First Therapy Session? Here’s What You’re Really Walking Into

Last Updated:

June 20th, 2025

Your first therapy session can feel like a leap into the unknown. Will you be expected to talk about everything straight away? Will the therapist understand what you’re going through? These are natural worries, and you’re not the only one who’s had them. But therapy isn’t about putting you on the spot. It’s about creating a space where real change can begin, at your pace.

What is addiction therapy?

Addiction therapy is a form of psychological treatment designed to help people understand and recover from addiction. It focuses on the emotional, behavioural and mental aspects of substance use or compulsive behaviours, giving you a safe space to explore why addiction developed and how to build healthier ways of coping.

Addiction therapy isn’t one-size-fits-all. There are several types of therapy available, and the one recommended for you will depend on your personal situation.

Common therapies used in addiction treatment include:

Cognitive behavioural therapy (CBT)
Dialectical behaviour therapy (DBT)
Group therapy
Family therapy
One-to-one counselling
Motivational interviewing (MI)
12-Step facilitation therapy

Each therapy brings a different approach, and many rehab programmes use a combination to give you the best chance at long-term recovery.

Everything you need to know about your first addiction therapy session

Being told to start addiction therapy can stir up all sorts of nerves. Opening up to a stranger or a whole group isn’t easy. But once you settle in, it often becomes one of the most helpful parts of recovery. Here’s a breakdown of common therapies, why they’re recommended and what your first session might look like.

Cognitive behavioural therapy (CBT)

CBT is a structured therapy that helps you understand how your thoughts, emotions and behaviours are linked, especially when those patterns lead to addictive behaviour. It teaches practical strategies to spot unhelpful thinking and replace it with healthier responses.

Why CBT might be chosen for you

CBT is often recommended if your addiction is tied to anxiety, trauma, stress or unhelpful habits. If you’re recovering from alcohol, cannabis, cocaine or painkillers, CBT can help you take back control when a trigger appears. For instance, if you drink after work, CBT helps you change how you think about that stress and how you act on it.

What the first session is like

The first session is all about getting comfortable. Your therapist will ask what’s brought you to therapy and what you’re hoping to change. You won’t have to go into painful memories straight away. Instead, you’ll start identifying patterns, things you do automatically, like using drugs when anxious. You might be asked to note a few triggers before your next session, but there’s no pressure. It’s a conversation, not an interrogation.

Dialectical behaviour therapy (DBT)

DBT helps you manage overwhelming emotions, impulsive behaviours and relationship conflict. It includes skills like mindfulness, emotional regulation and distress tolerance, making it useful when emotional pain drives your addiction.

Why DBT might be chosen for you

If you’ve struggled with intense emotions or acted impulsively when upset, DBT helps you slow down and make better choices. It’s especially useful if your addiction comes alongside conditions like borderline personality disorder, PTSD or eating disorders. You might be recovering from alcohol, benzos, opioids or stimulants used to numb or escape emotional distress.

What the first session is like

Your therapist will walk you through how DBT works. You’ll talk about what happens when emotions feel too strong and how you usually cope. You won’t be expected to “fix” anything in session one. The focus is on understanding your patterns and introducing the idea that there are healthier ways to respond, even if they don’t feel possible yet. You may leave with a small mindfulness exercise, like noting your emotional reactions without judging them.

Group therapy

Group therapy involves meeting with others who are also in recovery. Everyone gets the chance to share and listen. You’re not expected to speak every time, but over time, the group can become a source of connection, reflection and mutual encouragement.

Why group therapy might be chosen for you

If your addiction has left you feeling isolated or ashamed, group therapy can be powerfully healing. It’s used in treatment for nearly all types of addiction, both substance and behavioural and often tailored by theme (like relapse prevention or trauma). It helps you realise you’re not alone and that recovery is possible, even if it doesn’t feel that way yet.

What the first session is like

Most first sessions begin with a round of introductions, often just your name and how you’re feeling. There’s no pressure to share your story right away. A therapist or group leader sets a topic and guides the discussion. Some people speak. Others listen. You’ll be reminded that what’s said in the room stays in the room. Many people are surprised by how much they relate to what others say, even if they haven’t spoken yet.

Family therapy

Family therapy brings together you and the people closest to you to rebuild trust, set boundaries and understand how addiction has affected everyone involved. It’s not about blame. It’s about moving forward together.

Why family therapy might be chosen for you

If your addiction has strained or damaged relationships, family therapy can help repair them. Whether you’ve been struggling with alcohol, cocaine, GHB or painkillers, involving family can strengthen your recovery. It also helps your loved ones understand that addiction isn’t you deep down, rather, a mask that’s controlling you.

What the first session is like

The therapist will explain that the goal is to create a safe space where everyone can speak honestly. Each person might be invited to share what they’re hoping to get from the sessions. Some emotions may surface, perhaps anger, sadness or even confusion, but your therapist will guide the conversation and make sure everyone is heard. You won’t be forced to confront anything too big too soon. The focus is on small steps: understanding, communication and trust.

How is addiction therapy used in addiction recovery programmes?

Therapy sits at the heart of most addiction recovery programmes. While detox helps clear your body of the substance, therapy is what helps you understand why the addiction took hold in the first place and how to stop it from taking over again.

In many cases, therapy can begin as early as the detox stage, especially if you’re finding the experience emotionally or physically difficult. Having someone to talk to during this period can provide comfort, support and early insight into how you tend to cope with discomfort.

Once detox is complete, therapy becomes even more central. This is where you start to dig into the root causes of your addiction, whether that’s past trauma, stress, low self-worth or something else entirely. Understanding the underlying reasons behind your addiction is what gives therapy its power. It helps you become aware of your patterns, your triggers and the beliefs that may have kept you stuck.

From there, you and your therapist (or therapy team) can build a personalised and far more effective relapse prevention plan.

What are the next steps?

If you’re struggling with addiction, it can feel overwhelming, but support is available. At UKAT, our recovery plans are built around evidence-based addiction therapies that go beyond just treating symptoms. We help you understand the root of your addiction and build real, lasting change. Reach out today and take the first step toward a healthier, more stable future.