How Therapy Actually Works: What to Expect in Your First Few Sessions | Therapy in Richmond, VA

So you’re thinking about starting therapy. Maybe you’ve been sitting with the idea for a while, or maybe someone you trust finally nudged you in this direction. Either way, you’re here — and that already says something about your courage.

One of the biggest barriers to starting therapy isn’t finding a therapist or even making the call. It’s the unknown. What actually happens in a session? Will I have to lie on a couch and talk about my childhood? What if I cry? What if I don’t know what to say?

At Candor Therapy Network in Richmond, VA, we hear these questions all the time — and we love them. Because the more you understand about how therapy works, the more comfortable you’ll feel walking through the door (or logging into your virtual session). Let’s pull back the curtain.

Before Your First Session: What Happens Behind the Scenes

Therapy begins before you ever sit down with your therapist. Once you reach out and book a consultation, here’s what typically happens:

A brief intake process. You’ll fill out some paperwork — think of it like a getting-to-know-you form. This usually covers basic information about what brought you to therapy, your mental health history, and your goals. It helps your therapist prepare so you can hit the ground running.

Matching with a therapist. Not every therapist is the right fit for every person, and that’s okay. At Candor, our team includes therapists with a range of specialties — from anxiety and depression to couples therapy and teen counseling. We’ll connect you with someone whose expertise aligns with what you need.

Scheduling logistics. Whether you’re coming to our Richmond, VA office or connecting from anywhere in Virginia through secure telehealth, we’ll find a time that works for your life. Therapy shouldn’t feel like another stressor on your to-do list.

Your First Session: The Real Deal

Let’s be honest — the first session can feel a little awkward. That’s completely normal. Think of it like a first conversation with someone new. You’re both figuring each other out.

Here’s what a first session at Candor Therapy Network usually looks like:

Your therapist will ask questions — but you’re in control. They’ll want to understand what’s going on in your life, what’s been weighing on you, and what you’re hoping to get out of therapy. You don’t have to have all the answers. “I don’t really know, I just know something feels off” is a perfectly valid starting point.

There’s no pressure to dive deep right away. Your first session is about building a foundation. You’re not going to be asked to unpack your entire life story in 50 minutes. A good therapist understands that trust takes time.

You’ll talk about goals together. Therapy isn’t aimless talking. Together, you and your therapist will start sketching out what you want to work on. Maybe it’s managing anxiety that’s been keeping you up at night. Maybe it’s processing something from your past. Maybe you just want to feel more like yourself again. According to the American Psychological Association, setting clear goals early in therapy is one of the strongest predictors of positive outcomes.

You’ll get a sense of the vibe. The therapeutic relationship — the connection between you and your therapist — is the single most important factor in whether therapy works. If something doesn’t feel right, it’s okay to say so. We’d rather help you find the right fit than have you give up on therapy altogether.

Sessions Two Through Five: Where the Work Begins

If the first session is about setting the stage, sessions two through five are where you start building momentum. Here’s what that might look like:

Identifying patterns. Your therapist will help you start noticing the thoughts, feelings, and behaviors that show up repeatedly in your life. Maybe you realize that your anxiety spikes every Sunday night, or that you tend to shut down during conflict. These patterns aren’t flaws — they’re clues.

Learning new tools. Depending on your needs, your therapist might introduce coping strategies, grounding techniques, or new ways of thinking about old problems. Research from the National Institute of Mental Health shows that evidence-based approaches like cognitive behavioral therapy (CBT) can produce meaningful changes in just a few weeks.

Building the relationship. Trust doesn’t happen overnight. Over these early sessions, you’ll likely start feeling more comfortable being honest and vulnerable. That’s when the real magic happens.

Checking in on progress. A good therapist doesn’t just talk at you — they check in. How are you feeling about the work? Is anything not landing? Your feedback shapes the direction of your therapy. You’re not a passive participant; you’re a collaborator.

Common Myths About Starting Therapy (and the Truth)

“Therapy is only for people with serious problems.” Not even close. Therapy is for anyone who wants to understand themselves better, navigate a life transition, or just feel less stuck. You don’t need a crisis to deserve support.

“I should feel better after the first session.” Some people do. Some people feel emotionally stirred up. Both are normal. Therapy is a process, not a quick fix. Give yourself grace.

“My therapist is going to judge me.” Therapists are trained to hold space without judgment. At Candor, our team creates an environment where you can be fully yourself — the messy, complicated, real version of you.

“Virtual therapy can’t be as effective.” Research consistently shows that telehealth therapy produces outcomes comparable to in-person sessions. Whether you’re in Richmond or anywhere across Virginia, virtual sessions can be just as powerful.

How to Get the Most Out of Your Early Sessions

Be honest. Your therapist can only work with what you give them. You don’t have to share everything at once, but try to be as open as you can.

Show up consistently. Therapy works best when you commit to the process. Weekly sessions build momentum in a way that sporadic appointments can’t.

Reflect between sessions. Pay attention to what comes up during the week. Jot down notes, notice your patterns, and bring those observations to your next session.

Ask questions. Curious about why your therapist suggested something? Want to know more about a technique? Ask. Therapy is a partnership, and the best partnerships have open communication.

Frequently Asked Questions

What should I talk about in my first therapy session?

You can start wherever feels right. Most therapists will guide the conversation by asking about what brought you to therapy, your current stressors, and what you’re hoping to work on. There’s no wrong answer, and you don’t need to prepare a script. Check out our FAQ page for more details on getting started.

How long does it take for therapy to start working?

It depends on the person and what you’re working through. Some people notice shifts within the first few sessions, while deeper patterns may take longer to address. The important thing is that therapy is collaborative — you and your therapist will regularly check in on your progress and adjust as needed.

Does Candor Therapy Network offer therapy for first-time clients in Richmond, VA?

Absolutely. Many of the people who reach out to us are starting therapy for the very first time. Our therapists in Richmond, VA are experienced in meeting you where you are and making the process feel approachable and comfortable from day one.

Can I do therapy virtually if I live outside Richmond?

Yes. Candor Therapy Network serves all of Virginia through secure, HIPAA-compliant telehealth. Whether you’re in Northern Virginia, Hampton Roads, or a rural community, you can access the same quality care from the comfort of your home.

How do I know if my therapist is a good fit?

Trust your gut. Do you feel heard? Do you feel comfortable being honest? A strong therapeutic relationship is built on connection and trust. If something feels off after a few sessions, it’s okay to have that conversation with your therapist or explore other options on our team.

Ready to Start? We’re Here When You Are.

Starting therapy is one of the most meaningful things you can do for yourself — and you don’t have to figure it out alone. At Candor Therapy Network in Richmond, VA, we make the first step as easy as possible. Whether you want to come in person or connect virtually from anywhere in Virginia, we’ll meet you where you are.

Book your free consultation today and find out what therapy can look like for you.