What to Expect in Therapy

Therapy is a great way to improve your mental health. Understanding how it works can help you feel more comfortable and confident when you go.

A client once told me during her first visit, “I’ve been putting off therapy for too long and finally felt like the time was right. I knew I couldn’t face my problems alone anymore.” Perhaps you have also faced ambivalence about starting therapy in the past but have finally gathered the courage to seek help. And like so many others, you may also be dealing with new or worsening mental health challenges amid the coronavirus pandemic that are prompting you to try therapy. If questions such as, “What should I expect?” or, “How should I prepare for my first session?” are running through your mind, you’re not alone. Whatever your reason for getting help, one of the hardest parts is getting started. 

What to Expect From Your First Few Therapy Sessions

The Consultation

So you’ve made it to your first appointment and you’re sitting patiently in the virtual waiting room to meet your therapist for the first time. Maybe you’re trying your best to quell your anxiety but find yourself overcome with discomfort as your appointment time nears. To ease your mind, here’s an overview of what you can expect. 

The first appointment may be seen as a consultation, a chance to meet with your therapist and make sure you are a good fit. They will review some documents with you, informing you of the pros and cons of therapy, the limits of confidentiality, their privacy policy, and any additional policies they have in place, such as how to reach them between sessions, or their late cancellation policy. Your therapist will ask you what brings you to therapy and what you hope to get out of it, so they can start formulating ideas of how best to help you.  The therapist may explain their style of therapy and ask you if that is a good fit for you. Be sure to ask any questions you have. It may be helpful to make a list of the questions you have before the first session/consultation.

Ask questions! There are no right or wrong questions for your therapist. Remember, getting to know each other is a mutual experience. You might ask about their training, what type of therapy will be used and how it works, or how long therapy is expected to last. Or maybe you’ve researched your therapist prior to your first appointment. Don’t be afraid to ask clarifying questions or for information, you didn’t quite understand. Not every therapist is a good fit, and the more you know about your therapist and their style, the more comfortable you’ll feel about therapy overall. Gather information to determine if this working relationship feels like a good match for you. Some questions you might ask include: 

• How long have you been practicing?
• What therapy approach(es) do you use? Can you describe them to me?
• How much experience do you have working with people who have similar issues? 
• How long does treatment typically last?
• Is the teletherapy platform that you use safe and secure? 
• How should I prepare for my video session and what should I do if I have trouble connecting to the meeting?
• Is video therapy as effective as in-person therapy?

Your First Therapy Appointment

You’ll likely use your first session to get to know each other and build rapport, but also to cover the basics: how often you’ll see each other, how long you’d like to see a therapist if that’s something on your mind, what you should expect from the next session, and how payment is processed. Think of your first session as an orientation to therapy. This process, also known as the initial assessment, involves asking questions about how you’ve been feeling lately when you think any problems may have started, and what, if any, steps you’ve taken in order to feel better. There may be some additional forms to complete, too. Your first session may look different from subsequent visits that will likely focus more on learning new coping strategies and skills. Your therapist may ask questions such as:  

• What brings you to therapy?
• How long have you experienced these problems?
• Have you been in therapy before?
• What are ways that you cope with distress?
• Who is part of your support network? 
• Were you prompted to seek care mostly in response to COVID-19 concerns? 

Going to therapy for the first time can make a lot of people nervous. That’s normal! If your therapist does something that makes you feel uncomfortable, it’s okay to voice your concerns or find another therapist. But try to stick with it for a few sessions before you give up altogether!

Ending your first session

You’re nearing the end of your first session. What happens next? 

If continuing to work together makes sense, your therapist might summarize your first meeting and suggest some possible goals for therapy. You may also learn more about what to expect in follow-up sessions. In some cases, your therapist will teach you a skill or give you an assignment to complete before your next session, such as increasing healthy habits like taking a walk or engaging in a mindfulness exercise. Before wrapping up, you and your therapist will likely agree on a second appointment time. 

If at the end of your first session, you’re left with unanswered questions, or if your experience is not quite what you imagined, be open about how you feel with your therapist and ask questions. This process is about your mental health and personal growth, and you want to walk away feeling that you’re moving in a positive direction. 

How to Get the Most Out of Therapy

Every therapeutic relationship is unique. How you and your therapist operate is up to you, but there are a few things that are relatively universal.  

You Set Your Own Goals

Therapists work with a lot of different people, each with different needs and backgrounds. Your therapist is there to help you identify your own goals and find healthy ways to work towards them.

Be Open and Honest

Therapists aren’t mindreaders, so it’s important to be open about your problems and share what you’re feeling in session. Therapy takes time and effort, and your therapist will do their best work when you’re honest and open, even when that honesty feels uncomfortable. To get the most out of therapy, here are some things to keep in mind: Be honest with yourself and your therapist. The more honest you are, the better a therapist will be able to help you. And it’s a safe space! You can be sure that your therapist will not share your secrets. They won’t laugh at you or judge you. Their only goal is to help you.   

You Don’t Have to Share Anything You Don’t Want to or Before You’re Ready

Your therapist can be more effective at helping when you’re forthcoming with answers to their questions. At the same time, it’s important to know your limits. If your therapist asks you something and you’re not comfortable sharing, that’s okay. Just explain that you’re not ready to talk about it. As you build trust and rapport with your therapist, you’ll feel comfortable opening up more and more. The therapist isn’t there to force you to say anything you don’t want to.

Therapy Isn’t Just About Your Feelings

Sure, you’ll talk about your feelings, and you’ll often come away feeling better at the end of a session. But therapy is about much more than that. You’ll learn to question your negative thoughts and change your behaviors. You will become more self-aware of your behaviors and thoughts. Therapy is also about achieving your goals. If you’re unsatisfied with your career, relationships, or where you are in life, your therapist can help you create a road map to get to where you want to go.

Your therapist may encourage you to confront things you’ve been bottling up. This is all-important for your recovery. But it’s also challenging. Some days you might leave the office feeling sad or angry… but it’s all part of the process. Sometimes things get harder before they get easier—but they do get easier.

Start Feeling Better!

At the end of the day, therapy is all about feeling better. You deserve the life you want and therapists are there to help you do just that. If you still have questions about what to expect in therapy, I’d love to hear from you! I offer teletherapy (online mental health therapy) to those living in Florida and internationally. Learn more about my services or schedule an appointment. I look forward to hearing from you!