What to expect in your first Thriveworks therapy session

What happens during your first session

Your first session will run about 60 minutes. Whether you’re meeting online or in person, the process is essentially the same. Here’s how it breaks down:

Step 1: Introductions and why you’re here

About 5 to 10 minutes

The first few minutes are about settling in with a warm welcome. Your provider will share a bit about themselves—their background, what they specialize in, and how they approach therapy—before turning the focus to you.

They’ll want to know what brought you in. What’s been bothering you? How long has it been going on? What made you decide now was the time to seek help?

It’s normal to feel like you could spend the next 50 minutes talking about what brought you to this moment. But don’t feel pressured to cover everything in the first few minutes. You’ll have plenty of time to go deeper later in the session and in the ones that follow.

If you don’t have a straightforward answer or if it feels hard to articulate, that’s completely normal. Your provider isn’t looking for a polished explanation. They just want to get a sense of what’s been going on and why you’re here now.

Step 2: Setting clear expectations

About 5 minutes

Before getting deeper into your story, your provider will cover some important administrative information. These guidelines establish clear expectations and ensure you’re both on the same page about how therapy works at Thriveworks. You’ll discuss:

Informed consent

You’ll sign a consent form in your account before your first session, and your provider will walk through the key points so you know what you’ve agreed to. That includes what therapy involves and your rights throughout your care: you can ask questions about your treatment or our policies anytime, and you can choose to stop therapy whenever you want.

Between-session support

Your provider will also explain how to reach them between sessions and what to do in an emergency. Thriveworks providers aren’t available 24/7, so if you’re ever in crisis, call or text 988 or go to your nearest emergency room.

Confidentiality

Next, your provider will explain that what you talk about is private within your care team. That means what you say may be shared with people involved in your care at Thriveworks and with billing and administrative teams, but it doesn’t go anywhere else without your permission.

There are a few exceptions. Your provider is legally required to share information in the following situations:

• Concerns about abuse or neglect
• Risk of serious harm to you or someone else
• Court orders requiring disclosure

If any of these come up, your provider will be open about what needs to happen as soon as it’s safe to do so.

Cancellation policy

Lastly, you’ll go over our cancellation policy so you know what to expect if you need to reschedule or miss a session. In short, we ask for 48 hours’ notice if you need to cancel or reschedule. Canceling less than 48 hours before your scheduled session (or not showing up) may result in a $135 fee.

Step 3: Understanding the full picture of who you are

About 30 to 35 minutes

Mental health doesn’t exist in a vacuum. It’s connected to your physical well-being, your relationships, and your past. That’s why your provider will work toward a deeper understanding of your whole self.

The clinical term for this step is a biopsychosocial assessment. But don’t expect an exam—it’s more like a discussion. Your provider will ask you a series of questions about all the different pieces that make you who you are, including:

• Medical history (and any current medications)
• Family background
• Close relationships
• Coping skills and positive activities that support you
• Substance use history
• Any major life events

You’ll also be asked about thoughts of suicide or self-harm. Be honest about what you’re experiencing. Sharing doesn’t mean you’re going to the hospital. It just means your provider is fully informed and can help you get the right support. If risk is identified, you’ll work together on a safety plan that’s best for your well-being.

Some questions might seem unrelated to why you’re here, leaving you wondering, “Why does that matter?” Keep in mind that these are general intake questions meant to give your provider a helpful overview of your situation, and your discussions in the future will be much more in depth and personalized.

Step 4: Defining your goals

About 5 to 10 minutes

Now that you and your provider have discussed what you’re currently experiencing, it’s time to talk about where you want to go and how you’ll get there.

To help define what you’re working toward, your provider might ask questions like:

• What are you hoping to get out of therapy?
• What would success in this process look like for you?
• What are you hoping will change in your life?

Over the coming sessions, you’ll work together to create an actionable plan for reaching your goals and learn how to measure progress along the way.

RELATED: How to set therapy goals you feel good about (with real examples)

Step 5: Wrapping up and next steps

About 5 minutes

Before your session ends, your provider will likely share an insight, coping skill, or homework exercise for you to work with until your next session. They may also share a potential diagnosis if they’ve formed one, but keep in mind that this is just a starting point and may evolve as you work together.

Your provider will also check in about how the session went for you. They’ll want to know if you felt comfortable and safe, and if this seems like a good fit. If anything didn’t land right or if you have concerns, this is your opportunity to voice them.

If it doesn’t feel like the right match, say so. Your provider knows fit matters for your progress and can help you find another therapist.

Finally, you’ll schedule your next session based on a frequency that you and your provider discuss. Then, after your session, you’ll receive an email confirming that next visit.

How to prepare for your first session

Getting ready for your first session doesn’t require much, but a few simple steps can help you feel calmer and get the most out of your time.

Fill out required forms

Your provider can’t begin the intake process until the consent form in your Thriveworks account is complete, so be sure to finish it before your session. Doing it ahead of time also means more of your session is spent in conversation.

If you’re an adult, you’ll also see a few short clinical questionnaires about your symptoms and what’s bringing you in. While completing these beforehand isn’t required, it helps give your therapist a fuller picture of where you’re starting from.

One more thing: We require an active form of payment on file to ensure smooth billing for your care. This applies to most patients, with the exception of Medicaid and certain referral sources.

Gather your thoughts

Before your first session, take a moment to reflect on:

• What’s been most challenging for you lately?
• What do you hope to accomplish or gain from therapy?
• What questions do you have for your therapist?

You don’t need to have perfect answers or a polished explanation. Just knowing what’s on your mind will help you make the most of your time.

Find a quiet, private space

If you’re meeting online, find a dedicated quiet space where you can have a private, uninterrupted conversation. The only requirement is that you cannot be in a moving vehicle during your session—we want you to be safe, undistracted, and fully present for the conversation, so plan to be somewhere stationary.

You’re ready for this

You already took the biggest step by reaching out for help, and now you know exactly what to expect from your first session. While the structure of this first visit is different from future ones, that’s by design to lay the necessary groundwork for healing to happen. Your provider will take it from here and, together, you’ll start to craft a clear path forward.

Frequently asked questions (FAQs)

How much of the first session is paperwork versus actually talking through what brought me in?

The bulk of your first session will be spent in conversation, not going over paperwork. You’ll complete any required forms beforehand in your Thriveworks account (we’ll send you email and text reminders). Your provider will also cover some required administrative information during the first session, such as confidentiality, cancellation, and other policies, but it’s a brief overview.

What if I don’t actually know what’s wrong or why I’m there?

You don’t have to have anything figured out when you come to your first session. Most people don’t walk in knowing exactly what’s wrong. They just know something feels off or they’re struggling, and that’s enough. Your provider is trained to ask questions that will help them understand what you’re experiencing and what you hope to get out of therapy. While not necessary, this straightforward guide about what to talk about in therapy can help if you like to feel more prepared.

Will my provider share anything about themselves?

Yes, but it will only be brief, purposeful information that gives you a sense of who they are. They might mention their background, what they specialize in, and how they approach therapy. But the focus of each therapy session will be on you, so they won’t spend too much time talking about themselves.

Will I get any actual help or tools on day one?

Your provider may present a coping skill, some insights about what you’re experiencing, or a resource to try. The goal is for you to leave with something concrete you can work with, though it varies by provider.

Will my provider offer a diagnosis?

Your provider will likely have some thoughts on what might be going on, and they may even offer a preliminary diagnosis. But therapy isn’t about handing you a diagnosis in the first hour, and a real understanding of what you’re going through can take a few sessions. Any initial impressions may shift as your provider gets to know you better.

Is everything I say confidential?

Almost everything you say is private within your care team at Thriveworks. There are a few exceptions where your provider is required to share information, mostly to keep someone safe. These include concerns about abuse or neglect, situations where someone is at risk of serious harm, and certain legal requirements like a court order.

How do we decide when and how often to meet going forward?

Your provider will recommend how often you should meet based on what’s needed to see progress with your goals. It depends on what you’re working on and what will be most effective for you. You’ll discuss this together and can always adjust along the way.

What if I don’t feel a connection with my provider? Can I switch without starting over?

Yes, you can switch providers anytime, and your current provider can help you find a better fit. If you’d rather not bring it up with them, call us and we’ll help you find someone who’s a great match. Your new therapist will typically do their own intake session so they can understand your situation through their own lens. However, some insurance plans only cover one intake session per year, so check with your insurance provider to confirm what your plan covers first.

Can you do therapy and take medication at the same time?

Yes. For some conditions, including depression, research shows combining talk therapy and medication is more effective than either treatment alone. At Thriveworks, you can do both in one provider network, so your therapist and psychiatric provider can work together.

Your therapist can refer you if they think medication could help, or you can book an initial psychiatric session on your own. If you’re just curious about whether medication might be right for you, that’s OK too. You can ask questions and get an expert perspective without committing.

If I’m a minor, will my therapist tell my parents everything?

No, not everything. Your provider will keep your parents informed about your progress and any important concerns, but they’ll also protect conversations that should stay confidential. If there’s a safety concern, your therapist will be open with you about what needs to be disclosed.

If I say I’m having suicidal thoughts, will I be sent to the hospital?

Sharing doesn’t automatically mean hospitalization. If you’re in immediate danger, yes, that’s where you need to be. But in most cases, your therapist’s goal is to help you get to a better place and prevent needing to go to the hospital. Being honest about what you’re experiencing helps your therapist give you the best support possible.

Why is the first session so different from regular therapy sessions?

The first session is structured differently because your provider needs to gather important information to create an informed care plan. It’s more of an information-gathering session, whereas future sessions will be more open-ended and focused on the actual therapeutic work.

How long do I have to be in therapy?

It depends on your goals and what you’re working through. Many people see meaningful progress within about 12 sessions, but it can be more or less depending on your specific needs. You and your therapist will discuss this and can adjust as you go.