What to Expect in Therapy

January 9, 2023

You've made the first and hardest step - deciding that you need help.  Now let us help you make the most of your sessions. No therapy is one size fits all, here's what you need to know before your first session. 


Therapy is new to me.  What can I expect?

So, things have been a little hairy for you lately?  You’ve been struggling more than usual.  You’re feeling overwhelmed, unmotivated, triggered, exhausted, hopeless, and/or confused and you’re not sure what to do about it.  You do a google search of therapists in your area or that take your insurance.  Heck, that might be how you found your way here.  Talking to someone might sound nice, or it might sound terrifying- either way, I’m sure there are a lot of questions and uncertainty about these uncharted waters.

Well, I want to start by saying good for you!  You noticed you were struggling and you started looking for help.  I know it sounds cliche, but getting to the point where you recognize you aren’t okay and you start exploring help is a huge part of the battle.  So, whether you’ve scheduled your first session or are still waffling between making that initial contact, I hope to be able to give you some insight of what you can expect when you walk into a therapist’s office.

Woman in therapy with a mental health provider from Open Arms Wellness in St. Louis

It’s normal to feel uncomfortable

The therapeutic relationship, admittedly, is sort of a strange one.  You, as a client, meet this stranger with the expressed purpose of sharing deep, emotional, and vulnerable things with them.  Some people come in and immediately feel at ease with a therapist, but lots of people don’t feel cozy at first.  Either one and anything in between is normal.  It might take some time to start to feel comfortable sharing with your therapist.  Trust is tough for some people and they might need time to establish trust with their therapist before they can be open and vulnerable.  

A good therapist is going to be attuned to your needs, check in with you often, and allow you to get to know each other and establish a therapeutic rapport.    

You are in charge

If your therapist asks a question or brings up something you are not ready to share yet, it is absolutely okay to tell your therapist you aren’t ready to go there. Your therapist may have a master’s degree and some letters behind their name and a fancy office, but you are still the one in charge and the expert of your own experience. If things feel too much, too soon, too fast, you get to put on the brakes. If the conversation goes somewhere you aren’t ready for it to go, you get to speak to that. If your therapist reflects something that feels inaccurate, you get to set the record straight.  You get to speak to your needs and expect that they will be respected.  A therapist’s first job is to make sure you are supported, whatever that might look like.  This space and time is yours.  Do not be afraid to ask for what you need or ask questions when you’re unsure. You are ultimately in the driver’s seat with your therapist providing support while riding shotgun. 

a woman uses a laptop. This relates to online therapy in Missouri. Online therapy in Missouri provides you effective online therapy.

Compassion, empathy, and non-judgement

Above all else you should expect to feel welcomed and supported in any therapeutic space you enter.  Yes, all therapists are different.  Every therapist has their own way of doing things, their own energy and their own way of reflecting and providing support, but at the heart of it should be compassion, empathy, and non-judgement. A therapist’s job is to work with you to create a safe space for you to process, and safety is built on that compassion, empathy, and non-judgement.  So much of a therapist’s job is validating your experience because we often second guess our decisions and minimize our experiences.  Receiving compassionate support can make all the difference in the world for someone who is struggling.

Find the right fit

One size does not fit all.  Do not feel discouraged if you find a therapist and you don’t click with them and do not feel embarrassed, ashamed, or afraid to seek another therapist to find a better fit. Just like buying new shoes, sometimes we try something and it doesn’t work for us.  Maybe they are too small or too big or they rub us the wrong way or don’t go with our outfit.  And just like you wouldn’t (at least I hope) buy a pair of shoes that didn’t work for you, you don’t have to stay with a therapist that doesn’t seem to be meeting your needs.  Every client’s needs are different and every therapist is different.  Maybe you need someone who is very sweet and quiet who will gently reflect difficult things.  Or maybe you need someone who is a little rougher around the edges, who will lovingly but firmly call you out on things. Some clients want an “all business” therapist while others might want someone who is more “warm and fuzzy” or who uses a lot of humor.  There are lots of different therapists out there so don’t get discouraged if the first one doesn’t click and don’t be afraid to try someone new.   

Therapy can often be difficult.  You are processing trauma, emotions, and maladaptive coping skills after all.  But even when things feel uncomfortable. The most important thing to keep in mind is that you should feel supported and cared about. Your therapist should be with you every step of the way and checking in with how you are doing.  You should also always feel free to ask your therapist questions about their process, how they lead sessions, what modalities they use, and what they expect from you as a client and what you should expect from them as a clinician.  Therapy is not a secret.  It is not meant to be manipulative or sneaky, and if your clinician isn’t willing to discuss your questions with you, they aren’t the best clinician for you.