What to Expect from Therapy

If you are considering seeking mental health support, or about to start therapy (sometimes called psychotherapy, talk therapy, or counseling), you may be wondering what to expect from therapy or how to prepare for therapy. It is common to have misconceptions, biases, or conflicting feelings that may impact what you expect from therapy.

Above all, you should expect a therapeutic environment that is compassionate, empathetic, and safe. A therapist or counselor’s role is to offer you insights into your experiences, advice on how to handle issues, and evidence-based treatment for mental health conditions. Successful therapy is not only supported by a well-trained therapist —it largely depends on cooperation and investment from you, the client. Knowing what to expect from therapy can help you better prepare and be open to the experience.

What to Expect in the First Therapy Session

The first therapy session can be a source of anxiety for some people. If you are nervous about your first therapy session, that’s normal. Remember that the goal of the first session is for the therapist to get to know you. A well-trained therapist will do that by asking questions about your life, your background, and what brought you to therapy.

The other important goal of the first session is for you to see if you feel comfortable with them. “Interviewing” your therapist about their approach, what kinds of issues they are most experienced addressing, and anything else that is relevant to your reason for seeking therapy is a useful way of finding a good fit. You can ask questions like:

  • What kind of person and/or issue do you have the most experience working with?
  • How do you approach therapy? Are there specific modalities you use?
  • Can you give me an idea of what I can expect to happen in our sessions?
  • (If you are a minor) What kinds of things do you have to share with my parents/guardians and what is just between you and me?

You and your therapist will discuss your goals regarding what you want to get out of therapy. This will help to focus your sessions and give you perspective on how you want to grow. These goals may need to change over time depending on circumstances, so it’s good practice to keep checking in about them as the therapeutic relationship continues.

What to Talk About in Therapy

If you’re wondering what to talk about in therapy, it’s helpful to understand that people go to therapy for all sorts of reasons: getting treatment for mental health conditions, healing from trauma, working out conflicts, improving their relationships, or just having a safe, neutral space to talk about their life. You may be looking for support managing symptoms of a chronic mental health issue like depression, or you may want an outside opinion on a difficult relationship in your life. Whatever your reason for seeking therapy, it is valid, and your therapist is there to support you.

If you are in therapy for a specific event or set of symptoms, they may start by asking about what may have preceded those things. For example, “When is the earliest time you remember feeling that way?” is a common question, so that they can start to get at the root of your specific issue.

What Teens Can Expect About Privacy in Therapy

Legally speaking, if you are a minor in therapy, a therapist may be able to share information from your sessions with your parents, but not with other third parties, like employers. However, most therapists understand that privacy helps therapy be more successful, and protects young people from potentially damaging situations at home. You can make sure your privacy is protected by setting a boundary with your therapist about what you do and do not want your parents to know.

How to Know When Therapy is Working

There are a few key ingredients to a successful therapy experience. Some are within your control as the client, and some are not, but understanding them can help you know how to prepare for therapy and set yourself up for success. The success of your therapy will depend primarily on:

  • Readiness and commitment to change: Therapy starts when you are ready for it. For people who are pressured into therapy—especially young people—it can be difficult to feel as though you’re gaining anything when you don’t want to be there. But if you have chosen to commit to treatment by showing up on time, participating, and doing whatever work is asked of you outside of sessions, you will see the benefits of therapy.
  • Logistical and financial resources: If you can’t pay for, get transportation to and from, or manage other logistics around regular therapy sessions, it may be more difficult to see the benefits. Some of these things might be within our control, and others may not be. This can be a barrier to treatment, but knowing your limitations can help you find a treatment option that works better for you.
  • Client-therapist fit: The client-therapist relationship is one that, obviously, affects the quality of therapy and its likelihood to succeed. If a relationship is forced, or there are incompatibilities, therapy may feel more taxing than it does helpful.
  • Therapist qualifications: Part of the client-therapist fit is whether their expertise fits what you need. Depending on their qualifications, specializations, and experience, they may be able to help you reach your goals, or they may lack the experience to help you. For example, if your goal is to heal from a trauma, seek a therapist with training in trauma care or trauma-informed therapy; if you see a therapist who doesn’t have that training, it may do more harm than good. It’s important to be aware of things like this when you’re trying out a therapist to ensure you end up with the right person.

What’s important to know is that even if a therapy experience does not have the outcomes we want, just the act of trying it out can be helpful. Learning to advocate for yourself is a crucial skill, especially when navigating mental health care.

Signs That You Found the Right Therapist: Green Flags and Red Flags

Pay attention to your feelings about therapy. These “green flags” are signs that you’ve found a good therapist for you:

  • You feel respected and validated in sessions.
  • You feel that they are actively listening and paying attention.
  • They do not inappropriately share information about themselves or other clients.
  • You feel some kind of progress or change as sessions continue.

And these “red flags” mean it may be time to find another therapist:

  • You feel insulted, hurt, or judged .
  • You sense that they do not listen to you or pay attention in session.
  • They share information about their clients or themselves that feels too personal.
  • If you are a minor, they do not respect your privacy and share all sessions with your parents, despite what they told you about what they do and do not share.

How Long Does Therapy Last?

Depending on your personal therapeutic goals and health insurance parameters, therapy can be a short-term program with a set amount of sessions, or can be a long-term commitment. A short-term commitment may be for dealing with a specific event or getting advice on a particular issue. A longer commitment is often helpful for managing symptoms of chronic mental health issues like depression, or for having a reliable space for personal growth over time.

If your therapy is not legally mandated, you can choose to leave therapy at any time. There are many reasons you may choose to leave. Some are practical, like the financial or time commitment, or if you or your therapist moves. Some are based on your progress—you may feel it’s time to end therapy because you’ve reached your goals, or you may decide to leave a particular therapist because they are not meeting your needs.

What To Do If You Feel Therapy Is Not Working

If you do not feel like therapy is working, talk with your therapist about it and try to create a better treatment plan. Speaking with your therapist about why you feel like treatment isn’t working not only can help make the treatment more effective, but it can help you practice valuable communication skills.

There are some circumstances where it’s better to take a break altogether or seek another therapist. Remember, you have the right to choose a therapist that best fits your needs, and this means leaving a therapist if they do not respect your boundaries and needs. If you choose to leave because you are unhappy with your therapist, it’s a good idea to talk to them about why so they can learn lessons they can then bring to potential new clients.

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