What happens in a Therapy Session?


The fact that you have decided to seek therapeutic help is already an important step in changing your life for the better, as many people avoid asking for help due to concerns such as social stigma, fear of the unknown, or deeply rooted unhealthy coping mechanisms.

Despite how much progress has been made, social stigma still prevails over seeking mental health treatment when you feel unwell. Even if we are not talking about specific mental health concerns, studies show each individual will have to deal with at least one psychological issue at one point in their life, and many of them avoid seeking help.

What we need to remember is that coping mechanisms work differently for each and every individual. There is no shame in seeking help to improve our abilities to cope with difficult situations, just as there is no shame is second-guessing our decision, even as we are about to enter the counsellor’s office. 

Whether you are looking for methods to improve your life or seeking support regarding specific mental-health concerns, having a clearer idea of what to expect from a therapy session is a good method to ease off some of the concerns and understand the benefits can be immense. 

Know that uncertainty is normal

If you went through the process of scheduling an appointment with a therapist, then there is probably a good reason that pushed you to do so. Be it because a friend suggested it or because you felt things are not right, the reason still exists.

It is not uncommon for first-time patients to want to cancel their appointment minutes after entering the waiting room. Questions such as, What am I doing here? Is this the right decision? Should I maybe talk to a friend instead? are bound to go through your mind at some point. Acknowledge that this is perfectly normal to happen, but don’t let these feelings stop you from seeking professional help. 

Make sure to bring these concerns up with your therapist – it’s not the first time they have to deal with patients second-guessing their decision to go to therapy, and they can help you overcome doubt.

The first session will open with some practical aspects

While therapists may use different approaches with their patients, most first sessions will start off by discussing some practical matters with you. This includes insurance and fees to understand the benefits that are covered and the available options for your particular situation. 

Another aspect that will be discussed is your medical history, including current medication (psychiatric or not) you may be taking, issues you are confronted with, and symptoms you may be experiencing. 

Your expectations about these sessions will also be discussed so that the counsellor can get a grasp of your understanding of therapy.

The reason why therapy opens up with these aspects is so that the counsellor can get a clearer idea of your current health state and see they are a suited match for you. In situations when the therapist feels they may not be the best specialist to address your concerns, they will refer you to another professional.  

Then, it is time for an open conversation

Once they start feeling you have become more comfortable with being in a therapist’s office, the counsellor will start guiding you through a conversation about yourself. There may be a series of questions they will ask, but remember there is no right or wrong answer to this. The therapist is only doing this to get to know you better.

If there are aspects you are not comfortable talking about yet, you don’t have to. As professionals working with UK Therapy Guide point out, therapy can only be successful if you are honest and open. It is only normal to want to establish trust before you can open up to a person, so they will not push you into disclosing things you are not ready to share yet. It is common for patients to of through months of therapy before they can fully trust and open up to their counsellor. 

It is worth pointing out that anything you decide to disclose will be kept between you and the counsellor. The only exceptions come if the therapist fears you may be a threat to yourself or others around you. For example, domestic violence or neglect that involves children or disabled people fall into this category. 

Expect yourself to go through a chain of emotions while talking about things that you may or may not have shared with people by now. At times, you can feel nervous, angry, or even sad, but you will also feel comfort and relief once you are able to finally talk about your experiences. 

Therapy is very different from talking to your best friend

As you prepare for your first therapy session, you need to remember that a therapist and a friend are not one and the same. The main difference comes from reciprocity: while a friendship is based on equality and a reciprocal rapport, meaning you need to give and receive, time spent with your therapist focuses solely on you and your needs. While many therapists appreciate the gesture, they won’t get mad if you don’t ask about their day. 

In addition, remember that therapists are professionals with expertise in their field, trained to have a non-judgmental, unbiased approach to your issues. They will be able to observe your life through different lenses and can point out patterns you or your best friend won’t be able to recognise. They will also provide fact-based advice on how to make important life changes, building or breaking habits, and developing healthy coping skills.

Some therapists can also suggest practicable actions you can take to improve your life, such as setting goals, tracking your progress, and building skills. Others even give their clients homework, which consists in actively applying the skills and tools learned in therapy to everyday life.

At the end of the session, the therapist will review what has been discussed, offer their opinion, and propose an action plan for your collaboration. It may not always involve a diagnosis, but their suggestions will provide an idea on what you should expect if you decide to continue working together. 

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