What happens in the first session for depression?

The first session is a conversation, not a test. The shape varies between clinicians and between presentations, but the general arc is the same. The first part is about meeting each other, getting a sense of what has been going on, and starting to map the picture together. The second part is about working out what would be useful from here, what kind of work might fit, and what the next few sessions could look like. There is nothing you need to bring, prepare, or perform. With depression in particular, even getting to the session can take real effort, so if you have made it that far, the hardest part of the day may already be behind you. There is no right way to do a first session. Arriving is the start.

Written and reviewed by Matthew Hallam, Registered Psychologist (AHPRA PSY0002471369). 4 min read. Published 28 May 2026. Last reviewed 28 May 2026. Next review 28 May 2027.

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The general shape

A first session usually runs for 50 to 60 minutes, in person at our Kew or Croydon rooms or online. The early part is given to introductions and to the practical side: confidentiality, what the session is for, what happens with the information you share, and how the Medicare rebate works if you have a Mental Health Treatment Plan. The middle part is where the real conversation begins. The clinician will ask what brings you in, and follow that with questions that build the picture: when this started, what makes it heavier or lighter, what you have already tried, and what is going on in the rest of your life. The end of the session usually involves some reflection on what has been heard, a sketch of what the work could look like, and a discussion of when to meet again. A thorough first assessment, and a plan worked out together rather than handed down, is what the evidence describes as good practice in depression care (National Institute for Health and Care Excellence, 2022).

There is real variation in how each clinician handles the time. Some use brief questionnaires, such as the PHQ-9 or the K10, to help build the picture; others rely on conversation; many use a mix. Some are more structured in a first session, others more relational. That variation reflects different training orientations rather than different quality.

What the conversation is for

The conversation is not an exam. The clinician is not checking whether your depression is real, or bad enough to count. Most are trying to understand three things in a first session: what has been happening, what shape it has taken, and what you would want to be different. That last one matters. A good deal of depression care rests on the two people in the room building a shared sense of what the work is for and how to go about it, rather than the clinician deciding alone (National Institute for Health and Care Excellence, 2022). If you have never put words to what you would want to be different, that is fine. The clinician can help you work it out.

It is also fine to arrive without the words. Depression can make describing things feel flat, effortful, or strangely far away, and the first session is built to accommodate that. The clinician's job is to help you find the account, not to wait for you to deliver it neatly. The session goes at the pace it needs to. If something is too hard to talk about in detail, the clinician will mark where you have reached and return to it later, or leave it, depending on what is useful.

A last point worth naming: the relationship itself is part of the work, not just the setting for it. Research on depression treatment points to the working relationship between client and clinician as one of the things that matters, which is part of why the fit between you and the person across from you is worth taking seriously from the start (Videtta et al., 2025).

What you might be wondering

A few questions come up often.

Will I have to explain everything from the start? No. You can tell as much or as little of the history as you want to in a first session. The clinician will ask about what they need to know to be useful, and you decide what feels right to share.

What if I cannot find the energy, or the words? Both are common with depression, and both are fine. The clinician will adjust the pace and help carry the conversation. You will not have failed the session.

Do I need a diagnosis or a referral first? No. You can see a psychologist without either. If you would like the Medicare rebate, that comes through a Mental Health Treatment Plan, which your GP can arrange. You do not need to have any of that sorted to book a first session.

Will I be given homework? Sometimes there is something to take away, sometimes not. It depends on what is useful for the work you are starting. Most first sessions do not include homework.

Will it help? The first session is not about producing a result. It is about laying the foundation for the work that follows, and working out whether this is the right place and the right person for it. What the session sets up is the start of that work, not its conclusion.

What to bring, and what is not required

The first session is a beginning, not a performance. The shape described here is the general one; the practice has its own way of working within it, which we will talk through when we meet. If you would like a shorter conversation before booking a first session, the Meet and Greet is a free 15-minute call or in-person meeting, with no obligation, to see whether we are the right fit. With depression especially, the decision to start is often the hard part. Once that is made, the rest is built together, one session at a time.

This content is general information only. It is not a substitute for individual psychological or medical advice. Reading this does not establish a therapeutic relationship with Equal Psychology or any of their clinicians.