First Timers Guide to Therapy: What to Expect and How to Prepare
Attending therapy for the first time or with a new therapist, can be understandably daunting. You might find yourself feeling vulnerable, unsure, anxious, or awkward at the thought of it and, as with anything that we are experiencing for the first time, this is completely normal. There are a lot of misconceptions, dated suggestions, and even an air of secrecy around what happens during a therapy session. In this article I’m hoping to put your mind at ease by busting some of those therapy myths and sharing a little about what you can expect.
What can I expect before my first session?
Many therapists, including myself, offer an initial consultation call to all new referrals. The purpose of this call is to help us both establish if I am best suited for your current needs, based on my training, experience and specialisms. If so, we will book an appointment for an initial ‘assessment’ session. If I’m not the best fit for you, I will try my best to recommend an alternative therapist who is.
What can I expect during my first session?
The aim of the initial session, often referred to as an assessment session, is for us to get to know each other and for me to learn, in more depth, about what problem or problems bring you to therapy. You’ll be asked questions which enable me to get a good understanding of your current difficulties, their impact, your current circumstances, a brief personal history, and what you hope to gain from coming to therapy. Therapy is a collaborative process. What you choose to talk about, or not, is completely up to you. You are in control. You will not be made to talk about anything you prefer not to.
You can read more about what to expect in your initial therapy session here.
What can I expect during a typical therapy session?
The content of every therapy session varies, but there are some similarities in terms of the structure:
⋒ The Beginning
A quick check-in around how you’ve been.
To ensure we optimise our time together, we will set a short agenda, highlighting what you want to cover in the session,.
⋒ The Middle
Review any home-tasks discussed in the previous session.
Cover the agenda items set - these are typically anything following on from things discussed in the previous session or anything significant that has happened since we last spoke.
⋒ The End
Summarise the key ‘take home’ messages.
Discuss any home-tasks which could consolidate any insights learned.
Agree on a time to meet again and say goodbye!
Have a read of this article, to learn in more depth about what a typical therapy session might involve.
How long does a typical therapy session last?
Sessions usually last 50 minutes. This is known as a standard ‘therapeutic hour’. There are various theories about the origins of the 50 minute therapeutic hour but no consensus on exactly when and why it was established. However, it has remained the typical industry standard, and for good reason. These include psychological reasons (research has shown a 50 minute session is more containing, and less fatiguing for the client than a 60 minute session), as well as practical reasons (it’s easier for people to schedule into their busy timetable or lunch hour. It also enables a short break for therapists to make notes or prepare between clients).
How many sessions will I need? How frequently should I come?
The answers to these questions vary. They depend upon your unique clinical circumstances (such as your specific difficulties and goals) as well as practical considerations (such as your availability and finances or insurance coverage). Typically though, people get the most from therapy if they regularly attend weekly and for a minimum of six therapy sessions (following the initial assessment session). We’ll discuss your specific circumstances and clinical needs following the assessment session.
Is my therapy session confidential?
Yes, except for a few important exceptions. Anything you discuss in a therapy session is kept between you and me. I, like all therapists, receive clinical supervision with another therapist, in line with professional regulatory guidance. Although clinical work is discussed within these supervision sessions, all discussions are anonymous. The main situation where confidentiality may need to be compromised is if I was concerned regarding risk; to or from others, or to yourself. This, fortunately, is rare. You’ll be provided with written information regarding confidentiality, and its limitations, before you commence therapy.
How can I get the most out of therapy?
Below are some suggestions to help you to get the most out of your therapy experience:
01 | Privacy - Ensure you have access to a safe, quiet and private space for the session, where you won’t be disturbed.
02 | Minimise Interruptions - Hang a do not disturb sign on the door, turn off any phone & computer notifications. This is time for you.
03 | Environment - Ensure your space is calm, uncluttered and comfortable. Sit, stand or walk and talk - whatever feels best for you.
04 | Lighting - Choose a location with good natural light, where possible; ideally avoid having your back to a window.
05 | Positioning - You should have at least your head and shoulders in the picture. Think of a passport photo.
06 | Optimise Tech - Ensure you have a reliable internet connection, and if possible, use headphones with a microphone
07 | Tissues - Your session may bring up difficult emotions. It’s a good idea to have tissues handy, just in case.
08 | Comfort - Have a comforting object to hand e.g. a blanket, lit candle, water, hot drink, or anything which helps you feel at ease.
09 | Therapy Notebook - You may find it helpful to note down any insights, reflections and action points from the session.
10 | Aftercare - Try to have a break before continuing with your day. Take a walk, listen to music, or connect with a loved one.
How will I know when I’m ready to end therapy?
You’ll know you’re ready to end therapy when you feel you’ve overcome the challenges that initially brought you in and achieved the goals you set for yourself. This might look like a greater sense of emotional stability, healthier coping strategies, or feeling more in control of your life. While therapy is a personal journey, reaching a point where you feel confident managing future challenges on your own is often a key sign that you’re ready to conclude your sessions.
What can I expect after therapy ends?
After therapy, you will hopefully leave with a toolkit of valuable strategies to help maintain the progress you’ve made and manage any setbacks that may arise. These tools will empower you to navigate challenges with greater resilience and confidence. Many clients find that months or even years later, top-up or review therapy sessions can be incredibly beneficial. Revisiting therapy to refresh your skills or gain new perspectives is something I always offer and encourage for my clients, whenever the need arises, to ensure long-lasting wellbeing.
Want to learn more about therapy sessions?
If you found this useful, you may also like to read:
Further Support
Please get in touch if you would like to discuss my availability for therapy. And for clinical psychology strategies and resources direct to your inbox, sign up to my fortnightly newsletter, Unfrazzled, your go-to source for refuge in the chaos. Each edition curates a blend of psychological insights, practical tips, and inspiration to help you untangle the knots of modern life ⋒