What to expect when starting therapy*

Starting counselling can feel overwhelming, but your therapist has your back. They will be working hard from the very beginning to help put you at ease.

Every therapist has had or are having therapy, so we know the feelings of fear, anxiety, and vulnerability that can arise when you’re starting out. Starting therapy can also feel exciting – perhaps the thought of finally having someone to talk to about things that have been bottled up, or perhaps feelings of pride at taking such a brave step. It often all shows up at the very beginning.

The therapeutic relationship is key

The therapeutic relationship is the cornerstone of therapy. If you don’t feel safe, if you don’t feel a good rapport, if you get a bad vibe, then this isn’t the therapist for you.

Most therapists appreciate that they won’t be the right fit for everyone, and its up to you, the client, whether you want to continue or whether you want to look again to find someone else who is better suited to your needs.

Is this the right therapist – and is this the right client?

At the start of therapy, your therapist will be thinking about this too. We are often assessing whether we are the best person for the job – are we experienced enough in the right area or would it be better for both of us to make a referral? Equally, we may find ourselves keen to work with you, if we believe we can really help you or empathise with a part of your story.

It is also totally fine (and actually encouraged) for you to ask your therapist questions about their way of working and experience. They may be protective of their boundaries around personal information, but they will be as honest and open as they feel appropriate (and helpful to you) in response to your queries.

So, you should never feel pressure or obligated to carry on with a particular therapist if you are not feeling it. Your therapy is your decision, so take your time to find the right person.

But what about the practicalities – what’s therapy really like?

Most therapists start off with a bit of history-taking. They might ask you some questions about your life and lifestyle to get a more general picture of you. They may also ask you some specifics about your family and background. Again, this is all to help make sure that they understand how best to work with you and flag anything that they may not be equipped to work with, as well as checking for any risk that you are not safe.

Some therapists may simply ask ‘what brought you here today?’ or ‘how can I help you?’ to get things started. Everyone’s approach is unique, so there is no right or wrong, and some therapists may tweak their approach, once they get a feel for what you may need.

What shall I talk about?

Once some of the initial questions are out of the way, the floor is yours. You get to decide what you talk about and how you tell your story. Your therapist will not have an agenda or a particular expectation for what you talk about. They may ask some questions to prompt you if that feels helpful, but they may keep quiet so as not to interrupt your flow. It all depends on how your therapist works and what they feel you need in the moment.

There is also no pressure for you to ‘get it all out’ in the first session or two. It may be that you have come to therapy for something very specific, but difficult experiences take time to explain, and sometimes it takes months or even years of therapy to get there. That’s totally fine too, your therapist isn’t in a rush, and will be patient with you. Just take your time and you will get to it all when you’re ready.

The other important thing to note, is that nothing is off limits. Your therapist won’t judge you or criticise you. They will empathise and be compassionate – whatever you have to say, we are ready to hear it and we want you to feel safe enough to share your full truth.

What happens at the end of the session?

Sessions are 50-minutes long, affectionately known as a ‘therapeutic hour’. Some counsellors hold sessions for slightly longer or slightly less, but 50 minutes is standard practice and most common.

Your therapist will be keeping an eye on the time throughout your session – but they will do this subtly. If you catch them looking at the clock, it’s because they need to make sure you are safe and calm at the end of the session, so they will be making decisions all the time about how to responsibly end the session and make sure you’re going to be ok when you leave.  

It can sometimes feel like you’re only just getting started when the time is up, but it should never feel like an abrupt ending.

At the end of the session, you may feel a little emotional or tired, and your therapist may encourage you to be gentle for the rest of the day or take a little walk to shake things out a bit. They may encourage you to take some notes to capture the session, if they think it will be helpful – you can do this anyway, whether or not your therapist suggests it!

How long does it take to feel better?

It’s important to have realistic expectations. Therapy isn’t a quick fix, it can take time and patience. It might also feel harder before it feels better. Counselling can be a transformative process but it’s also very unique to every individual, so some may feel that they only need a handful of sessions, whilst some might stay in therapy for much longer. Again, how long you are in therapy is a personal decision, and staying in therapy for a while doesn’t mean that you’re doing it wrong or that you’re not ok.

Some people come to therapy for a specific issue and stay longer as they unravel more about themselves. Some enjoy being in therapy as more of a ‘maintenance’ measure, in the same way that they would go to the gym for physical fitness, they stay in therapy to keep their mental health in check.

Therapy is a process – and it’s not always linear

Yes therapy can be hard work, it can be emotional and it’s definitely an investment. But therapy isn’t always heavy - it can be light, it can be funny, there can be laughter and shared moments of magic.

Counselling can be a real journey of self-reflection and discovery, not to mention self-care. Give it a try – it might be the best gift you’ve ever given yourself.

*This blog has been written from the perspective of an Integrative therapist. Each modality and style of therapy will differ, but the above account is how most Integrative practitioners work. Here you will find further information on different approaches and styles of therapy.