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The Ultimate Guide to Preparing for Your First Therapy or Coaching Session

Updated: Oct 18

According to a recent poll by the Canadian Mental Health Association (CMHA), the number of people seeking mental health support in Canada has grown significantly.


A person preparing for their first therapy session with a laptop and a notebook and mouse

Despite this rise in people seeking mental health support, it’s completely normal to feel anxious or uncertain before your first therapy or coaching session. Many people wonder if they’ll be judged, whether they’re asking the “right” questions, or how to explain their concerns effectively.


You may also ask yourself:


  • What is the first coaching or therapy session?

  • Do I need to prepare for the first session?

  • What questions will a therapist or coach ask in this first consultation?

  • What questions can I ask a coach or therapist during the first consultation? 


To help you start your journey with therapy or coaching, Blue Sky Learning has created this guide to answer common questions about the initial coaching and therapy session and how to prepare for your first session.


What Happens During Your First Therapy or Coaching Session?


The first session with a therapist or coach is sometimes called the initial therapy or coaching consultation. During this session, you'll discuss various life challenges and neurotypes, such as:



The first session with a therapist serves as a basic conversation between you and your potential therapist. While it doesn't usually dive into deep traumas, it is an opportunity for both parties to learn if you are the right fit to work together.


This session aims to establish a strong therapeutic or coaching alliance or a relationship based on mutual respect, safety, and trust. 


If you feel anxious, you can let your therapist or coach know to your therapist or coach to help ease the process. Some practical strategies include:


  • Write down your concerns ahead of time.

  • Treat the conversation like a casual chat where you can be your authentic self without fear of judgment. 


  • Ask the therapist or coach questions as they arise, and don't feel pressured to share everything in the first session. 

  • Ask for breaks if the conversation feels overwhelming.

  • Use grounding exercises or deep breathing techniques during the session. Use this breathing GIF below.



At the end of the consultation, you should have clarity on your most pressing questions and whether the therapist or coach feels like the right fit for you. If your first session doesn't leave you feeling comfortable or aligned, it is acceptable to seek another coach or therapist.


Topics the Therapist or Coach Will Discuss


Being asked questions may invoke anxiety in some individuals. If you experience anxiety, it's important to let your therapist or coach know so they can help. To alleviate some of your anxiety regarding the potential topics up for discussion, Blue Sky Learning has compiled a list of possible topics.


  • Legal matters such as confidentiality: Therapists explain confidentiality rules to ensure you understand what information stays private, when disclosure might be required (e.g., risk of harm), and to build trust from the outset.

  • Cost and sliding scale options: Discussing fees and potential sliding scales upfront allows you to plan financially and ensures therapy is accessible without added stress.

  • Insurance coverage: Helps you understand what portion of the therapy may be reimbursed, preventing unexpected costs and ensuring financial clarity.

  • Waiting list length: Provides transparency on scheduling and helps manage expectations about when you can start sessions or receive additional services.

  • Location: Whether sessions will take place virtually or in person, this clarifies logistics so you can plan your environment and comfort level, which is especially important for privacy and accessibility.

  • Frequency and duration of therapy: Ensures you understand the recommended session schedule, helping to maintain continuity and maximize progress.

  • Goals for the sessions: Align expectations between you and your therapist, enabling a clear roadmap for progress and measurable outcomes.

  • Experience and the modalities used: Gives insight into the therapist’s training, expertise, and therapeutic approaches, helping you assess fit and comfort with their methods.

  • Potential need for referrals to external sources, including neurodivergent support groups or an ADHD diagnosis. This helps you access additional resources that may complement therapy, offering a more holistic approach to support.


These topics may vary depending on the specific coach or therapist, but most first therapy or coaching sessions include discussions on these.


Common Questions Asked in Your First Therapy or Coaching Session


There is no clear number of questions or a standardized questionnaire that all therapists or coaches will use. The questions will differ based on the individual approach of the therapist or coach, as well as your specific circumstances.


During the first session, if you encounter a question that feels uncomfortable, you can choose to revisit it after you have had some time to think. Remember, providing the therapist or coach with as much context as you are comfortable with will help them gain a more accurate understanding of your needs and whether they can support you effectively.


Although the questions will differ, here are some potential questions the therapist or coach may ask you during the consultation: 


  • What are your pronouns? 

    • Asking pronouns ensures that the therapist respects your gender identity and communicates appropriately, creating a safe and affirming environment.

  • What brings you here? 

    • Helps the therapist understand your primary concerns and the reasons you’re seeking support, setting the stage for a focused and relevant plan.

  • What are your goals for our sessions?

    • Clarifies what you hope to achieve, allowing the therapist to tailor strategies to your specific needs and track progress effectively. Try to determine your goals with this free therapy goals bank.

  • Have you attended therapy or coaching before?

    • Provides context about your prior experiences, what worked, what didn’t, and helps avoid repeating ineffective approaches.

  • What are you looking for in your sessions? 

    • Reveals your expectations and priorities, ensuring that the sessions are aligned with your personal needs. Discover potential reasons for going to therapy.

  • Do you have a formal diagnosis?

    • Allows the therapist to understand your mental health background and consider whether additional assessments or referrals might be needed.

  • Can you afford the therapy rate? Do you need a sliding scale? 

    • Ensures that financial constraints are addressed upfront so you can engage consistently without added stress.

  • What has helped you in the past?

    • Helps the therapist identify strategies, approaches, or tools that resonate with you and have proven effective previously.

  • How frequently would you like to come to sessions?

    • Determines scheduling needs and ensures the session frequency supports your goals and lifestyle.

  • Do you have insurance?

    • Confirms coverage details and whether financial assistance or reimbursement options can be considered.

  • Do you feel you have enough privacy for online sessions?

    • Ensures a safe, confidential environment, which is critical for open communication and trust.

  • What approaches have helped you in the past?

    • Provides insight into therapeutic techniques you respond to best, allowing the therapist to personalize their methods.

  • Do you have supportive people in your life?

    • Helps assess your support network and identify areas where additional resources or coping strategies may be needed.

  • What would you consider your strengths and areas for growth?

    • Offers a balanced understanding of your skills and challenges, helping the therapist guide you in leveraging strengths while addressing areas of difficulty. Try this free strengths-based therapy worksheet to familiarize yourself with your strengths.


The goal of the therapist or coach asking you questions is to get to know you and see if you are a fit for them as a client. If you are not a fit for their therapeutic approach, they ethically need to refer you to someone who does to get the care you need.


You can write down potential answers ahead of time. For example, when a therapist asks, “What brings you here?” you could describe a recent challenge at work, a recurring anxiety, or a long-standing pattern you want to address. This isn’t about perfect answers. It’s about giving your therapist enough context to support you effectively.


Questions You Should Ask Your Therapist or Coach


The coaching or therapy consultation is not just a chance for the therapist to get to know you, but it is also a chance for you to get to know that therapist better. The process of determining if the two of you can form a strong therapeutic alliance is collaborative, and you will have a chance here to determine if you feel it is a fit for you, too. 


There is no exhaustive list of questions to ask a therapist or coach in a session. Here are some questions you could ask: 


  • Could you share more about your practice? 

    • Helps you understand their areas of focus and whether they aligns with your needs.

  • What modalities or approaches are you trained in? 

    • Ensures you know what techniques they use and if they fit your learning style or goals.

  • What conditions or neurotypes are you trained in to provide support for? 

    • Confirms experience with ADHD, autism, or other neurodivergent identities.

  • Would you have to break confidentiality? If so, when? 

    • Clarifies limits of privacy and ensures you feel safe sharing sensitive information.

  • How frequently do you usually meet with clients? 

    • Helps plan scheduling and maintain consistent support.

  • What are your fees? Do you offer a sliding scale?

    • Ensures financial expectations align with your budget.

  • Do you offer support for neuroqueer individuals?

    • Ensures that your identity will be respected and understood, which is particularly important if you’ve experienced bias or misunderstanding. Feeling safe in your sessions helps you engage fully and build trust faster.

  • What are your policies around insurance and cancellation fees? 

    • Understanding financial logistics upfront avoids surprises later and helps you plan your sessions sustainably.

  • How should I prepare for our first session of working together after this consultation?

    • This clarifies expectations and ensures you arrive ready to make the most of your sessions. 

  • How would I know if our sessions together are working? 

    • Helps you set measurable goals and understand what progress looks like, so you can evaluate the effectiveness of your support.

  • Could you explain intersectionality to me? 

    • If your therapist is familiar with intersectionality, they can better appreciate how overlapping aspects of identity affect your experiences and challenges.

  • Do you have experience working with individuals with my identity and background? 

    • Confirms that your therapist or coach can provide culturally competent, inclusive, and relevant support.

  • I need to discuss my experiences with systemic discrimination. Are you comfortable discussing this topic, and do you have experience discussing systemic discrimination? 

    • Ensures you can address sensitive topics safely and that your lived experiences will be understood without bias.

  • Do you have a waitlist? If so, how long?

    • Helps manage expectations for starting therapy and plan interim support if needed.


Reflection: Take a moment to write down your top three priorities for your first session. Which concerns feel most urgent? Which are more long-term? This simple exercise can make your first session more focused and productive.


Closing Reflection Prompt


After reading this guide, take 5–10 minutes to jot down your expectations, questions, and anxieties about your first session. Doing this prep work can help you feel more in control and make the first session more effective. Even a few bullet points can help you enter your session feeling confident and organized.


You may also want to reflect on the feelings after the session to ascertain if the therapist or coach is the right fit for you. Consider questions like:


  • Do our schedules align? 

  • Have they worked with individuals with similar conditions or identities to mine?

  • Do I feel safe with them? 

  • Do I feel I could build trust with them? 

  • Do their fees and my ability to pay align? 

  • Are they covered by my insurance? 

  • Do our approaches to coaching or therapy align? 

  • Are they knowledgeable in the areas I need support in? 

  • Do I feel I can be myself around them? 

  • Do I feel supported, heard, and understood?


If you determine that the therapist or coach feels like a good fit, you can reach out to schedule your first official working session.


FAQs About the First Therapy or Coaching Session


How should I prepare for my first therapy or coaching session?

Prepare by listing your goals, any questions, and relevant medical or therapy history. Remember, the first session is about getting comfortable and building trust.

What if I feel anxious during my first session?

It’s normal to feel nervous. You can share your anxiety with your therapist or coach. They can help you feel more at ease with grounding techniques or accommodations.

Can I switch therapists or coaches if it doesn’t feel like a good fit?



Book a Free Consultation With Blue Sky Learning


Are you a neurodivergent individual in need of support from an ADHD coach, autism coach, AuDHD coach, or executive functioning coach? Blue Sky Learning is here to help.

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Book a free 20-minute consultation with one of Blue Sky Learning's team members by emailing hello@blueskylearning.ca or following the link below. You can also explore their biographies on Psychology Today to learn more about each therapist.




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