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What to Expect When Starting Therapy

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Getting Started With Therapy

You’ve done your homework and settled on a therapist. After much anticipation, the day of your first treatment session has arrived. Your emotions are all over the place, from excitement to worry to sighing relief. The problem is that they all seem to arise at once, making it hard to determine which emotion is dominant. When do we get a chance to talk? Where should I start? What do I say?

You might have addressed some of these concerns in the message you sent when you booked an appointment with the psychotherapist. However, most people are left with questions and are unsure how to prepare for what lies ahead. When you start therapy, it’s not only you who experiences changes. Your environment changes, too.

Psychotherapy not only affects you on the inside but also impacts the outside world, including social and professional interactions. Since each therapeutic journey is unique and personal, there is no foolproof way to prepare for this transition.

First Things to Know About Therapy

To some extent, your first session with the therapist will mirror a visit to the doctor. When you arrive, you fill out some paperwork, then wait to be called into the office. If you’re seeing a therapist who works from an at-home office, you should expect a more relaxed atmosphere. You’ll likely have some paperwork to complete while you wait, such as:

  • HIPAA Notice of Privacy Practices
  • Insurance coverage and payment arrangements
  • Current medications and medical history
  • Symptom-specific questionnaire
  • Release of Information forms
  • Understanding the Therapist-Patient Contract

If you prefer to discuss your responses with your therapist in person, you are generally not required to complete the symptom questionnaire in writing.

First Day of Therapy

Your therapist’s approach to your first session will differ from subsequent sessions. You and your therapist will establish rapport during the first session and discuss the next steps. In the future, your visits will serve a more therapeutic purpose. You may choose to delve deeper into a particular symptom or problem, or explore issues or trauma that arise in sessions.

Don’t expect your problems to end after just one session. You will likely need to commit to a longer course of treatment. The goal of therapy should be to provide long-term benefits, not just temporary relief.

Your therapist may pose the following questions during your first session:

  • Why did you decide to seek help through talk therapy?
  • Where do you think you’re falling short?
  • What are your symptoms?

A few inquiries into your background will cover topics such as your upbringing, schooling, and relationships, both romantic and platonic. You and your therapist should also agree on a timeline for treatment, the approach you will take, and the terms of payment and confidentiality.

Time Required for Therapy

Although you may be curious about how long it will take until you start to “feel better,” there is, unfortunately, no easy answer. Many insurance policies only pay for a certain number of sessions per year, so you may need to consider that and work out a payment plan with your therapist.

Also, some therapists do not accept insurance. In this case, you must pay the therapist directly and request reimbursement from your insurance plan or bear the cost yourself.

Methods of Treatment

Therapists use a wide range of methods that can aid in managing mental health problems, the resolution of personal concerns, and the development of positive new habits. You may feel more prepared for your therapy sessions if you know what methods your therapist intends to utilize. Some common types of therapy include:

  • Person-centered treatment: therapy that focuses on the client; an interpersonal kind of psychotherapy that focuses on expressing positive, unconditional esteem for the individual.
  • Behavior or cognitive therapy: emphasizes the importance of establishing links between one’s mental, emotional, and physical states.
  • Existential therapy: instead of treating symptoms, this therapy focuses on individuals’ free choice and self-determination.
  • Gestalt therapy: focuses on the present moment and current challenges in patients’ lives instead of dwelling on the past.
  • Psychoanalytic or psychodynamic therapy: aims to help patients face, understand, and change the psychological dynamics contributing to their emotional distress.

Some Things to Expect When You Start Therapy

It is common for those in psychotherapy to commit an hour weekly to discussing their feelings and problems in sessions. Allowing yourself this time and space might help you reflect on your life and gain insight into the experiences that have molded you. A lasting therapy connection is possible if you and your therapist can form a solid alliance. The longer you commit to psychotherapy, the more you’ll get to flex that ‘seeing beyond’ muscle, a skill that will serve you well even after your sessions.

You Become Caught in Your Thoughts More Often

It’s usual for people in therapy to start thinking more profoundly and more deeply about themselves and their world. Having a trained expert prompt you with open-ended questions is a great way to encourage introspection and growth. It may cause you to re-think your interactions with others and the choices you make. Do not be alarmed if, after engaging your thinking brain, you find yourself overthinking things sometimes. This is part of the process and nothing to be concerned about.

People in Your Life May Push Back Against the New You

When people first begin treatment, they are often unprepared for its profound impact on their interpersonal connections. You may have spent a good portion of your life adjusting your behavior, thoughts, and emotions to fit into specific relationship puzzles. All that changes when you begin therapy. You’ll be going through a period of tremendous development and transformation, and the way you relate to others may change as you get better at knowing and meeting your own needs.

Some people in your life may resist these changes in you. That can be discouraging, but preparing ahead of time will help you have patience as they adjust to the new you. Remember, it is not your job to force people to accept you as you are. You can try to play a role for them, but how others react to you will ultimately be determined by their life experiences, emotional maturity, and many other factors outside of your control.

You May Start Recognizing Toxic Tendencies

It should be no surprise that peoples’ responses and actions toward others depend on their upbringing and taught behaviors, some of which may be more beneficial than others. During therapy, you may become aware of destructive patterns passed down to you through the generations. Once you give them a name, you can take steps to alter them, hopefully making them more manageable for future generations.

You Broaden Your Range of Feelings

Recognizing and giving words to one’s feelings is a fundamental step in the therapeutic process. Most psychotherapists, regardless of their method or style, can assist you in learning to put words to your emotions. Repeatedly doing so will help you develop a more robust emotional toolkit.

You May Find Yourself with More Questions than Answers

It’s possible that as you go into your past and discover the things that made you into the person you are now, you’ll find that you have more questions than answers. It’s good to wonder how your experiences have influenced you up to this point, but it’s important to remember that you don’t have to rush to find the answers. In fact, it’s healthy to take your time with some questions.


By starting the therapy process, you’ve already proven your dedication to learning more about who you are. One’s first treatment session is often the beginning of a journey toward improved mental and physical health and increased resilience.

If you or someone you know experiences mental health issues, it is important to seek help from a qualified professional. Our Resource Specialists can help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.

Contact a Resource Specialist

Author Bio: Vincenzo Sinisi SAPA, IPA, HPCSA, is a clinical psychologist, psychoanalyst, group analyst, and the founder of TherapyRoute.com an excellent resource for finding great nearby therapists worldwide.

Resources to Recover and Our Sponsor Laurel House Celebrate Black History Month

February is Black History Month, a time for celebrating the outstanding achievements of Blacks and African Americans and their central role in US history. It is also a time to recognize the struggles Black people have faced throughout our nation's history and give tribute to the strength and resilience of generations of Black Americans who have risen above adversity.

Black History Month originated from an idea by Harvard-educated historian Carter G. Woodson, who wrote the Journal of Negro History in 1916 to herald the achievements of overlooked African Americans in US history and culture. In 1926 he led an effort by the Association for the Study of Afro-American Life and History (ASALH) to officially declare the second week of February as "Negro History Week." These dates align with the birthdays of two crucial figures in Black American history: Abraham Lincoln (February 12, 1809), who signed the Emancipation Proclamation officially ending slavery in the United States, and the Black American abolitionist and author Frederick Douglass (February 14, 1818), who escaped from slavery to become one of the most influential civil and human rights advocates of the 19th century. In 1976, President Gerald Ford gave official governmental recognition to the observance by declaring February "Black History Month."

Without the contributions of Blacks and African Americans to more than 500 years of US history, culture, entertainment and the arts, science, athletics, industry and the economy, public service, and the Armed Forces, we would not be the country we are today.

Photo by SHVETS production: https://www.pexels.com/photo/client-listen-to-anonymous-psychologist-7176297/

The opinions and views expressed in any guest blog post do not necessarily reflect those of www.rtor.org or its sponsor, Laurel House, Inc. The author and www.rtor.org have no affiliations with any products or services mentioned in the article or linked to therein. Guest Authors may have affiliations to products mentioned or linked to in their author bios.

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