Wondering What to Expect When You Start Therapy?
Not knowing what therapy is going to be like is one major hesitation when people are considering therapy. I see this a lot in my workshops– people are generally interested or feel that it may help, but are scared because we don’t talk about what happens inside the therapy room.
And for the sake of staying on one topic, this post essentially assumes that you’ve already found a therapist you would like to work with. If you’re also wondering about what the process is like to finding a therapist, I write more about that here. And, if you’re wondering what all the different types of mental health professionals are, I break that down here.
So in this post, I’m breaking down the major milestones of therapy, and what you can expect in each step of the process, so you know what to expect when you’re thinking about whether therapy is the right step for you.
I find it helpful to break down therapy into three main phases: the Beginning, Middle, and End phases of therapy.
Briefly, the phases can be summarized as:
Beginning phase: Building a strong relationship with your therapist, so you can start feel more comfortable talking about vulnerable topics
Middle phase: The phase of work, transformation, and growth
End phase: Realizing you’ve achieved your goals, consolidating the things you learned and areas of growth, and ultimately ending therapy.
Let’s dive into these phases with a little more detail.
The Beginning Stage
The beginning stage starts right at the beginning of this new relationship you’re developing with your therapist! So likely, it’ll start in the intake session.
Intake Session
In this session, you’ll talk about what brings you to therapy. Your therapist will be really interested in getting to know you, what you believe and think about these challenges you’re facing, and also how these challenges are impacting your life.
Your therapist is, in general, trying to get to know you a little bit better. It may help to remind yourself that you’ve lived in your shoes you whole entire life, but your therapist is only meeting you now for the first time! And so there’s a whole lotta you to get to know, and we’re more than thrilled that we get this opportunity to know you.
So your therapist might ask questions around:
how you grew up
what stage of life you’re in
what significant relationships you have in your life
what a typical week looks like for you
These questions are just to help your therapist get a deeper understanding of how the problems you want to solve fit into your life on the whole. Your therapist may also want to set goals for therapy. Basically, it’s about asking what ‘feeling better’ actually means to you.
Whether it’s to be able to better handle your emotions, disentangle from toxic relationships, build more confidence, or accomplish something you’ve been wanting to do – it’s helpful to have a guide on what you hope to achieve at the end of therapy.
The First Few Sessions
After the intake session– we enter into the regular phase of therapy. I might still categorize this as the beginning phase of therapy, because although you’re developing some comfort with your therapist, you may still not be ready to be your full self with your therapist. You’ve only met them a few times, and so it makes sense to not be ready to disclose some of the sensitive challenges you’re facing.
In these first few sessions (and there is no right answer to how many sessions it’ll take you to warm up to your therapist), it’s common to spend therapy talking about some of the challenges that are coming up in your life currently, without getting too too deep.
Your therapist is also gathering more information here. They may ask questions around how you respond to these challenges you’re facing, how you understand why these dynamics are coming up, and anything else that feels important.
The transition from the Beginning Stage to the Middle Stage is a process– it’s usually not one moment when you realize: I trust this person! Hopefully over the course of the first few sessions, the trust will build and you’ll start feeling more comfortable going into some deeper, more vulnerable topics.
The Middle Stage
Typically how I know we’re in this stage, is when a client will disclose something that’s quite difficult and emotional for them. That courage to be vulnerable is how I know we’re ready to start doing “the work” of therapy.
And before we get into discussing this stage, how much work you choose to do depends on the goals you’ve set. A common misconception I hear is the idea that if you start therapy, you’ll need to dig up all your childhood traumas and revisit all the hardships you’ve faced.
You do NOT have to unpack all the difficulties you’ve ever faced in your life– you get to choose what you want to talk about in therapy. If you’re really wanting to get skills and strategies to cope better, you might not be doing a super deep dive in this phase.
And so I don’t want to scare you into thinking that the work is always super deep and only about uncovering and healing trauma– it’s not. The work in therapy is towards whatever goals and topics you set out as being important for you.
The Messy Middle
This stage is the Messy Middle, or where progress sometimes feels like it slows down. That makes sense, though, given that we’re likely digging up stuff that’s been suppressed, or maybe we’re actually thinking about and reflecting on some of these things for the first time. It may be uncomfortable, and at times it will be challenging.
But often I also find that there’s a sense of liberation– of knowing and feeling like there actually is a way to feel better, and that often brings a lot of hope into the process that makes this discomfort worth it.
How this middle stage goes is different for everyone, and so it’s hard to explain what this stage will be like for you. In general though, there will be some elements of insight-building around what has led you to this point, and also what are the barriers that keep you stuck in this current cycle. There will likely also be some psychoeducation which is where your therapist brings in models or information that helps you understand why you’re feeling or responding in a certain way, as well as how to get out of the cycles. There will also be some emotional processing, because with any challenging situation, there likely also are painful emotions associated. You’ll likely also learn skills and strategies, and throughout the process of therapy you’ll begin to practice turning to those strategies, as opposed to other coping methods that may not be as helpful.
Getting through this messy middle is tough and requires some perseverance, because it won’t always feel great and sometimes may not feel like you’re making a ton of progress. But if you’re able to stick with the process, this is where you’re most likely to see major benefits and growth from therapy.
How long will it take for me to feel better from therapy?
This is a question I get a lot from folks considering therapy, and typically this means how long can I expect to be in this messy middle stage of therapy? As perhaps unsatisfying as this may be, my answer is– it really depends.
Depending on how deeply rooted some of the issues you’re seeking therapy with is, it may take some time to undo those. Also, it depends on how deep the topics you’re looking to go in therapy. Perhaps you’re really looking for strategies for coping, which may result in seeing improvements very quickly, whereas if you’re hoping to really get to the root of the trauma and heal those wounds– that will be a longer process.
The End Stage
Now we are finally at the end stage of therapy! Congratulations! So you’ve put in the effort, shown up to therapy consistently, and embraced the process of therapy, and now you’re seeing the results.
Once you’ve reached your goals for therapy, this does not mean you should abruptly cancel all future sessions. Or worse, ghost your therapist! Therapists actually have a way to end therapy productively. Therapy is meant to end– helpful therapy is meant to set you up so you don’t need therapy anymore.
So if you feel like you’re getting the sense that you’ve done the major pieces of work you came to therapy for, let your therapist know! They won’t be offended that you don’t want to see them anymore– if anything, it’s a strong testament to both the work you put in and the work they facilitated.
I would probably recommend scheduling at least one last session where you focus on the termination of therapy. I find that a lot of people don’t know… what a termination session even means?
Termination Session
Termination sessions are incredibly helpful to setting you up to be ready to face the challenges of life, when you don’t have the carved out time of a therapy session.
In the termination session, we’ll usually:
Evaluate the progress you’ve made on your goals for therapy & take a moment to appreciate all the changes you’ve made!
Recap the skills and strategies you learned in therapy and how you’ll implement them as you continue to weather life’s ups-and-downs.
Process any feelings you have about the ending of therapy! (And yes, it’s okay and perfectly normal to feel sad)
Essentially, this termination session sets us up to have a productive ending to this meaningful relationship. We experience relationship endings in life, but we often don’t experience an ending that is healthy and productive. Having one last session to have space to reflect back on the experience of therapy can be very beneficial to your overall experience of therapy.
So there you have it–an overview of what to expect when you’re thinking about going to therapy for the first time. I hope that answered some questions you had about what therapy actually looks like, and what to expect when you enter into therapy.
If you have any questions or want me to go into any more detail about any of the things mentioned, please leave it in a comment down below!
