What Happens In A Therapy Session And How Can I Prepare?

Medically reviewed by Paige Henry, LMSW, J.D. and Andrea Brant, LMHC
Updated September 28, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention substance use-related topics that could be triggering to the reader. If you or someone you love is struggling with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357). Support is available 24/7. Please see our Get Help Now page for more immediate resources.

Therapy is increasingly popular as more people seek support for everyday life concerns. The Centers for Disease Control and Prevention reported that in 2019, nearly one in five adults reached out for help with mental health challenges.

If you wonder if therapy may be helpful, you may have questions about the process. Understanding what to expect from talking to a therapist before beginning treatment can give you the information you need to feel comfortable as you begin counseling sessions. In this article, we’ll explore what it is, how it happens, and how it may benefit you.

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Therapy definition and background

Therapy is meeting with a mental health professional to discuss life challenges and symptoms of different mental health conditions.

You do not need to be diagnosed with a mental illness to partake in talk therapy, though therapists can be a helpful resource for addressing mental health concerns.

Attending therapy sessions can be a valuable tool under a variety of circumstances:

  • Undergoing a life transition, such as working through a career change, moving to a new city, or starting or ending a relationship
  • Wanting to improve your aptitude in a particular area of your life, such as your communication skills
  • Handling the stress of being a new parent or learning parenting tips and tricks
  • Developing stress management techniques through behavioral counseling
  • Experiencing intimate relationship challenges
  • Creating more work-life balance
  • Working on body image concerns
  • Cutting back on substance use or eliminating substance use (smoking, drinking, etc.)
  • Learning more about yourself and understanding how your past experiences have shaped your beliefs about the world
  • Addressing conflicts with family members
  • Increasing self-confidence
  • Navigating the concerns and challenges of everyday life
  • Managing the symptoms of mental health conditions such as depression, anxiety, post-traumatic stress disorder, substance use disorder, bipolar disorder, mood disorders, eating disorders, phobias, and others

What to expect during your first session

Your first session may not be a particularly emotionally intense experience. Usually, you and your therapist will work on getting to know each other and determining the right path and type of therapy to address your concerns. 

Forms and logistical documents

Your therapist will probably have a variety of forms with detailed questions you’ll need to complete to become their client officially.

The number and type of documents required may vary depending on the therapist or the therapist's office/setting (i.e., receiving counseling at a hospital or clinic, at a face-to-face practice, via an online platform, etc.). 

They may also ask you to complete these forms before your first session. Mental health care is still health care, so any information you provide to your therapist or their office will remain secret, just like with forms you fill out when you visit your doctor. 

Important preliminary information

In an initial session, the therapist typically invites the client to discuss any information about themselves that they believe would be helpful for the therapist to know.

This information can include details about your life, such as what your living situation looks like (if you live with your parents, roommates, a partner, children, etc.), who are the meaningful people in your life, what you do for a living, your favorite hobbies, etc. 

You will probably talk about the reason you are seeking professional help, such as current difficulties in your life, concerns you may have about your mental state, or any specific areas of your life you want to work on, such as improving low self-esteem or developing healthy coping skills.

You may also discuss your goals in the first session.

Building a therapeutic relationship

You and your therapist may take several sessions to build a strong relationship and rapport so you feel comfortable enough to speak openly about your life and experiences. Don’t worry if you don’t feel a strong connection with your therapist after the first session. 

Expectations for ongoing treatment

An appointment can be seen as a problem-solving session for many people. Depending on how often you meet with your therapist, you may start your session by telling them about any updates, changes, or developments since your last session, particularly those related to any challenges or mental health conditions you may be experiencing. 

A session usually involves telling your therapist what is happening in your life and how you feel about it. Then, your therapist uses their knowledge of human psychology and behavior to help address concerns in your life and move one step closer to the life you hope to have one day. 

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Being open and honest with your therapist during sessions can be important. When you seek advice from a therapist rather than a friend or relative, you won't have to worry about guilt trips or hurting someone's feelings.

You and your therapist will not have a relationship outside the office, so your life choices won’t impact them, which allows them to listen objectively. They can hear what you say without judging, criticizing, or interrupting. 

Sometimes, your therapist may assign you “homework” to complete before your next session. This homework may involve activities intended to improve your mental state or to address life challenges.

Your therapist may ask you to practice mindful breathing a few times weekly or to log your emotions in a feelings journal. 

You may change your behavior in specific environments or interactions or do something that takes you outside of your comfort zone.

In your follow-up session, you and your therapist will probably talk about how it felt to complete the homework assignment, whether you became stuck or frustrated at any point, and how you think about how the exercises impacted your progress. 

Finding support for life challenges

Therapy can be beneficial for many people for a wide variety of reasons, not all of which need to relate to mental health concerns. If you think you could benefit from speaking to a trained professional, consider online treatment through a platform such as BetterHelp

Online treatment options

Online treatment can be more convenient than in-person therapy. If you are attending therapy for the first time, it may be more reassuring to experience your first session from the comfort of your home.

With online treatment, you can find a therapist who is experienced supporting individuals with mental health concerns. You can also switch providers if the first therapist you meet with isn’t the right fit for you. The freedom, flexibility, and comfort offered by online counseling could make it a beneficial resource.

The efficacy of online counseling

Research has shown that online cognitive behavioral therapy (CBT) is as effective as traditional in-person therapy when addressing mental health concerns and life challenges.

One study found that online therapy effectively treated various mental health conditions, including anxiety, depression, obsessive-compulsive disorder, post-traumatic stress disorder, and more. 

Online counseling may also be a more cost-effective option for patients than other types of therapy. Online therapy could provide a helpful start if you want to learn more about how counseling can help improve your life.  

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Takeaway

It can feel overwhelming to consider therapy, primarily if you have never attended a therapy session before and aren’t sure what to expect. Therapy is typically a conversation between you and a mental health professional about improving your life and addressing mental health-related challenges. No reason is too small to begin the therapeutic process, and you can connect with a therapist who understands your unique needs. If in-person therapy seems too intimidating, online therapy could be a helpful alternative that may also be more convenient and cost-effective.
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