You have decided that you want to see a therapist and you are probably wondering: What the heck is actually going to happen in therapy?

 

Great question!  BUT- First of all, give yourself a pat on the back for deciding to reach out for help. Taking the first step of deciding to get help shows bravery!

As for your question: There are a variety of types of therapy and it can occur in a variety of settings. So, let’s break this down.

In Person? Online? Phone? Where It All Happens

 

• In Person Therapy
  

  When you think about therapy, you undoubtedly picture an office setting. This image may include a therapist at a desk or sitting in a chair with a notepad talking with a client on a couch or seated in another comfortable chair. For decades, therapy has occurred this way. Most often, when attending an in person therapy session, you and a therapist will meet in an office setting with comfortable seating, similar to a small living room.  The room may feel inviting, safe, and private.

 

• Online/Virtual Therapy
  

  In the recent decades, more and more people have been able to find the mental health support that they need through online counseling. The growth in technology has allowed access for so many people who reside in areas with limited mental health resources. Additionally, online counseling is great for people with busy schedules who have a need for flexibility. There may be an added benefit to participate in your therapy session from the comfort of your own home. Some people have wondered about the impact of online counseling compared to in person. According to an article published by the National Institute of Health, online therapy is as effective as in person therapy for a variety of mental health issues.

 

• Telephone Therapy
  

  Just like online therapy, the use of therapy via telephone has grown over the past decades. In this setting, your therapist would call you directly via a secure phone line for sessions. “Both phone and video appear as effective as in-person care for reducing symptoms” according to an article published by the National Institute of Health. Engaging in therapy by phone also eliminates the challenges of commuting and conflicts with busy schedules. If you reside in a remote area with limited resources, telephone therapy may be a great (and maybe only) option for you.

 

Because research has found that each setting is equally effective for most mental health concerns, it’s up to you to evaluate your needs, schedule, and access to resources. Once you have decided what setting works best for you, you may want to explore what this journey may look like:

What Happens in the First Session?

First of all, it’s 1,000 percent normal to feel nervous about the first session! It’s like a first date or a job interview… there is so much that is new and unknown.

You probably have tons of questions and your therapist will, too!

Just like a first date, you and your therapist will want to decide if it is a good fit for you and your needs. Yes! You can choose to meet with another therapist if you feel that you do not connect during that first session.

In that first session, your therapist will probably ask about what motivated you to seek therapy or “What brings you into therapy today?’.  You will also be encouraged to identify your expectations or goals for therapy.

You can and should ask some questions. You can ask about the therapist’s style or approach to therapy. You may have questions about the therapist’s past work and familiarity with clients who share similar needs and experiences. You may wonder about the frequency of sessions and length of treatment.

By the end of the first session, you should have some information about the therapist’s approach, personality, and expectations. You may also have clear expectations about the frequency of the sessions and the course of therapy.

The first session also usually includes reviewing paperwork and agreements regarding confidentiality, payment, cancellation procedures, practice policies, HIPAA, and more. This is what I often refer to as “the business part.”

What Does Therapy Look Like?

When working with a mental health professional, you will work together to address your needs and concerns. Your therapist will help you to navigate your feelings, coping strategies, and what you want to work on in sessions.

Therapy is for you and about you. Your needs and progress are the priority.

What Should I Expect in Therapy?

• Go for the goals
  

  In therapy, you will identify your own goals to work on. Even during the first session, your therapist will ask “What do you want to get out of therapy?”. Your therapist will assist you with identifying your goals as well as steps to achieve these goals. As you progress in therapy, you will evaluate and alter your goals. Things can change which can create a need to refocus, so therapy can be fluid and flexible. It’s important to evaluate and adjust along the way. The overall goal is that you get what you feel you need.

 

• Say things when you are ready
  

  Inviting a complete stranger into your world and sharing your deepest thoughts and feelings with them can be uncomfortable! This feeling can be reduced when you feel safe and have a connection with your therapist. Over time, you will continue to build trust in the relationship. If topics or questions come up and you are reluctant to talk about them, you can let your therapist know that you are uncomfortable discussing them at this time. It is completely okay to say that you do not want to talk about it yet. Over time, this may change as you become more at ease and comfortable in therapy.

 

• Let’s talk about feelings and more
  

  Therapy does involve a bit of talking about feelings, but what else happens can vary depending on the approach of your therapist. Your therapist will facilitate the discussion of your feelings, even the challenging ones. Additionally, your therapist may encourage you to challenge your thoughts, explore coping strategies, and change your behavior choices. You may practice some skills in sessions, including mindfulness or calming techniques or communication strategies. Outside of the session, you may have homework which can include journaling, reading, etc… Therapy is about all of you, including feelings, thoughts, behaviors, and more.

 

• Is this going to last forever
  

  You can work with a therapist for a long time or a short time or somewhere in the middle. The plan for your course of therapy can be discussed with your therapist at the beginning of treatment. You may want to address it as you evaluate goals and progress as well. Some people plan to meet for at least 8 weeks (short term) and then decide the next steps. The next steps can be:

• • continue to meet with decreased frequency
  • continue indefinitely at the same frequency
  • terminate completely
  • end with the plan to reconnect “as needed”

You are the Priority in Therapy

It is important that you remember that your choice to enter therapy was to help yourself. Therapy is for you and you are the priority.

If at any time, you feel uncomfortable or dissatisfied with therapy, you can speak up.  Your feedback can help the therapist to better help you. You can also request to change to another therapist. If you talk with your therapist about your concerns, they may provide you with referrals that better meet your needs. You do not have to stay with the same therapist if the relationship is not a good fit. You do not have to stay with the first therapist you meet with… there are so many therapists out there to choose from!

In circling back to the earlier analogy of a first date… you don’t have to marry your first date.

What I Hope You Know

I hope that you know that you are brave for reaching out for support. This can be awkward and overwhelming because it feels like there is so much that is unknown. Hopefully, you feel that you know a little more about what to expect.

Working with a therapist can improve your mental health. You can find the strengths and skills you already possess to better help yourself through therapy. Whether you participate in therapy for a short or long term or online, phone, or in person– it can be beneficial. I hope that you find the support that is best for you!

 

About the Author- Kathy Davis, LCSW

Kathy Davis, LCSW provides virtual therapy at Resolve Counseling in Texas. She works with families, children, teens, and adults providing online therapy for anxiety, depression, grief, and trauma.