I’m New to Therapy, What Can I Expect?
Have you been curious about starting therapy but feel nervous about what to expect? You’re not alone. As a therapist this is a very common question I get from prospective clients.
It’s natural to be curious about therapy, it is a very unique experience and requires a lot of vulnerability. Read more to find out what you can expect from therapy sessions.
Reminder: Each therapist operates with their own unique style and personality. Although I provide information on how sessions go, please keep in mind this is a generalized summary of a very personalized experience. To learn more about different styles of therapists, check out my other blog post on different approaches to therapy.
The First Session
The first session is what we call an “intake” session. It will likely last about an hour and will usually be a bit more structured with the therapist asking questions to get to know you, your background, and why you’re starting therapy.
In my intake sessions, for example, I’ll ask new clients about: family history, mental health history, job or occupation, relationships, general health and wellbeing, hobbies, and more.
I also review my policies in the first session and give a little bit of an “orientation” to what clients can expect from therapy sessions.
If you’ve never been in therapy before, the first session can feel both overwhelming and relieving. It may be nice to finally open up and talk about what’s been on your mind, and at times it may feel uncomfortable being asked so many questions by someone you just met. Please remember you get to decide your boundaries in therapy, and if you don’t feel comfortable answering a question, you can express that to your therapist.
The First Few Sessions
During this assessment phase, both you and your therapist are learning more about each other and if it is the “right” fit for both of you. To be clear: this doesn’t mean your therapist is deciding if they like you or not, but rather if they have the proper training or skills to work with your therapeutic needs.
In the first few sessions, you’ll continue to share more about yourself, your life and background and your therapist will be using this information to create a treatment plan, meaning which interventions or treatment strategies would be most helpful for your goals.
You may continue to feel uncomfortable or awkward in the first few sessions, I often recommend giving it about 3 sessions before making a call on therapist – client fit.
The Interventions Phase
Once your therapist has gotten to know you a bit better, they will start what we call the interventions phase. Your therapist will give more feedback and explore tools to help you based on what they’ve learned about you. They may make connections or ask better questions to help you reflect and gain insight. They may teach you therapy skills, like mindfulness or emotion regulation.
For example, if I notice in the first few sessions my client discusses their anxiety, and worrying about bad things happening, I may begin with some psychoeducation on common cognitive distortions, from there we would build skills to challenge cognitive distortions, a common tool used in cognitive behavioral therapy, also known as CBT.
As the sessions progress, you’ll likely become more comfortable with your therapist, allowing them to dig a little “deeper” or understand some of the emotional processes underlying potential barriers to change. By this point, you’ll have been reflecting quite a bit, so it’s also likely that you will increase your self-compassion, self-awareness and insight in this phase. You’ll hopefully start to feel more and more seen and understood by your therapist, a good sign that the therapeutic relationship is a good fit!
Therapy is a collaborative process and your active participation is crucial. During this phase, you would work to apply the skills and perspective you learned in therapy into your daily life.
The Maintenance Phase
Not everyone enters therapy with the goal of one day stopping or terminating sessions. They may see therapy as a regular check-in for mental hygiene and overall well-being.
I’ve been very lucky to have clients who have been with me for long periods of time. These clients may have met their original treatment goals, but continue treatment for support, feedback, reminders and what we call “maintenance” of symptoms.
While it would be great to hear a client never experienced anxiety again, that’s not a realistic therapy goal. However, it’s likely that during this phase we can lower the cadence of sessions due to clients feeling that they have a good handle on managing symptoms on their own. They may still experience anxiety, but feel more confident in their ability to handle it when it comes up.
When is a Good Time to Stop Therapy?
Some clients prefer to stop treatment once they’ve felt like they are handling the original stressors that brought them to therapy sufficiently on their own. This means the treatment goals have been met, the initial stressors have been alleviated or mitigated enough for the client to resume a fulfilling life. In other words, when we run out of things to talk about.
I’m happy to hear the progress my clients are making, but if we’re finding that there’s less and less each week for us to discuss, reflect on, or problem-solve, this may be a sign that it’s a good time to stop or pause sessions. This would begin the termination phase. Where we’d reflect on the progress you’ve made, the goals you’ve met and celebrate your wins!
Again, not everyone goes to therapy with the goal of terminating, and many clients prefer to meet on a regular basis consistently over many months or years to have space for support and reflection. As the client, you have the right to decide if you want to continue or stop sessions, and you always have the right to change your mind.
Can I Come Back After Terminating Therapy?
Yes, you can always come back!
Curious about starting therapy? Find out more about working with me here.