What actually happens in a first therapy session

A lot of people put off starting therapy because they do not know what to expect. Here is what my initial consultations look like, step by step.

The initial consultation is 50 minutes, either in my clinic room near Clapham Common or on a secure video call. It is a chance for both of us to decide whether working together makes sense, and there is no obligation to book further sessions.

Before we meet

You will receive a short form asking what has brought you to therapy, any previous support you have had, and your GP details. You can write as much or as little as you like. Some people write a page; some write a single line. Both are fine.

In the room

I start by explaining confidentiality and its limits, so you know exactly what stays between us. Then I will ask what has been happening, how long it has been going on, and what you would like to be different. You do not need to have the words ready. Part of my job is to help find them.

Towards the end I will share how I understand what you have told me and suggest a way forward: usually a number of weekly sessions with a review point, sometimes a referral to a service that is a better fit. If I am not the right person for you, I will say so and help you find someone who is.

Please note that I am not an emergency service. If you are in crisis or worried about your safety, call NHS 111, contact Samaritans free on 116 123 at any time, or go to your nearest A&E.