What happens in your first session with a psychologist

Before you sit down: forms and consent

Most practices send paperwork before the first appointment: a consent form and a short questionnaire about what is bringing you, your contact details, your GP, any medication and an emergency contact. The questionnaire is a starting point for the conversation, not a test; brief answers are fine.

The consent form matters more than it looks. It sets out how your information is handled, the fee and cancellation terms, what happens in an emergency and the limits of confidentiality. Under the Code of Health and Disability Services Consumers' Rights, a psychologist can only work with you if you have made an informed choice and given informed consent, so read it, and ask about anything unclear. You can withdraw consent later.

The night before, it can help to write down three things: an everyday example of the problem ("I check the door is locked eight or nine times, then drive back to check again"), roughly when it started, and what you would like to be different.

The first ten minutes

Expect introductions, a check that the room (or the video link) is private enough, and a short explanation of how the session will run. Your psychologist will usually explain confidentiality in plain terms: what you say stays between you, with the exceptions of a serious risk to your safety or someone else's, or a legal requirement such as a court order. They may mention that they discuss their work with a supervisor, usually without identifying you, which is a normal professional standard.

Then they will ask some version of "What's brought you here?" Say it however it comes out. "I don't really know, I just can't cope with things I used to cope with" is a complete and useful answer. Psychologists are used to people who are nervous, tearful or unsure where to begin, and the first few minutes are often the hardest part of the whole process.

The questions you are likely to be asked

The middle of the session is an assessment conversation. It is wide-ranging because the psychologist is trying to understand the whole picture rather than only the main problem. Common areas include:

• The problem itself: when it started, what makes it better or worse, how often it happens and what it stops you doing.
• Daily life: sleep, appetite, energy, work or study, relationships, alcohol and other substances.
• History: family, significant events, earlier periods of difficulty and anything that has helped before, including previous therapy.
• Health: physical conditions and current medication. A psychologist does not prescribe or adjust medication; that stays with your GP or psychiatrist, but they need to know what you take.
• Safety: questions about thoughts of self-harm or suicide are routine, asked of everyone, and asked calmly. Answering honestly helps your psychologist plan properly.
• Goals: what you want from therapy, which can be as concrete as "get back to driving on the motorway" or as broad as "stop feeling like this".

Some psychologists also use short standard questionnaires about mood or anxiety. These give a baseline so you can both see change over time.

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What you do not have to share

You set the pace. If a question goes somewhere you are not ready for, you can say "I'd rather not go into that yet" and a good psychologist will respect it and move on. This is especially true of trauma: a first session does not require you to describe what happened in detail, and for many treatments that detail is approached gradually, if at all, once you have agreed a plan.

You are also entitled to ask questions back. Right 6 of the Code gives you the right to information about your options, including the expected benefits, risks and costs. Reasonable things to ask: What approach would you use for this? How many sessions might it take? How will we know it is working? What happens if I am not improving?

And you can decide at the end that this psychologist is not the right fit. That is not rude; fit is one of the strongest predictors of how therapy goes, and psychologists know it.

Agreeing a plan

Towards the end, your psychologist will usually summarise what they have heard and offer an initial explanation, sometimes called a formulation, of what seems to be keeping the problem going. For someone with panic attacks, that might be the loop between noticing a racing heart, fearing collapse, and avoiding places where it has happened. For someone with low mood, it might be withdrawal that removes the very things that used to lift them.

From there you agree a plan: the approach (CBT, ERP, EMDR, ACT or another), a rough number of sessions to review at, how often you will meet, and whether there will be between-session practice. Plans change as you go, and you should expect to review them together rather than be locked in. If the psychologist thinks a different service would serve you better, such as your GP, a psychiatrist or a specialist programme, they should say so.

If your first session is online

A video first session follows the same shape. The differences are practical. Test your link, camera and microphone a few minutes early. Choose a room where you will not be overheard; a parked car, a bedroom with the door shut or a spare office all work, and headphones add privacy. Have water and tissues within reach. Tell anyone in the house that you are not to be interrupted for an hour.

If the connection drops, do not panic. Most practices will tell you in advance whether to rejoin the link, wait for a phone call or email, so you know the fallback before it is needed. Research comparing video and in-person therapy finds similar outcomes for most common problems; our guide on whether online therapy is effective goes into the evidence.

After the session, and what to expect at Mindwell

It is common to feel tired, lighter, raw or all three after a first session. You have said things out loud that may never have been said before. Give yourself a quiet hour if you can. Your psychologist writes brief clinical notes, which you have a right to access, and nothing is shared with anyone, including your GP or insurer, without your consent except where the law requires or allows it.

At Mindwell, booking triggers a confirmation email with your video link and calendar invite, and a separate email with a short intake form that takes about five minutes to complete: consent and a brief questionnaire. Sessions are 50 minutes by video through Carepatron, which runs in your browser with nothing to download. Your first session gathers history and goals and agrees a plan, and later sessions are typically weekly or fortnightly. You can pick a psychologist from our team or let us match you with whoever is free first; a first appointment is typically available within 7 days. We work with adults 18+ across New Zealand and are not a crisis service; if you need urgent help, call 111 or 1737.

Related support: How to choose a psychologist · Privacy and confidentiality online · Is online therapy effective? · How it works