What to Expect in Your First Session with a Therapist for Severe Depression
- pritampaul055
- 1 day ago
- 3 min read

Starting therapy can feel intimidating—especially if you’re dealing with the weight of severe depression. You might worry about what to say, how much to share, or whether it will actually help. But the first session with a therapist for severe depression is designed to be a gentle, supportive introduction to your mental health journey.
This blog will walk you through what to expect, so you feel more at ease taking that important first step toward healing.
1. Before the Session: Setting the Stage
Once you’ve booked your appointment, your therapist may send you an intake form. This usually includes basic questions about your mental health history, current symptoms, medications (if any), and any specific goals or concerns.
Filling this in before the session helps your therapist get a general idea of your background so they can better tailor their approach from the start.
2. A Warm Welcome and Building Trust
The first session is all about creating a safe, non-judgmental space. Your therapist will likely begin by introducing themselves and explaining how therapy works, including confidentiality and your rights as a client.
You don’t need to “perform” or worry about saying the right things. There’s no pressure to dive into your deepest feelings right away. The goal is simply to start building trust.
3. Talking About What Brought You Here
Expect some gentle questions such as:
How long have you been feeling this way?
What symptoms are most challenging for you?
Have you experienced this before?
How is it affecting your day-to-day life?
You are always in control of what you share. If something feels too overwhelming to talk about, it’s okay to say so. Over time, as you feel safer, the deeper conversations will come naturally.
4. Understanding Your Unique Needs
Everyone’s experience of depression is different. For some, it might feel like a constant heaviness. For others, it may be a loss of interest in life, frequent fatigue, or difficulty connecting with others. Your therapist will help you explore how depression is specifically impacting you.
This session is also a chance for you to ask questions—whether about their approach, experience with depression, or anything else you’d like to know.
5. Exploring Therapy Goals and Next Steps
Once your therapist has a clearer picture of your struggles, they’ll help you identify some early goals for therapy. These might include:
Managing overwhelming thoughts
Reducing social withdrawal
Developing healthier coping mechanisms
Improving self-worth
If you’re also struggling with anxiety or work-related pressure, your therapist may incorporate techniques used by stress management therapists to help you manage these issues in parallel.
6. Setting Expectations and Frequency
You’ll also discuss how often sessions should take place—usually weekly to begin with—and the type of therapy that might be used. This could include Cognitive Behavioural Therapy (CBT), person-centred therapy, or psychodynamic therapy, depending on your needs.
Consistency is key. Therapy is not a quick fix, but regular sessions will help you begin to notice shifts in how you think and feel.
7. Therapy Beyond Depression
Often, severe depression can be accompanied by low self-esteem or unresolved trauma. If this is the case, your therapist may take an integrated approach. For instance, some therapists are also trained as self esteem therapists, helping clients build inner confidence while working through depressive symptoms.
This holistic view can be especially beneficial in long-term recovery.
Final Thoughts
Your first session with a therapist for severe depression isn’t about finding all the answers—it’s about taking the first step toward healing. It’s perfectly okay to feel nervous or unsure. What matters most is that you’ve decided to seek help, and that choice alone is a powerful act of self-care.
Therapy is a journey, and every journey begins with one step. That first conversation could be the beginning of a stronger, more resilient you.
If you're ready to explore how therapy can support you, don’t hesitate to reach out. Help is closer than you think.
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