What to Expect When You Are Expecting…To Start Therapy

Starting Therapy

“Psychotherapy can be one of the greatest and most rewarding adventures, it can bring with it the deepest feelings of personal worth, of purpose and richness in living.” ~ Eda Leshan

In 2018, 56.7% of U.S. adults with a mental illness did not receive treatment. Maybe you are thinking about seeing a therapist…but you have no idea what to expect, or where to start. You may wonder what happens during sessions, how long will you be in therapy, how you will know that you are done in therapy, or a million other questions. These are common and completely valid concerns, and my goal in this post is to cover that basic information so you will know what to expect when you are expecting…to see a therapist.

What to expect before you start. 

Before going to therapy, it is important to identify the areas in your life that need help and healing. Consider whether it is an individual or relational issue. This step is huge because it requires humility and courage to admit that you need help and to be vulnerable. The next step is finding the right therapist for you. Brainstorm what qualities (such as experience or personal characteristics) are important to you in a therapist; not everyone is looking for the same thing when starting therapy. For example, researchers Susan Hardin and Barbara Yanico asked men and women what they looked for in a potential therapist and found differences in genders: Men tended to want an efficient counseling process, for the therapist to be directive and self-disclosing; while women have higher expectations for the therapist to be open, accepting, genuine, attractive, and trustworthy. Regardless of gender, these researchers found that prospective clients expect empathy, expertness, and concreteness from an experienced therapist, and a positive outcome. What are you looking for?

What to expect when choosing a therapist.

Once you have found a potential therapist, you may experience trepidation about meeting and disclosing your private struggles to this stranger. To help the matter, I urge you to familiarize yourself with the therapist(s) you are considering. Here are three helpful suggestions:

  1. Look at their google listing and familiarize yourself with their website. For example, on Cluff Counseling’s page, I have a section entitled “About Me” where you will find information about me like my hobbies, interests, educational experience and training. I also have a “Frequently Asked Questions” section that will give you insight to my structure and style as a therapist. 
  2. Do not be afraid to ask for a phone consultation before setting your first appointment.
  3. Ask your questions! Create 3-4 questions you would like to ask each of the potential therapists that you are considering. Common questions I hear are: Do I take insurance? How much is each session? Does it cost more for couple sessions? Do I have experience treating ______? Do I have a sliding fee scale? What is my cancellation policy? Do I do couple therapy if that is needed down the road? How long is each session? What do you need to bring to the first session? 

Remember, you are the client and so it is important that the therapist is a good fit for you. If the first one you talk to, or meet with, does not feel right, reach out to the next one on your list. 

What to expect when you start.

Many people are curious about the frequency of sessions, as well as what typically happens during a session. I schedule one 50-minute session a week–unless a client requests to meet more or less frequently, or needs longer sessions.  In the initial session, I always ask why the person decided to start therapy now, rather than a few weeks ago, or months down the road. The response to this question helps shed some light on the process the process went through to get to my office.  

Next, I begin to gather some history on the problem. If I am seeing a couple, I may ask how they met, what attracted them to each other, the highlights and lowlights of their relationship history. If I am meeting with an individual, I may ask how long the problem has been present, what they have tried, what has given them some relief, and who is in their support system. I spend the first several sessions gathering more information and helping the person feel comfortable with me. 

Lastly, I ask how they would know that therapy can help them. Their response helps me understand what they specifically want to address during our sessions together, and orients me to establish measurable goals for the client. I do not want a client to feel they are committing the rest of their life to therapy; setting goals ascertains that there will be an end to therapy!

What to expect during regular sessions.

Once the initial phase of information gathering is complete, we will get to work on meeting the goals. Often, I will give homework assignments to be completed between sessions that will support the work we are doing in session. We will work on coping skills and tools that can be practiced and applied to any unhealthy patterns in the client’s life. Areas where trauma work is needed are identified and a plan is created to do that work. Goals are continually assessed to  make sure they still fit the needs of the client. I remind my clients that the time spent with me is theirs and I invite their feedback; I do not want my clients to ever feel they have wasted their time in a session. Please do not hesitate to speak up to your therapist if your needs are not getting met!

What to expect when therapy is nearing an end.

One of the ways I know a client is close to graduating therapy is when a client or I suggest less frequent sessions. This speaks volumes about the progress and signifies they are feeling more grounded, are reaching their therapy goals, have established a support system outside of therapy, and are ready to put what they have learned into practice on their own. I find great joy when my clients no longer need my help…my goal is to work myself out of the job! My door is and will forever be open to my clients should they need a tune-up. My final question for clients, during their last session, is how they will know if/when they need to come back to see me. The message I want them to hear is that I believe in them and that coming back to me is always an option. 

If you have been considering getting into therapy, I highly recommend you to do so now.  If you are ready to schedule a session but feel nervous, remember that it is completely normal to feel a little anxious about starting something new! It is the therapist’s job to create a safe, comfortable counseling environment where you can begin to address your individual or relational worries. If you think you may need medication, a therapist can refer you to a psychiatrist, and together the therapist and psychiatrist can address your concerns. 

I love my job. You will find the best version of yourself as you shed the weight of trauma or addiction and work through any relational issues you are facing. I am here for you! Please contact me today to get started!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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