What to Expect in Your First Couples Therapy Session in Los Angeles
If you've decided to try couples therapy in Los Angeles, you've already done the hard part. Seriously—reaching out takes courage, especially when you're not sure what you're walking into.
After reading about how to choose the right couples therapist in Los Angeles, you've booked your first session. Now what?
The good news is you've found someone to support you and your partner(s) through a challenging time. If this is your first time in couples therapy, this process likely feels a bit mysterious. For a lot of us, the unknown can be anxiety-provoking, so it can be helpful to know what to expect before you begin the journey.
If it's not your first time in couples therapy, you already have some idea of what's coming—but you also know that each provider is different. Understanding what to expect about their style, both therapeutic and administrative, matters.
Before Your First Session: The Intake Process
Before you step into the therapy space, your couples therapist in Los Angeles will have you complete intake forms. Whether through an online client portal or in the office waiting room, there's going to be paperwork.
What can you expect from those forms? There are a few things you'll likely see across California practices:
Good faith estimate (required by law)
Notice of privacy practices (HIPAA compliance)
Informed consent forms (outlining the therapeutic relationship)
You'll fill out forms requiring identifying information like name, date of birth, and home address. Most practices will ask you about what brings you to therapy, to describe your symptoms, and state your goals for treatment. These intake questionnaires can be pretty detailed and potentially overwhelming.
Here's what I want you to know: as therapists, we're not judging you based on your intake form. Filling it out to the best of your abilities helps us help you.
Many therapists include clinical assessments as part of the process to screen for mood, anxiety, and trauma-related disorders. If you're using insurance, the provider will complete an insurance verification process before the first session, which requires your insurance information and a photo ID. If you're paying out of pocket (private pay), providers will collect your payment information either in person or via the online client portal before your first session.
What Actually Happens in the First 50 Minutes
Once you're in the room, things vary by provider, but there's a general flow most couples therapists in Los Angeles follow.
Introductions and consent: Your therapist will typically start with introductions, making sure you know their name, their credential (LMFT, LCSW, PsyD), as well as the limits to confidentiality and mandated reporting requirements. Many therapists make space for clients to ask questions right at the start to help ease anxiety.
Sharing your story: In relationship therapy, the therapist will ask all parties to share their perspective on the relationship and the issues impacting it. This isn't about determining who's "right"—it's about understanding how each person experiences the relationship.
Observation: While you're talking, the therapist observes relational patterns and works to get an initial sense of the dynamic between you.
Let me normalize a couple of things: It's okay—and quite common—for partners to disagree about what the problem truly is. You might even fight in session. That's okay. It's helpful information for the clinician, and they can help you through some de-escalation and grounding techniques to make it easier to stay engaged and connected.
What Your Couples Therapist in Los Angeles Is Paying Attention To
Your couples therapist is tracking many things in the first session:
How you communicate with each other: Are you talking to each other or only to the therapist?
How you speak about each other: Are descriptions respectful, dismissive, contemptuous?
Conflict patterns: How does conflict start and escalate between you?
Vulnerability: What happens when one person gets vulnerable? Does the other move toward them or away?
Commitment levels: If it wasn't asked in the intake directly, they may ask about levels of commitment to the relationship
Verbal and non-verbal cues: Body language, tone, eye contact—these all tell a story
Clinical fit: They're also assessing if couples therapy is the right fit or if individual work is what's needed first
This might sound intense, but remember: your therapist isn't judging you. They're gathering information to figure out how to best support your relationship.
The Assessment Period: What Comes Next
The therapist is assessing many different things in the first session, but the assessment period is ongoing. Many couples therapists will take 3-4 sessions to do a thorough assessment.
During this time, they're assessing for:
Relational fit: Do our styles mesh well? Do you feel safe with me?
Treatment planning: Is their therapeutic modality the best fit for the presenting issues?
Safety concerns: They're looking for signs that mean referral to individual therapy is most needed, such as intimate partner violence or severe emotional dysregulation
If you're referred to another couples therapist or to individual therapy at the end of this assessment period, it may feel like rejection. I want you to know: the therapist is making a clinical call that they feel will serve your journey better than continuing treatment that isn't well-suited to your situation. A good therapist in Los Angeles knows their limitations and will connect you with the right resources.
How to Prepare for Your First Couples Therapy Session in Los Angeles
Here are some practical tips for navigating your first session:
Bring questions about the process. Remember that just as your therapist is assessing you, you're assessing them. Maybe you didn't ask many questions during the consultation, or more arose after the call. Ask them in the first session.
It's okay to be nervous. If the therapeutic fit is right, you'll eventually be sharing a lot about yourselves in the process. You'll want to get a sense if this is someone you can open up to.
You don't need to agree on everything—or anything. It's common for one partner to even be unsure that they want to do therapy at all. Bring that up in session. A good couples therapist will help you process that ambivalence.
Show up as your whole self. Honesty helps the process tremendously. You don't need to have it all together or present a united front.
Give yourself time after therapy. Things can get emotional, and you may want more time to get yourself together before moving on to other tasks, meetings, or responsibilities. Schedule your session accordingly.
What If We Fight During the Session?
Yes, fights happen in couples therapy in Los Angeles—or anywhere else, for that matter. It's common and a valuable part of the process.
Your therapist will likely interrupt the cycle when things escalate. They might call a time-out and ask questions like, "Okay, what just happened there?" They may guide you through a grounding exercise like a 5-senses check-in or a body scan.
The focus is often to slow down, become more aware of the dynamic, and practice doing things differently. This is where the real work happens—not in avoiding conflict, but in learning to move through it in healthier ways.
Your Next Step
Essentially, the first couples therapy session is about getting to know each other. The therapist learns about you as individuals, your dynamic as a couple, and how the problems you're experiencing manifest in the relationship.
In a successful first session, you'll leave with a sense of whether this therapist is right for you. Trust your gut. If something feels off, that's important information. If something feels right—even if it's uncomfortable—that matters too.
Ready to book your first session? Schedule a free 15-minute consultation.
About the Author: Jasmine McMeeking is a Licensed Marriage and Family Therapist specializing in couples therapy in Los Angeles. She works with couples navigating major life transitions. Her approach combines Emotionally Focused Therapy with expressive arts, and narrative therapy. Learn more about my approach to couples therapy or book a free 15-minute consultation.