First Session Turns 5

Written by Rob Pintwala
Last updated on: May 16, 2024

In 2018 my wife quit therapy before it started.

Instead of getting help, she got a sales pitch from a clinic intake coordinator. After weeks building the courage to reach out, she got "matched" with a therapist who left her feeling empty, misunderstood, and alone.

My wife is not alone in her experience. As many as 50% folks don’t get past their first session. Finding any therapist is easy. But trying to find the right therapist in 2018 felt a lot like trying to date using a pay phone and a phone book.

Making the decision to find help is hard — it takes courage. The process of actually finding that help shouldn’t be even harder.

The Problem

If you’re looking for a “client-centred” therapist, there are literally thousands to choose from. But good luck getting any sense of who they are, how they work, and if they’re the right fit before committing. 

And the finding help process just gets worse from there. To book a session, you’ll typically have to submit an online form. When will the clinic or therapist respond? Often never, but who knows! If you are lucky enough to hear back, it’ll often be a templated “sorry, my practice is currently full” message. Back to square one…

But let's say you do manage to schedule a therapist. The next step is usually a “free” phone consultation. Don't expect much progress, though — after the confidentiality and admin rigamarole, you might have a few minutes to determine if it’s a fit.

Oh yeah, and that call might not even be with the therapist — often it’s with a junior clinic coordinator, like the one my wife spoke with. 

Not great, right? The problem is simple, but extremely troubling: the process of finding help is broken.

The Solution

In 2019 I launched First Session to solve that problem.

I bought a camera, emailed 100 therapists, and interviewed 10 of them.

Focusing on fit, I thought videos would be a big differentiator to humanize the experience and help folks gauge for compatibility before booking.

I hacked together 3 minute Youtube videos for each therapist, put them on a single webpage, and crossed my fingers.

What We've Learned

5 years and 12,000 sessions have passed since then. I'm proud of what we've achieved.

The past few weeks I've been reflecting a lot on what we've learned since 2019, and how that influences what we do next.

First, here's the big things we've learned: 

The Right Fit, the First Time 

Switching therapists is hard, despite what “instant therapy” platforms advertise. 

Building trust with a stranger and sharing your most personal thoughts and feelings is emotionally taxing. It’s hard enough to do once, let alone multiple times. 

The result is troubling — constantly switching therapists often results in clients abandoning therapy altogether. 

Constant conversations with First Session therapists and therapy seekers confirms it — finding the right fit sooner is invaluable in making long-term, meaningful change.

Solving that problem and scaling that solution is why First Session exists. Helping anyone find the right fit right away is at the very core as a company.

Connection Over Convenience 

We live in the era of dopamine hits and quick fixes. Apps touting 24/7 therapist or the ability to “switch therapists as many times as you want!” do not set therapy seekers up for sustainable wellness. 

Convenience is a quick fix — and quick fixes never work. 

The real fix comes from commitment and consistency. And genuine connection between therapist and patient is a determining factor in ensuring that commitment and consistency.

We optimize for that connection.

Relatability Builds Trust

After years of university, many therapists have difficulty getting away from “academic speak.” Unfortunately, the majority of therapy seekers haven’t studied psychotherapy, and are often intimidated or overwhelmed by dense jargon. 

The solution? Keep it simple and speak like a human — be relatable. 

Relatability allows for better dialogue, connection, and trust. After years of bookings and thousands of conversations, every First Session therapist now communicates with simple, relatable language in intro videos and bios.

Agency and Choice

The idea of having an algorithm pick a therapist for you is tempting. It’s truly convenient! But that convenience comes at the cost of an important first step in long-term results. 

While not always the case, the feeling of losing control is a major contributing factor in mental health challenges. The bold decision to take action is critical.

We’re building First Session to equip folks with the tools, information, and experience they need to follow their intuition and make that decision confidently. 

The first step to change happens once you confidently take action.

Friction Slows Progress 

Online calendars, appointment booking, and payments have existed for decades.

But many therapists need that extra push to get their practice’s backend up-to-speed. We provide that push. In fact, we mandate it.

Easier booking, simpler billing, quicker communication. Less admin friction = more commitment, a stronger connection, and steadier progress. 

What’s Next

Based on everything we’ve learned and the progress we’ve made, we’re focussing on 3 core themes in the coming months and years: 

Help Every Therapy Seeker Find the Right Fit 

This has been core to First Session from the very start, and there’s still so much to be done. 

For example: many folks bring unintended baggage to their search for a therapist. Maybe they burnt out constantly switching therapists on instant therapy platforms. Or maybe they waited months for a recommended therapist that completely missed the mark. 

A therapy seeker’s prior experience deeply impacts their current search. We need to meet those seekers where they’re at. 

Right now, we’re building a new search engine to account for a seeker’s prior experiences with therapy. 

It’s an important step, and the first of many to come. 

Remove Friction from the Therapy Seeking Process

If friction slows progress, let’s permanently remove it. 

To start, we’re laser focused on providing total transparency around insurance coverage and billing. Because few things are more frustrating than finding the perfect fit, only to discover it’s not covered. 

It’s the first step of many in ensuring that anyone can feel totally qualified and informed during the therapy seeking process. 

Build the Best Platform for the Best Therapists

Therapists become therapists to help people overcome challenges and reach new heights.

But therapists are bogged down by hours of admin work that, over time, can negatively affect their impact as a therapist. 

Helping therapists do more of what they do best without the hours of administrative work has been core to First Session from the very beginning. 

Therapists are incredible people doing amazing work for our society. They deserve more from the tools and technology they use. So that’s what we’re building.

It’s been an incredible 5 years. I’m proud of everything we’ve achieved. The mission ahead of us is a lofty one. We’re motivated, inspired, and excited to build towards it with you over the coming months and years. 

Thanks for being here.

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About the Author

Rob Pintwala

Rob is the founder of First Session. He has always been passionate about mental health and psychology. While completing his Bachelor of Commerce degree at McGill University, he experienced prolonged period of depression, which eventually motivated him to start a company in the mental health space. Prior to starting First Session, Rob worked for several high growth tech companies including Uber and Bench Accounting.