What to Expect in Therapy According to a Therapist

There are a lot of misconceptions about therapy. Trust me — as a therapist, I know all about this. I’ve had clients who are coming for the first time ask me where the couch is, thinking they are supposed to lie down and muse about their childhood. I’ve also had clients tell me they expected something out of the movie One Flew Over the Cuckoo’s Nest, with aggressive treatment options and an unsympathetic therapist. Many are often very surprised to find out that therapy is nothing like that.

No matter what, starting therapy can seem like an intimidating process, especially if you don’t know what to expect. Therapy is actually quite different from what you see in the movies and in pop culture. It requires commitment and hard work, but it can be an incredibly rewarding and life-changing experience. It can be one of the best things you do for yourself, and knowing what to expect can help eliminate any unnecessary anxiety. Here are some things to keep in mind that might demystify the process of therapy.

What is scheduling your first appointment like?

Once you’ve decided which therapist or group practice you’d like to work with, it’s time to call and schedule your first appointment. Your therapist or the intake coordinator will likely ask for your insurance information (if you’re using insurance), your availability for scheduling, and they may ask for a very brief and generic description of what you are hoping to work on in therapy.

For example, if you are struggling with anxiety, you could simply tell the intake coordinator, “I’m looking for help with my anxiety.” This will help them pair you with an experienced therapist in the group practice.

After you’ve scheduled your first appointment, you may be able to fill out your intake paperwork ahead of your first appointment. Some practices have you fill this paperwork out ahead of time while others have you complete it at your first appointment.

What happens during the initial consultation?

Think of your first appointment as your introductory session, which means that it will differ from future therapy sessions in the way that it is structured. You may have some paperwork to fill out before your appointment (confidentiality forms, privacy policy, contact information, etc.) and your therapist may ask you to fill out a questionnaire regarding your symptoms and what you are coming to therapy for.

Afterwards, you and your therapist will meet to discuss your goals for therapy based on the information from your intake paperwork and the information that’s gathered during the session. Your therapist will probably introduce themselves, provide some information about their experience and training, and explain their treatment approach. They will also ask you questions about your symptom history, current stressors, and other kinds of general information.

The purpose of asking these questions is so that your therapist can get an idea of how to best help you. Based on the information you discuss, he or she will put together a treatment plan that is tailored to your goals for therapy. Your therapist may share this treatment plan with you at the end of your first session or at the beginning of your next session.

What does a typical session look like?

After your initial consultation, your therapy sessions will go a little differently now that you and your therapist have decided on your goals for treatment. In a typical session, your therapist will help you use examples from your life to learn and implement strategies to help you treat your symptoms and work towards your goals. For example, if you are struggling with anxiety, your therapist may help you learn relaxation techniques as well as healthier ways of thinking.

They might also give you homework between sessions, such as strategies to practice. Homework can help speed up your progress in therapy. I always tell my clients that those who do their homework often see better and quicker results compared to my clients who show up for their sessions but leave everything they learned at the door when they walk out.

How long will therapy take?

My clients often ask me how long they can expect to be in therapy. Because every person moves at a different pace, has different experiences, and different goals, it often isn’t possible to provide an exact number. However, your therapist may be able to provide a broad estimate of the number of sessions.

For example, if you are looking to learn some strategies for managing your anxiety when giving speeches, you may be able to complete that in six to eight sessions. On the other hand, if you are dealing with the effects of trauma, it could take much longer.

In reality, the quality of your work during your sessions is much more important than the number of sessions. When you and your therapist are able to do quality work, you will likely see results much faster.