What to Expect from Your First Therapy Session for Stress

What to Expect from Your First Therapy Session for Stress

Starting therapy can feel like a big step, especially if stress has been weighing you down for a while. Many people worry about what their first therapy session for stress will be like — Will it be awkward? What will the therapist ask? Should you bring anything?

This guide walks you through everything you need to know, from what stress actually is, to what an assessment may include, to the questions to ask your therapist so you feel more confident when you walk in.

Understanding Stress and Why Counselling Can Help

Stress is your body’s natural response to pressure. A little can be motivating, but constant or overwhelming stress can lead to headaches, poor sleep, irritability, and even physical health issues.

Different counselling techniques for stress can help you regain control:

• Cognitive Behavioural Therapy (CBT): Focuses on identifying unhelpful thought patterns and changing them.
• Person-centred counselling: Offers a safe, supportive space to talk openly about your experiences.
• Mindfulness-based therapy: Helps you stay grounded and calm when your mind is racing.
• Solution-focused approaches: Encourage practical problem-solving and goal setting.

Your therapist may use a blend of these methods, depending on your needs.

What Happens in Your First Therapy Session for Stress

Most first sessions are more of an assessment than a full counselling session. The therapist wants to understand your situation and how stress affects your life.

Common Assessments: CORE-OM

You may be asked to complete a questionnaire, such as the CORE-OM (Clinical Outcomes in Routine Evaluation – Outcome Measure). This asks about your feelings, daily functioning, and wellbeing. It helps establish a starting point so you and your therapist can measure progress over time.

Questions Your Therapist May Ask You

During the first meeting, expect open-ended questions like:

• When did stress begin to feel unmanageable?
• What situations make it worse?
• How is stress affecting your relationships, work, or health?
• What coping strategies have you tried so far?
• What would you like therapy to help you achieve?

They may also ask about your medical history, medication, or past counselling experiences. Remember — you don’t have to answer everything at once. Therapy goes at your pace.

Useful Questions to Ask Your Therapist

It’s just as important that you feel comfortable with your therapist. Here are good questions to ask your therapist in the first session:

• What qualifications and training do you have?
• Are you a member of a professional body such as BACP or UKCP?
• Do you have experience working with stress and anxiety clients?
• Do you hold professional insurance?
• What is your therapeutic approach?
• How many sessions do you usually recommend?

Asking these helps you feel reassured and makes sure you’re working with someone qualified and experienced.

What to Bring to Your First Therapy Session

You don’t need to bring much, but a few items can make things more comfortable:

• Water: Talking can be tiring, and staying hydrated helps.
• Fidget toys or a stress ball: Useful if you get restless or anxious.
• Notebook and pen: Jot down insights or things you want to remember.
• Tissues: Most therapists provide these, but it never hurts to be prepared.
• Grounding object: Something small like a stone or bracelet to help you feel steady.

These little things can ease nerves and help you settle into the space.

How the First Counselling Session Feels

Think of it as a cross between a relaxed chat and a structured interview. You’ll talk, your therapist will listen, and together you’ll start building a picture of what support you need.

It’s common to leave the first session feeling lighter, tired, or even a bit emotional. Don’t overthink whether you said “enough” or even “too much”— therapy is a process, and the first session is just the start.

Next Steps After Your First Therapy Session

At the end, your therapist will usually summarise what you’ve discussed and suggest a way forward. This might include:

• Booking regular weekly or fortnightly sessions.
• Setting initial goals to work towards.
• Recommending a different type of therapy if appropriate.

Remember, you are not tied to one therapist. If it doesn’t feel like the right fit, you can try someone else. Finding the right therapist is part of the journey.

Don't forget - ironically - your first therapy session may feel stressful! It may be helpful to give yourself some space, peace and quiet to process. This may also be a really useful routine to support your wellbeing after every session.

Key Takeaways

• Your first therapy session for stress is mainly about assessment and building trust.
• You may complete forms like the CORE-OM to measure your starting point.
• Be prepared to answer questions about your stress, but also ask your therapist about their qualifications, experience, and insurance.
• Bring small comforts like water, a notebook, or fidget toys to help you relax.
• Expect to feel a range of emotions afterwards and give yourself space to process— that’s normal.

Final Thoughts

Beginning therapy can feel daunting, but it’s also an important step in looking after your wellbeing. By knowing what to expect from your first therapy session, you can walk in feeling more confident and open to the process.

Stress doesn’t have to control your life. With the right therapist and techniques, counselling can give you the tools to manage stress, rebuild balance, and feel more in control again.

Written by Emilie Watson BA (Hons) MBACP