What to Expect in Your First Grief Therapy Session in New York
So you've decided to reach out for grief therapy. Maybe you've been thinking about it for weeks or months. Maybe something happened recently that made you realize you can't do this alone anymore.
Now you're staring at a contact form or holding your phone, and you're nervous. What will I say? What if I cry the whole time? What if they think my grief isn't "bad enough"? What if I can't put my feelings into words?
I'm Lindsay Fernandez, a Licensed Mental Health Counselor in New York who specializes in Grief Therapy. I've sat across many people in their first session, and I want to walk you through exactly what happens so you know what to expect.
The truth is, there's no "wrong" way to show up to your first grief therapy session. But knowing what's coming can make it feel less scary.
Before Your First Session
Finding the right therapist
Not every therapist is the right fit for grief work. You want someone who:
Specializes in grief and loss (not just lists it as something they treat)
Makes you feel comfortable when you read their website or profile
Understands your specific type of loss (parent, child, partner, pregnancy, relationship, etc.)
Offers the logistics you need (online vs. in-person, schedule availability, cost)
In New York, many grief therapists offer online sessions, which means you can work with someone who specializes in your specific situation even if they're not in your immediate area.
The consultation call
Many therapists, including myself, offer a free consultation call before your first official session. This is a brief conversation (usually 15-20 minutes) where you can:
Ask questions about their approach and experience
Share a bit about what you're going through
Get a sense of whether you feel comfortable with them
Discuss practical details (insurance, scheduling, fees)
This isn't a therapy session - it's more like a getting-to-know-you conversation. You're interviewing me as much as I’m getting to know you.
If something feels off during the consultation, that's important information. You want to work with someone who feels like the right fit.
What to prepare (or not prepare)
You don't need to prepare anything formal for your first session. You don't need to write out your story or have a clear agenda. In fact, trying to over-prepare often adds unnecessary stress.
What can be helpful:
Thinking about what brought you to therapy right now (even if the answer is just "I'm struggling")
Considering what you're hoping therapy might help with
Having tissues nearby if you're doing online therapy
Being somewhere private where you can speak freely
What you definitely don't need:
A timeline of your grief
A clear explanation of all your feelings
Answers to why you're feeling the way you are
To have it all together
What Happens in the First Session
The first few minutes
When you join the session (online) or arrive at the office, your therapist will likely start with some informal conversation to help you feel comfortable. This might sound like:
"Thanks for being here. How was your day?"
"Can you hear me okay?" (for online sessions)
"Before we dive in, do you have any questions about how this works?"
This isn't small talk for the sake of it - it's helping you settle into the space and transition from your day into therapy mode.
Discussing confidentiality and consent
Your therapist will explain confidentiality - what stays private and the rare situations where they'd need to break confidentiality (imminent danger to yourself or others, child abuse, etc.). This is a standard part of every first session.
You'll also discuss informed consent, which is essentially: here's how therapy works, here's what you can expect from me, here's what I need from you, and here are your rights as a client.
I know this part can feel formal and clinical, but it's important. You need to know that what you share is protected and that you're entering into this relationship with clear understanding.
"Tell me what brought you here"
This is usually how the actual therapy part begins. Your therapist will invite you to share why you're seeking support.
There's no right or wrong way to answer this. Some people start at the beginning: "My mom died six months ago and I haven't been able to function since." Others start with how they're feeling right now: "I don't know why I'm here exactly, I just know I'm not okay."
Both are completely fine.
Your therapist might ask some follow-up questions to understand your situation better:
"Can you tell me about your person?"
"What's been hardest for you?"
"Have you had support from family or friends?"
"Is there anything else going on in your life right now?"
These aren't interrogation questions - they're helping your therapist understand your unique experience and what you need.
It's okay to cry
Let's address this directly: you might cry in your first session. You might cry a lot. That's completely normal and expected in grief therapy.
Your therapist has tissues ready. They're not uncomfortable with tears. They're not going to rush you or try to make you stop crying. Crying is part of processing grief, and therapy is one of the few places where you can cry without worrying about making others uncomfortable.
On the flip side, you might not cry at all in your first session. Some people are too nervous or shut down. Some people have cried so much already that they feel numb. That's also completely normal.
There's no "right" amount of emotion to show in therapy.
It's also okay to not know what to say
Sometimes people freeze up in their first session. You've been thinking about what to say for days, but now that you're here, the words won't come.
That's okay too.
A good grief therapist knows how to sit with silence. They'll help you find the words when you're ready, and they won't pressure you to share more than you're comfortable with.
If you're struggling to articulate something, you can say that: "I'm not sure how to explain this" or "I know what I'm feeling but I can't find the words." Your therapist can help you from there.
Building your story together
In that first session, your therapist is trying to understand your story: what happened, who you lost, what your life looked like before and after, what you're struggling with now.
But they're not just gathering facts. They're listening for:
What's most painful for you
Where you feel stuck
What emotions are coming up
What support you have (or don't have)
What you're hoping will change
This information helps them understand how to best support you going forward.
Discussing what therapy will look like
Toward the end of the first session, your therapist will usually talk about what ongoing therapy might look like:
How often you'll meet (usually weekly to start)
What approaches they use (CBT, narrative therapy, EMDR, etc.)
What you can expect in future sessions
Any homework or between-session work (though this is rare in grief therapy)
This is also a good time to ask any questions you have about the process.
What First Sessions Look Like at ETGCS
Since you're considering working with me, let me tell you specifically what to expect in our first session together.
My approach to first sessions
I keep things conversational and real. I'm not going to sit across from you with a clipboard taking notes while you pour your heart out. I'm going to talk with you like a human being who's going through something incredibly hard.
I'll ask you to tell me about your person if you've experienced a death. I want to know who they were to you, not just that you lost them. Your grief is connected to love, and honoring that relationship is part of the work we do.
If you're dealing with another kind of loss (your old self, divorce, life transition, becoming a caregiver), I want to understand what your life looked like before and what's changed now.
What I'll explain about my approach
I use several therapeutic approaches depending on what you need:
Narrative therapy - We work on how you're making sense of your loss and how you tell your story to yourself and others.
Emotional focused therapy - We process the actual feelings that come up, not just talk about them intellectually.
Cognitive behavioral therapy - If anxiety is part of your grief experience, we address the thought patterns keeping you stuck.
Mindfulness-based techniques - We work on being present with grief without being consumed by it.
But honestly, in the first session, we're not diving deep into therapeutic modalities. We're building connection and trust. Everything else follows from that.
What makes my approach different
I'm real with people. I'm not going to give you clinical language or therapeutic platitudes. I've experienced significant loss myself - I lost my mom in 2011. I'm also a mother, so I understand the complexity of grieving while trying to care for others.
I share this not to center my experience, but so you know I'm not speaking from a textbook. I've sat where you're sitting, and that informs how I show up for you.
Common Worries About First Sessions (And The Reality)
"What if I can't stop crying?"
Reality: Crying is normal and expected. Bring your tissues. Take all the time you need. We'll pause if you need to collect yourself, but there's no pressure to hold it together.
"What if I don't cry and they think I'm not really grieving?"
Reality: Not everyone cries in session, especially in the first one. Some people are cried out. Some people are numb. Some people process differently. None of this means your grief isn't real.
"What if my grief isn't 'bad enough' for therapy?"
Reality: There's no minimum threshold for deserving support. If you're struggling enough to reach out, that's enough. Your grief doesn't need to be compared to anyone else's.
"What if I can't explain what I'm feeling?"
Reality: Most people can't fully articulate their grief, especially early on. That's part of why you're here - to help make sense of it. Your therapist will help you find the words.
"What if they judge me for how I'm coping?"
Reality: A good grief therapist has seen it all and isn't here to judge. Whether you've been drinking too much, avoiding everyone, or doing things you're not proud of - your therapist is there to help, not shame you.
"What if I don't like them?"
Reality: That's valuable information. You can either give it another session or two to see if comfort builds, or you can find a different therapist. Fit matters tremendously in therapy.
After Your First Session
How you might feel
After your first session, you might feel:
Relieved that you finally took the step
Exhausted from being emotionally vulnerable
Hopeful that support exists
Uncertain if it helped
Raw or exposed
More emotional than usual
All of these are normal. First sessions can be emotionally draining, even when they go well.
Deciding if you want to continue
You don't have to decide immediately whether this therapist is right for you. It's reasonable to give it 2-3 sessions to see if the relationship feels like it's building.
But trust your gut. If something feels fundamentally wrong, it's okay to look for someone else.
What happens next
If you decide to continue, you'll schedule your next session (usually the following week). Ongoing sessions typically look different from the first one - less focused on your story and more focused on processing and working through your grief.
Taking the First Step
If you're reading this and you've been putting off reaching out, I want to encourage you: the first session is often the hardest step, but it's also the most important one.
You don't have to have it all figured out. You don't have to be articulate or composed. You just have to show up.
At Evolving Through Grief Counseling Services, I provide online grief therapy throughout New York. I work with people dealing with loss, life transitions, postpartum challenges, and caregiver stress.
If you're ready to take that first step, visit etgcs.com/contact to schedule a free consultation. We'll talk briefly about what you're experiencing, and if it feels like a good fit, we'll schedule your first session.
You deserve support. Your grief deserves attention. And reaching out doesn't mean you're weak - it means you're ready to not carry this alone anymore.
Lindsay Fernandez, LMHC, is a Licensed Mental Health Counselor specializing in grief therapy, postpartum mental health, life transitions, and caregiver support. She provides compassionate, authentic online therapy throughout New York at Evolving Through Grief Counseling Services.
