There are many situations that lead people to therapy, but the common reason people go to therapy is to feel better.  

Increasingly, our society recognizes that therapists provide benefits because while they are objective listeners, they are also invested in the well-being of each and every client. Having written about who provides mental health and substance abuse care and how to find providers, I turn now to what to expect when you go to therapy. 

A good thing to keep in mind is that there are many things therapists do that are consistent from one therapist to the next. However, each therapist is going to be different due to their personality; their theories about how problems develop and people change; their experiences as a therapist; and the training they have received. Ideally, your therapist will be warm, nonjudgemental, genuine and interested in you and the reasons you have come to therapy. Sometimes people feel immediate positive feelings about their therapist and the therapy process, but other times, it can take a few sessions to find a connection and rhythm that suits you. I advise everyone who is unsure about starting therapy to give it some time. If after two to three sessions it is still uncomfortable, talk to your therapist about your discomfort to see what adjustments can be made. If you are still uncomfortable, you need to find a different therapist. Often, your current therapist will be happy to help you find a better match so you can have a positive therapy experience. 

The first session with a new therapist often brings up anxiety. Even if you have had many experiences in therapy, nervousness is normal because you are entrusting a relative stranger with information about yourself which is quite private. Your hopes are high and yet your guard is up because you are already hurting and may fear adding to that hurt by opening up. 

Most therapists will have some sort of intake process.  By “intake” we mean the exchange of information that needs to happen before we can get to the real work. Many clients have been feeling such anticipation about getting into therapy that it may feel disappointing to spend the first session going over seemingly basic questions about themselves. Rest assured, there are reasons each therapist chooses to do the intake process as they do, and they will definitely get to the deeper reasons you have come to therapy as you meet for more sessions. 

What you do in therapy can depend a lot on the type of theories and therapy skills your therapist has trained in as well as why you are seeking help. Most therapists are first taught how to listen and reflect on what the client says. This is called Rogerian Therapy after Carl Rogers. The stereotypical therapy, where the client lies on the couch and talks for an hour, goes back to Sigmund Freud and isn’t often practiced anymore. These days, the therapies research finds most effective are based on cognitive-behavioral theories which say our thoughts affect how we feel and behave. Some therapies work more on behaviors and others involve more verbal processing of your thoughts and experiences. For instance, a person who has a trauma is going to talk about that trauma, while a person with social anxiety may talk about their fear but will also practice interacting with people. One important thing that happens in therapy is learning new skills.  This includes skills for coping when you are overwhelmed, skills for taking a new perspective and skills for effective communication. 

If you have been interested in going to therapy but haven’t because you are unsure what it will be like, I hope this information has been helpful.

Ask prospective therapists what types of therapy they do, what training they have had and even what their personality in session is like. Let them know if you have specific interests or needs.  For example, you may be looking for a calm therapist who is patient and can help you with a trauma, or you may like someone who is motivating and good at helping you set goals.

As a mentor of mine used to say, we want to be healthier, happier and higher functioning, and good therapy is going to help us achieve that. 

Nora Sinclair is a licensed professional counselor and a national certified counselor based in Lexington, S.C.