If you’re thinking about starting therapy for anxiety, not knowing what happens next can make it harder to book that first call.
Here is what to expect in anxiety therapy during the first month at Insightful Roots, session by session, from the first intake review to the week-four check-in.
Many people who reach out have been in therapy before and felt like it had no direction.
Others have never started because they don’t know what they’re signing up for.
Either way, a clear picture of the first month can take some of the guesswork out of it.
What happens before the first session?
Before you start, you fill out an intake questionnaire.
It asks why you’re coming to therapy, what you’ve already tried, a little about your background and history, and what you hope to get out of therapy.
Your therapist reads it before you meet.
They write down notes, comments and questions about anything that seems worth exploring further.
That way, your first session starts with someone who has already spent time understanding what you shared.
What to expect in anxiety therapy at your first session
In the first session, you and your therapist review your intake together.
The goal is to get a fuller understanding of what you need support with.
Sometimes people come in saying, “I’m just really anxious and I don’t know what to do.” As you talk through the intake together, a bigger picture often comes into view.
Maybe there isn’t much of a support system. Maybe sleep or eating has slipped.
Those details matter, because they shape what to focus on first.
Some people come in wanting to figure out their whole life direction.
That’s a valid goal. It’s also hard to get there without a base foundation: taking care of yourself, eating, drinking water, moving your body and having people in your corner.
So part of the first session is figuring out what will help you feel steady enough to take on the larger things.
By the end of session one, you and your therapist sketch out a loose plan.
It covers what you’ll work on together, and your feedback helps shape it.
Some clients like very tangible homework.
Others have a hard time with it.
Both are okay, and the plan reflects what works for you.
What happens in the second session?
Session two usually starts with a check-in and some reflection.
How did the first session feel?
What came up afterward?
Did you think of anything you wanted to add?
It’s common for people to say, “I forgot to share this,” or “I kept thinking about what we talked about, and I want to expand on those goals.”
That’s part of the process.
Your mind keeps working after you leave the room.
The second session also continues gathering your history and building rapport with your therapist.
You’ll usually leave with something to practice between sessions.
For some people that’s reflective, like noticing why it’s hard to trust people and how that shows up at work.
For others it’s a coping skill, like deep breathing or a grounding exercise you learned in session.
What if I don’t do my therapy homework?
In sessions three and four, you and your therapist check in on how things are going.
What’s working?
What isn’t?
What needs a tweak?
If you practiced the homework, you look at what helped and what didn’t.
If you didn’t practice it, that’s useful information too.
Sometimes a task seems simple, and then you realize there are ten things standing in the way of doing it.
There’s no need to judge yourself for that.
Instead, you and your therapist look at those barriers and work through them before coming back to the goal.
This is one of the places where anxiety therapy can look different from what people expect.
The point is to understand what’s getting in the way and build from there.
Ashana Chand, APCC #20932, supervised by Marisa Ronquillo, LMFT #122594.
How do skills build over the first month?
As the weeks go on, the skills you work on build on each other.
For some people, the focus stays on grounding and coping skills for a while.
For others, the work moves toward communication, such as:
How to tell a partner, friend or boss that you need to set a boundary
How to handle the guilt that often comes after setting one
Where you start depends on how much you already know about yourself and how many skills you already have in your toolbox.
Some people walk in with years of insight.
Some are starting from scratch. Both are good places to begin.
Is anxiety therapy the same for everyone?
At Insightful Roots, there is no copy and paste treatment plan.
Everyone comes in at a different stage, with different support and different ways of taking care of themselves.
A plan that works for one person might not fit the next.
That’s why the check-ins matter.
Each session is a chance to ask what’s working and adjust.
If talk therapy hasn’t helped you in the past, a plan that keeps changing with your feedback can feel very different.
Anxiety therapy with Ashana in Sacramento and across California
Ashana is an anxiety therapist for self-aware overthinkers. She works with people, often in their 20s, who want to understand their anxiety and have a clear sense of where therapy is going. Her style is warm, approachable and easygoing.
How Ashana describes the first month of therapy together:
Session 1: Getting to know you. Building a connection and understanding what brings you to therapy, your history and what you’ve already tried, then beginning a plan together.
Sessions 2 and 3: Understanding patterns and building skills. Exploring patterns connected to what you’re experiencing, practicing skills, and checking in about what feels useful.
Week 4: Checking in on the plan. Looking at what’s helping, what still feels difficult and what might need to change, including how therapy itself is feeling for you.
Frequently Asked Questions
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In the first month, therapy helps you see the bigger picture of what’s feeding your anxiety and builds a plan around it. You practice skills between sessions, like grounding or coping skills, and check in on what’s working so the plan can adjust.
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Yes. You and your therapist start a loose plan in the first session, based on your intake and your goals. It keeps getting updated as you check in on what’s working and what isn’t.
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That’s common, especially if you’ve had therapy that didn’t feel like a fit. Your therapist will ask how sessions are feeling for you, and you’re welcome to say when something isn’t working. The plan is meant to adapt to you.
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Many people come in with plenty of insight. The first month builds on what you already know and adds skills and practice between sessions. Your therapist tailors the work to where you are.
Book a free intro call
Ashana has weekday openings, in person at our Fair Oaks office near Sacramento and by telehealth across California. Book a free intro call to see if she’s the right fit.
