How does therapy work? What to expect

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

There are many different types of therapy, and every therapist is different. That said, there are a few things you can generally expect.

Your first session

Going to therapy for the first time can make a lot of people nervous. That’s normal! Think of your first appointment as a consultation. It’s a chance to meet with the therapist and make sure you’re a good fit. Some therapists will even provide a free consultation over the phone before your appointment.

During your first session, your therapist will probably start by asking what brings you to therapy, and what you hope to get out of it. They might explain their style of therapy and ask if it sounds like a good fit for you.

You might be wondering about their approach to therapy, any special techniques they use, or if they have worked with clients whose experiences were similar to yours. This is a great time to ask any questions that you have.

If your therapist does something that makes you feel uncomfortable, it’s okay to speak up or just find another therapist. You’re not stuck with the first therapist you try. If it doesn’t seem like the best fit for you after sticking it out for a few sessions, then don’t be afraid to switch therapists if it seems like you need a different approach.

What should I expect in therapy?

Once you find a therapist who fits your needs and goals, your therapy journey begins. Your therapist will guide you in doing the work of addressing your feelings or trauma or developing plans and coping skills.

Here’s what to expect in therapy:

• You set your own goals. Your therapist is there to help you identify your own goals and find healthy ways to work towards them. They are there to assist you in your healing journey and provide guidance, but you decide what goals you want to achieve.
• You don’t have to share anything before you’re ready. 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. Building trust with your therapist—like any relationship— takes time. You may open up more as you become more comfortable.
• Therapy is about more than your feelings. Yes, you will talk about your feelings, but therapy is about more than that. You’ll learn to question your negative thoughts and change your behaviors. Your therapist will encourage you to confront things you’ve been bottling up. This is challenging. And some days, you might end therapy feeling sad or angry, but this is part of the process and important for your recovery. Things do get easier over time.
• Sometimes, you’ll get homework. To really get the most out of therapy, sometimes you will have “homework.” This isn’t like the type of homework you get at school. It’s practical things like “write down how you feel each day,” or “introduce yourself to someone new.” This homework can help you learn new coping skills, identifying feelings, etc. If your therapist asks you to do something you don’t feel ready for, you can ask for something more manageable.

Some days, I go into my session thinking I have everything under control and nothing to talk about. But as soon as my therapist asks me the right question, I start pouring out thoughts I didn’t even realize I had. My brain tries to protect me from buried trauma, but it always results in disaster. My therapist sees that and pulls it out so I can deal and heal.

Long-term therapy

Most people need more than a few sessions to get the full benefit of therapy. And this is okay! It’s common to see a therapist regularly for several months or even years. Some people combine therapy with other treatment options like medication, support groups, and lifestyle changes. Your therapist will work with you to determine the best option for you.