What to expect when going to therapy?

A Guide for Those Who Considered Going to a Therapist

Amal Matar

(MSc in Clinical Mental Health Sciences)

Note: I use the word ‘therapist’ here to refer to any professional who offers psychotherapy, which includes clinical/counseling psychologists, family and couple therapists, and counselors. The points discussed in this blog can also cover the work of some psychiatrists especially those who are trained to give psychotherapy.

When some of my friends share with me something that is causing them serious distress, or when they discuss with me a reoccurring issue that impacts their lives negatively, I often ask them; “well, have you been to counseling or therapy?”. The answer is most likely to be no with a very common justification that goes something like “I’m kinda scared and I do not know what to expect” or “I’m afraid I might open a door that I will be unable to close”. This always makes me think, but isn’t that the purpose of therapy? Isn’t the main purpose of therapy is to open up plenty of doors that were locked and hidden away from yourself or from other people just like that secret drawer that everyone has in their room which is flooded with all sort of unspeakable random junk that you are too embarrassed for anyone to see what’s inside it by mistake?

In this blog, I wanted to share with you some of the things that you can expect from a therapy session based on my experience of sitting on both sides of the chairs, as an Honorary Psychologist Assistant and as a client. Hopefully, by the end of reading this blog, your uncertainty about taking the first step of booking an appointment will be resolved and you will feel more confident and reassured about doing it.

I have dealt with anxiety and depression throughout my adolescents thinking that it was only a “phase” that I must be going through as a teen during a time when being an “emo” was the cool thing in schools. It was only when I was 18 years old when I fully realized and accepted that what I was experiencing wasn’t just a phase, rather it was something that needed an intervention. I had no idea where to look for help or even what happens if I found the help I needed, but I decided to go to therapy. It took me about three years until I met the “perfect” therapist for me. She was the fourth therapist I have seen after not so successful attempts of finding a qualified and suitable therapist. My journey led me to think that there is a need to clear any mysteries around therapy for the public, especially in our society where visiting a mental health professional is still perceived as a taboo. So, from my personal experience as a client and from my experience in working in the mental health field, I wrote for you some expectations to keep in mind when going to therapy.

Illustration by Stephanie DeAngelis

What to expect from a therapy session?

You might have a first unsuccessful session with a therapist, but do not give up on therapy after the first session

I have seen a lot of people who thought therapy is “not for them” because they have had an unfortunate encounter with a therapist or a psychiatrist. Whether the therapist made you feel judged or used a lack of religiosity as an excuse or a cause for your psychological sufferings, or simply if the therapist’s approach was not the right one for you, that does not mean that therapy is not the answer for you. The relationship you have with your therapist is not like the relationship that you will have with a dentist or an ENT doctor. You are supposed to have a good connection and chemistry with your therapist as you’re going to have some deep and intimate conversation with him/her. So, if the therapist’s personality or style left you feeling extremely uncomfortable, I would say give therapy a second try and maybe a third one with another therapist. Build the courage to say no to unsuitable options and move on to the next one.

My recommendation: Before you make an appointment, make sure you check the CV of your therapist or ask the receptionist about their experience and specialty. You can also ask the therapist in the first session about his/her background. I also advise giving him/her a second chance, unless the first session was an absolute disaster. I understand that you might think that telling your story again and again to a different person might sound draining but you will get the hang of it eventually. For example, I can now tell my life story in only 10 minutes, impressive huh?

Expect to be asked lots of questions.

In your first session, you will be asked a lot of important and maybe sensitive questions that no one will probably ask you in your daily life when they first meet you. The therapist will ask you about the reason for your visit and some basic background questions about your age, occupation, marital status, education, number of siblings and children. You will also be asked about your sleep, appetite, mood, relationships with family, friends, and partner, history of mental illness, any medication you’re on, and any health conditions you have.

My recommendation: Prepare a rough statement that explains why you decided to visit a mental health professional. Also, prepare key points that you think are causing you great distress. Do not worry about staying on some sort of script when you talk, let things flow naturally. But perhaps if you reflect on the things you want to mention before going to your session that will make things easier for you. Remember to always be open and honest in your answers. Trust me, there’s nothing you could say that could shock the therapist. He/she had most likely have heard whatever you have shared before. The therapist isn’t your parent, he/she will not parent you or yell at you if you did “the wrong” thing. They are there to support you through it all.

You might fill out questionnaires.

Your therapist/psychiatrist might give you questionnaires to fill them out or he/she might ask you questions and fill them themselves. These questionnaires are effective tools that mental health professionals use to ensure that they are diagnosing or measuring important areas properly for your treatment plan.

My recommendation: Be as honest and as transparent as you can as your answers will affect the therapy and treatment you will be getting. If you did not disclose the challenges that you are facing, how can you expect to overcome them?

Expect complete anonymity and confidentiality

Your name and every information you share will be kept with your therapist only. Ethically and legally all mental health professionals cannot share anything that the client disclosed to anyone. Only if the client shared a serious plan to attempt suicide or to cause danger to others, the therapist will need to share this information. But if you experience any suicidal thoughts or if you are self-harming always share it with your therapist to get the help that you need, he/she will keep this confidential if it is not endangering your life.

My recommendation: If this topic is worrying you, discusses it with your therapist or ask for your consentform, which will explain your rights as a client/patient.

Expect thought-provoking and empathetic conversations

Your therapist is trained in listening and helping people who are in distress. They are there to walk with you and support you throughout everything. Expect to cry in front of him/her, but also expect to laugh. One of the tasks of therapists is to build a good relationship with their clients/patients, so they will make an effort to make you feel as comfortable and as safe as possible. There will be no judgments and no patronizing.

My recommendation: Remember that you are not going to like any other doctor visit that is usually very dry and technical. If you are with the right therapist, you will experience empathy, compassion, and encouragement. You will meet your new cheerleader.

Expect that therapy could be a life-long changing journey

Therapy might take weeks, months, or years for a person to fully practice and master what was introduced in the sessions. It is a slow learning process, but you will get there with time, practice, and plenty of self-compassion. You will learn a new technique in one week and you’ll probably try it successfully once if you tried really hard, but you might fail in the next try. That is completely NORMAL. It will take you a great deal of time to transform new techniques into automatic habits.

My recommendation: Always do your “homework”, practice, and forgive yourself if you were unable to apply what you learned. Just keep trying.

Seeking help for mental health can seem intimidating in a society that is used to keep things bottled in or used to share them with close family members or friends only. But perhaps you need a different kind of support, a support that is provided by a professional who dedicated his/her time and efforts to learn about the most recent evidence-based methods to help others. Give yourself a chance to explore more options out there to avoid any unnecessary unbearable suffering.

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