What to expect when starting therapy

For many of us, starting therapy is a huge step, often a vulnerable acknowledgement that we want help and support. And for most, even finding a therapist is a chore in and of itself -- how do you find someone? How do you find someone with availability?  What do all of those different acronyms and lingo-laced phrases even mean?  And perhaps most importantly, what can I expect out of therapy itself? 

Some of this confusion may arise from the fact that therapy can actually be very different with different people. Some therapists might be quite structured and provide a clear roadmap, set advice, and give homework, while others might be much more open-ended and exploratory, expecting the client to take the lead with what to talk about each session. Still others might practice a technique like EMDR that has its own unique format. But regardless of approach, your therapist should be able to help explain their particular style to you and help you become familiar and comfortable with being a client.

What to expect from a first session

For most therapists, first sessions are quite similar. Your therapist will often ask you some form of “what brings you here today?” in an effort to learn what has caused you to seek out therapy and to begin the process of getting to know you. They will often also take some time to explain their approach and what you can expect from working with them. Most therapists are very open to and encouraging of questions and, like in the broader therapy relationship, it is typical for that first session to be a dialog, in which you are learning about each other. Most therapists will also ask you to fill out some paperwork, either before or during the first session, that covers everything from confidentiality to payment and cancellation policies. 

While in a first session, it can be helpful to notice how comfortable you feel with the therapist. Though of course it can sometimes be awkward or uncomfortable to begin talking about yourself with a stranger, many people are able to get a sense of whether this person is someone they might be able to build a good relationship with. Do you feel comfortable in their presence? Do you feel like they are attuned to you, listening and understanding what you are saying? Do you feel like you might be able to trust and feel safe with them over time? 

Research has consistently shown that the therapeutic relationship is the most powerful indicator of success in therapy and that it is “essential to helping the client connect with, remain in, and get the most from therapy.”

Therapy can help - but it’s not a quick fix

Starting therapy can, in and of itself, feel like a relief. But it’s also important to remember that real, lasting change often unfolds over time. Though sometimes we do gain valuable tools that we can use immediately, oftentimes we grow, evolve, and change as we are able to be curious about ourselves and reconnect with parts of ourselves that we may have spent many years keeping at arms’ length.  Ultimately, this type of hard-won self-knowledge is what brings a sense of agency, healing, freedom, and peace. 

Related: How Long Does Therapy Last?