for discovery, getting comfortable, and beginning to build trust. 
Those first weeks are really about starting to understand yourself.
Here’s what you can truly expect in your first month.

The First Session

Your initial visit to the therapy session will normally be a combination of relief and apprehension. 
Your therapist will be there to guide you through those early conversations. 
They are aware that trust cannot be built in a night, that trust should be built slowly.
 Your therapist will:

• Ask about your background and experiences
• Invite you to share what’s bringing you in
• Go over your hopes or goals, even if they aren’t crystal clear yet
• Explain their approach, so you know what to expect (see more about therapy types)
• Follow up on your well-being

It is also normal to be nervous, be silent, or even cry during your first visit. 

Week Two

By your second session, the most awkward bits have faded.

In week two, you could notice a mix of feelings. You might be hopeful or, sometimes, have second thoughts. 

Maybe part of you wants to see results right away, while another part wishes you didn’t have to talk about feelings at all. Trust that all of this is normal and allowed.

Around this time, your therapist may:

• Refer back to your first conversation, which made you feel seen
• Begin helping you spot patterns in how you think, feel, or react
• Recommend simple grounding exercises or strategies (for more about this approach, read How Mindfulness-Based Therapy Helps You)
• Check in about your comfort with the process and adjust as needed

Your therapist is there to support you however you show up.

Weeks Three and Four

As you slip into weeks three and four, therapy begins to feel less like an experiment and more like a familiar routine.
The early nerves give way to the beginnings of trust and real self-reflection.
You might experience:

• More natural, flowing conversations, less “interview,” more dialogue
• Your therapist remembering key details, which helps you feel valued
• New connections between your past and your present struggles
• Glimmers of insight, sometimes when you least expect them
• Some discomfort as you touch on sensitive topics

At this stage, it’s common to start noticing the growing pains of therapy. Old ways of coping may be challenged.
You might find it’s tough to talk openly about certain things, or you may start to question your patterns for the first time.
But this is often when real change begins.

Sometimes you’ll talk through a difficult memory, and other times you may simply sit with your feelings. It’s all valuable and all part of your healing process.

Common First-Month Experiences

The Emotional Rollercoaster

Therapy shakes things up. Many people feel a little more fragile, sensitive, or even worse before they feel better. 
It means you’re beginning to touch real, meaningful places within yourself. The hardest weeks are actually signs of progress.
This might look like:

• Emotional ups and downs, or feeling caught off guard by new feelings
• Dreams or thoughts about issues you discuss in session
• Feeling raw, tired, or exposed after appointments
• Moments of clarity that arrive in the middle of an ordinary day
• Motivation for therapy that comes and goes week by week

Adjusting to Practical Realities

Beyond the feelings, there’s also the nitty-gritty routine:

• Consistency: Figuring out a session time you can stick with
• Logistics: Managing directions, parking, telehealth links, payments and reminders
• Boundaries: Deciding when you’re ready to share and when you need to hold back
• Homework: Sometimes your therapist may offer exercises or tools for you to try (curious about mindfulness practices? Learn more here)
• Self-care: Tuning in to your needs after vulnerable appointments

Building Trust and Rapport

The relationship you build with your therapist is unlike any other. You’re both getting to know how to speak the same language.
They’re learning about your communication style, triggers, and strengths. You’re learning whether you feel understood and respected.
Signs that the fit is good:

• You feel comfortable being open, even if you’re still a little nervous
• There are moments when it feels like your therapist “gets” you
• You look forward to at least some part of your therapy day
• You walk away feeling supported

If the connection feels off or if something makes you uncomfortable, it’s okay to talk about it. Many people face old patterns from previous relationships right there in the therapy space. 

A few red flags that deserve attention:

• Feeling misunderstood most of the time
• Noticing your therapist seems checked out or distracted
• Being pressured to talk about things before you’re ready
• Feeling judged, dismissed, or just completely unsupported

Finding the right therapist sometimes takes a bit of trial and error—trust your gut and speak up.

What Progress Looks Like

Don’t believe everything you see in the movies. Therapy breakthroughs usually aren’t dramatic “aha!” moments. Instead, progress creeps in quietly.

During your first month, positive change might mean:

• Noticing new awareness about your thoughts or reactions
• Sleeping a little more soundly after getting worries out in the open
• Feeling less alone, simply because you finally said something out loud
• Beginning to describe your emotions, rather than just feeling off
• Taking positive steps like sending an honest text, saying no, and asking for support

Progress often looks like little shifts in understanding or moments of self-kindness rather than huge leaps.

Keeping your Expectations and Being Committed

This initial phase is not really focused on the outcome, but rather on developing habits and trust. 

Keep in mind:

• Give It Time: Even little differences during your first month are a victory. The majority of them require many months to transform profoundly.
• Be Direct: State the unpleasant, perplexing or just plain strange about therapy. It aids you and your therapist in developing.
• Watch for Small Signs: A little less anxiety, an easier day, or one deeper breath.
• Stick with It: Cancellations can disrupt your momentum. Try to prioritize your standing appointment.

Many people at Doria Therapeutic Group discover parts of themselves they never noticed before.

Beyond Individual Sessions

By the end of the first month, you might be curious about options beyond one-on-one work. 
If you’ve ever longed for others who get it, group therapy can be a powerful way to feel less alone.
Are family relationships part of your story? 
Read on to learn how family therapy can help you form healthy boundaries and improve communication between family members

Preparing for Month Two and Beyond

As month one ends, you’ll probably know much more about what you need: deeper healing, new coping skills, or perhaps new therapeutic goals. You may be ready to:

• Tackle specific issues that came up during early sessions
• Develop and practice coping techniques as life throws challenges your way
• Deepen your exploration into old patterns that no longer serve you
• Set clear, meaningful goals for your own progress

Bringing curiosity and honesty along with you will help you get the most out of each step.

Book Your First Session Today

Showing up for that first month is, in itself, an act of courage, a true sign you’re invested in your well-being. 
At Doria Therapeutic Group, PLLC, our sensitive, trained and experienced therapists understand how daunting this start can be.
Our goal is to ensure that your initial month is nurturing and fruitful.

Contact Doria Therapeutic Group, PLLC, to book a first appointment.

FAQ

What should I expect in my first therapy session? 

Your first session is mostly about:

• Introductions
• Setting goals
• Filling out basic paperwork

 It’s about getting comfortable and learning what brought you to therapy; deep discussions often come later.

What is a red flag in therapy? 

• Ongoing judgment
• Therapist oversharing
• Pressure to talk about topics you’re not ready for
• A therapist who is distracted or dismissive