How long is the first therapy session?

The first session is typically one hour, structured into an opening framework-setting phase (around ten minutes), a substantial assessment phase (around thirty-five to forty minutes), and a closing direction-setting phase (around ten to fifteen minutes).

Will I receive a diagnosis in my first therapy session?

Not typically. The first session establishes a working clinical formulation. Where formal diagnosis is clinically appropriate, it often requires further sessions or specific assessment instruments. Adult ADHD and autism assessments at Behavioural Edge Psychology are conducted as separate, longer assessment processes using validated instruments such as the DIVA-5 and MIGDAS-2.

Do I need a referral from my GP?

You do not need a referral to see a psychologist privately. If you wish to access a Medicare rebate, you will need a Mental Health Treatment Plan (MHTP) from your GP, which supports up to ten individual psychology sessions per calendar year. NDIS, WorkCover, and TAC clients access psychology services through their respective funding frameworks.

What if I am not ready to talk about everything in the first session?

You set the pace. If a topic is too painful or you are not ready to discuss it, you can say so and the work will come back to it later. Setting the pace and choosing what is brought into the room is part of how the therapeutic relationship works.

Where are appointments held?

Consulting rooms are in Caulfield South and St Kilda. Telehealth is available across Victoria for clients whose schedules or location make in-person attendance impractical.

What to Expect in Your First Therapy Session

Sarah Fischer
May 12
5 min read

A practical guide to your first appointment at Behavioural Edge Psychology

The first therapy session at Behavioural Edge Psychology in Caulfield South and St Kilda follows a structured format. The opening ten minutes covers confidentiality, the therapist’s approach, and any practical questions. The substantial middle part is structured assessment, drawing out the presenting concern, relevant history, support systems, and previous therapy experience. The closing fifteen minutes is collaborative direction-setting, including initial impressions, a proposed therapeutic approach, and the recommended frequency of sessions. The session does not typically produce a final diagnosis, which often requires further assessment, and is not designed to solve the presenting problem in a single hour. The quality of the early therapeutic alliance is among the strongest predictors of therapy outcomes (Norcross & Lambert, 2018).

Starting therapy is a step that often involves a mix of relief and apprehension. People want to know what will actually happen in the room. They want to know whether they will be expected to share everything in the first hour, what the structure of the session will look like, and how to tell whether the work is going to suit them. This guide answers those questions for clients coming to Behavioural Edge Psychology for the first time about what to expect in your first therapy session.

Comfortable therapy room with a couch and plants, accompanying a blog post about what to expect in your first session at Behavioural Edge Psychology

Before your appointment

A few practical things happen before the first session, designed to make the time we spend together as useful as possible.

You will receive intake forms by email after booking. These cover basic contact details, consent to treatment, and a few questions about your reasons for seeking therapy and any relevant clinical history. Completing them before the appointment saves time and gives me a head start on understanding your situation.

If you are attending under a Mental Health Treatment Plan (MHTP) from your GP, please email a copy of the plan and the referral letter ahead of the appointment, or bring them with you. NDIS, WorkCover, and TAC clients should bring relevant approval documents.

Consulting rooms are in Caulfield South and St Kilda. Telehealth is available across Victoria. If you are attending in person, allow five to ten minutes to settle in. If you are joining by telehealth, find a private and reasonably quiet space where you will not be interrupted, and check your audio and camera in advance.

The first ten minutes

The opening part of the session sets up the framework for the work. I will introduce myself, explain how I practise, and cover the practical foundation of therapy. The key elements are confidentiality, my approach, and any logistical questions you want answered before we move into the assessment.

On confidentiality. What you share in session is confidential, with limited legal and ethical exceptions which I will outline at the start. These include circumstances where there is a serious and imminent risk of harm to you or to another person, where records are subpoenaed by a court, and where mandatory reporting obligations apply. The framework is the same one that applies to all AHPRA-registered psychologists in Australia.

On my approach. I draw on cognitive-behavioural therapy, acceptance and commitment therapy, schema therapy, and trauma-focused approaches, depending on the presentation and what you are working on. The therapy is evidence-based and trauma-informed. Where neurodivergence is part of the picture, the work is neurodiversity-affirming. I do not work from a single fixed protocol; the approach is matched to the person and the work.

On questions you might have. The first session is a reasonable place to ask about fees, cancellation policy, session frequency, expected duration of treatment, or anything else you want clarity on. Practical clarity at the start removes friction later.

The assessment phase

The substantial part of the first session is structured assessment. The goal is to get a working understanding of what is happening for you, what has brought you to therapy now, and what we will be working on together. The therapeutic relationship and the quality of the early therapeutic alliance are among the strongest predictors of therapy outcomes (Norcross & Lambert, 2018), and the assessment phase is partly where that alliance starts to form.

Questions in this part of the session tend to be open-ended. What is happening that prompted you to make the appointment. How is the issue affecting your daily life, your work, and your relationships. What you have already tried, including any previous therapy and what you found useful or unhelpful about it. Some broader context about your history, including significant life events, support systems, and any current life pressures.

You do not need to have prepared answers, and you are not expected to share everything in the first session. If a topic is too painful or you are not ready to discuss it, you can say so and we will come back to it later. Setting the pace is part of how the work is done.

What the first session is not

A few things are worth noting because they are common misconceptions.

The first session is not a complete diagnosis. Diagnosis, where it is clinically appropriate, often requires more than one session and may involve specific assessment instruments. The first session establishes a working clinical formulation that we refine as the work continues.

The first session does not solve the presenting problem. The early sessions are about understanding, planning, and beginning to build the relationship that will support the work. Substantive change tends to emerge across a course of therapy rather than in any single session.

You will not be expected to share more than you are comfortable sharing. You are the expert on your own life and the one who decides what is brought into the room.

The closing part of the session

In the last ten to fifteen minutes, I will outline what I have heard, share initial thoughts about what we might be working on, and discuss a possible direction. This is collaborative, not prescriptive. By the end of the first session, you should have a clear sense of what kind of work I think would be useful, what the likely shape of a course of therapy might look like, and what frequency of sessions makes sense given your circumstances.

We will agree a next appointment, typically within one to two weeks. Consistency in the early weeks of therapy helps the work get traction.

Getting in touch about what to expect in your first therapy session

You can book at behavioural-edge-psychology.au4.cliniko.com/bookings or contact the practice on 03 8771 4315. Behavioural Edge Psychology offers individual therapy and adult neurodivergence assessment for self-funded, Medicare-rebated, private health insurance, NDIS, WorkCover, and TAC clients.

References

Norcross, J. C., & Lambert, M. J. (2018). Psychotherapy relationships that work III. Psychotherapy, 55(4), 303 to 315.

About the author

Dr Sarah Fischer is the Principal Psychologist and CEO of Behavioural Edge Psychology, with consulting rooms in Caulfield South and St Kilda. She holds a PhD in Psychology from Deakin University and is registered with AHPRA, endorsed in organisational psychology.

Her clinical work sits at the intersection of evidence-based practice, trauma-informed care, and neurodiversity-affirming assessment. Her published research spans psychological safety, organisational trauma, trust and leadership, and has appeared in the Australian Journal of Psychology, Frontiers in Psychology, and the Journal of Healthcare Leadership.

To book an appointment, visit behavioural-edge-psychology.au4.cliniko.com/bookings or contact the practice on 03 8771 4315.

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