What to expect from therapy

You’ve decided you need psychotherapy, but the whole idea of it makes you nervous. You feel vulnerable at the thought of talking about your struggles, and you don’t know what to expect.

You’re not alone. Most people are at least a little nervous about starting therapy. But knowing what it entails can ease your anxiety and help you prepare for a successful experience. So with that in mind, here are a few things that might happen when you enter therapy:

It begins with an initial evaluation. At your first session, you will often be invited to share about what brought you into therapy. The therapist will likely follow up with more structured questions to give them a fuller understanding of the situation. The questions they’ll ask will differ depending upon that therapist’s approach and your particular problem. Generally speaking, they will ask you about your symptoms, current circumstances in all areas of your life, and personal history (because it may relate to your distress).

Therapy helps you take action. When you go to your doctor, you probably tell them your symptoms and then expect them to assess and cure the problem. Therapy is very different – it’s about helping you face particular struggles and relate differently to them.

You can more easily decide whether therapy is helping if you have goals for it. You may know there are certain feelings or experiences you’d like to get rid of, such as overwhelming sadness or recurring fears. This is a good start. The next step is to ask yourself how you’d like to feel in the long-run. Do you want to feel a sense of self-acceptance or inner peace, for example? If so, make those your goals. Otherwise, you might meet your short-term goal of no longer feeling sad, only to find yourself emotionally numb or constantly anxious. If you have trouble setting positive goals, ask your therapist for help.

You might feel worse before you feel better. Just as you might initially make a bigger mess when cleaning out a closet, therapy might stir up unpleasant feelings in the process of helping you feel better. Your distress should not be more than you can handle, though. So, tell your therapist if you are struggling with feeling upset by treatment.

You may learn new concrete coping skills. Your therapist might teach you more effective ways to manage your struggles.

Therapy is more than an intellectual exercise. Emotional healing happens, in part, by having new experiences as you learn to relate differently to familiar stressful circumstances.

Therapy can help you gain clarity and a new perspective on things that bother you. As a result, you may feel greater self-acceptance and comfort.

Your close relationships may change. You tend to relate in set ways with friends and loved ones. So, if you change, it may disrupt those old ways of interacting, forcing a change in your relationships.

While this list can help you understand what to expect from therapy, trying to describe therapy is a bit like trying to describe a song to someone. The only way to truly appreciate what it will be like is to experience it.


Entries for the Relationships blog are for general educational purposes only. They may or may not be relevant for your particular situation; and they should not be relied upon as a substitute for individual professional advice, diagnosis, or treatment. If you need help for an emotional or behavioral problem, please seek the assistance of a psychologist or other qualified mental health professional.

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