What Happens In Therapy Sessions?

What happens during therapy sessions?

What happens in therapy sessions depends on a few factors, including the client’s goals, individual needs, mental health concerns, and the types of therapy they use. For example, independent therapy sessions might look very different from sessions with a support group. Regardless, sessions usually involve conversations between the client and therapist to address issues that affect the client’s mental health and emotional well-being. 

You can attend therapy for different reasons—for diagnosed mental health issues or to sort through things that are simply troubling you. You may attend several sessions before noticing change, but gradual shifts are often a sign that you're making progress. Working with licensed therapists ensures your care is grounded in ethical standards and informed clinical practice. If CBT or the current method isn't helping, your therapist may suggest other forms of therapy that could be a better fit.

Setting expectations for what happens in therapy

During psychotherapy sessions, you and your therapist may discuss your concerns, goals, and how you feel daily. Some sessions may include learning coping skills to manage stress or anxiety, while others might focus on deeper emotional challenges. Your therapist will likely create a treatment plan that guides the work and helps track your progress. These sessions may take place in a therapist's office or virtually, depending on what's available and comfortable for you.

Your first session will likely serve as an introduction where you and your therapist will get to know each other and build rapport. They’ll ask you about your background, reasons for seeking therapy, and your end goals for treatment to get a good idea of how to proceed. They’ll also likely outline the typical structure of sessions, individual and security practices, whether you can use your health insurance, and any other logistical information you’ll need. 

Discussing your feelings and concerns

In subsequent sessions, you and your therapist will discuss any thoughts, feelings, and challenges you’re facing. This could involve work, relationships, stress, or other concerns. Your therapist will listen actively and ask open-ended questions to collect more information and explore deeper feelings, motivations, and other issues. 

Receiving feedback after each therapy session

Often, therapists and clients will set goals for therapy and work towards them. These might be short-term goals like managing stress better or long-term goals like improving self-esteem. At the end of the session, you and your therapist will summarize what you discussed and reflect on your impressions. You might get feedback on coping strategies or actions you can take to manage issues until the next session. Additionally, some therapists assign "homework," such as journaling or practicing certain skills between sessions.  Most therapy sessions last around 45 to 60 minutes. Toward the end, the therapist may wrap up the conversation and schedule the next session.

What does each type of therapy feel like?

Therapy feels different for everyone. How you feel in therapy can depend on factors like the type of therapy, what’s happening in your life, how long you’ve been attending, the subject matter you’re exploring, and more. You might feel relief, emotional exhaustion, or a sense of clarity. It’s normal to feel a mix of emotions depending on the topics discussed.

Therapy can feel different for everyone, and even individual psychotherapy sessions might vary depending on what you're going through. Sometimes, sessions feel calm and reflective; others might stir intense emotions. You may be introduced to new skills that help you manage these moments more effectively. For those living with mental illness, psychotherapy might feel overwhelming at first, but over time, it becomes a place of comfort and structure. How psychotherapy feels will also depend on your therapist's approach—some focus more on insight, while others guide with structure. Either way, the goal is to help you gain new insights into your patterns, thoughts, and emotional responses.

Will telling my therapist about my feelings make me cry?

Crying is a normal and healthy response in psychotherapy. You may find that bringing up painful memories or personal experiences brings tears, especially when you're beginning to unpack deeply held negative beliefs. During psychotherapy sessions, these emotions are welcomed and respected as part of the healing process.

It is common for people to cry in therapy, as it often involves exploring deeply personal topics that evoke strong emotions. Crying in therapy can be cathartic, helping people process and cope with difficult feelings. 

You can talk openly in therapy about what you're dealing with, and your therapist's training helps them guide the conversation in a helpful way.

How long does therapy last?

There isn’t a set time for therapy; treatment can range from a few sessions to years of sessions. Often, the length of therapy is proportionate to the length and severity of the types of issues presented in treatment. For example, people who have been abused, neglected, or otherwise traumatized as a child might need many years in therapy with a clinical psychologist. Similarly, people who have experienced severe trauma, like combat or other violent situations, might need more prolonged, intensive treatment. Some people come to therapy seeking guidance for a specific problem or to achieve a specific goal and might find they only need a few sessions.

There’s no fixed timeline for therapy. The number of psychotherapy sessions you attend often depends on the severity of your psychological problems and what you want to work through. Some people need only a few sessions, while others benefit from longer-term care to treat deeper issues. Your therapist may adjust the pace based on your comfort and goals, and progress often unfolds gradually over several sessions. Still, consistent effort and openness help move things forward, and many find they’re making progress even when it’s slow.

Is therapy worth it?

Whether therapy is “worth it” or not will depend on individual experience. Some people may find that therapy dramatically improves their quality of life and their ability to function productively. For others, therapy might not be helpful or, in some cases, might do more harm than good for their mental health. The American Psychiatric Association (APA) estimates roughly 75% of people who engage in psychotherapy find it at least partially beneficial, and in many cases, psychotherapy can be just as effective as medication for treating depression, anxiety, and many other mental conditions. If you’re contemplating speaking with a mental health professional, find a therapist who will work with you and honestly answer any questions you have about the benefits of treatment.

Therapy can be a life-changing experience, especially when used to treat persistent emotional pain or long-standing patterns tied to mental illness. Many find that talk therapy helps them feel more in control of their emotions and more grounded in their daily life. While psychotherapy doesn't work the same for everyone, most people report making progress when they stay committed to the process. If you're uncertain, it's OK to ask your therapist to answer questions about the process, their experience, or how they work. Sometimes, combining psychotherapy with medication may offer a more effective treatment. And remember, not everyone will have the same outcome, but that doesn't mean it's not worth trying.

What is the first question a therapist asks?

In your first appointment, your therapist may begin by asking what brought you to therapy and what you hope to gain from it. These initial conversations help shape the therapist's approach and allow them to begin forming a treatment plan that fits your needs and expectations.

Usually, therapists will open by asking why you’re seeking therapy. They’ll likely ask about your expectations of therapy if you’ve had past experiences with treatment, and if so, what your impressions were. In some cases, therapists will ask safety questions about whether you are currently having or have had suicidal or homicidal thoughts in the past.

They’ll inquire about your symptoms in the first session. They’ll likely ask about your relationship with your family and other supportive people in your life. They may ask you what you think your strengths are and areas of opportunity for improvement. They may work with you to set goals and develop an action plan to achieve them.

How do I know if I need therapy?

Deciding if you need therapy can depend on how you're feeling and the challenges you're facing. You might consider therapy if you’ve tried coping with mental health challenges on your own, but your problems persist or worsen, your emotional struggles are affecting your relationships, work, or health, or you’re seeking a better understanding of yourself and your emotions. Here are some signs that therapy might be helpful for you:

• You have persistent feelings of sadness, anxiety, or overwhelm.
• You have difficulty coping with stress or life changes.
• You have relationship struggles.
• You feel “stuck” or unfulfilled.
• You’re using harmful coping mechanisms.
• You struggle with low self-esteem or self-worth.
• You have trouble focusing.
• You have physical symptoms with no clear cause.
• You’d like to work on personal growth.
• You feel that you need to talk with someone objective. 

Therapy can also help if you're trying to treat something that's interfering with your daily life, like anxiety, low self-worth, or burnout.

Can you go to therapy even if nothing is wrong?

Therapy isn’t just for severe mental health issues—it can help with a wide range of concerns. For example, some people seek counseling for personal growth, to set and achieve goals, to strengthen relationships, and to cultivate greater self-esteem.

Therapy isn’t only for people with diagnosed mental health issues. Some attend sessions to build coping skills, improve relationships, or navigate life transitions more smoothly. It’s a place to grow, reflect, and strengthen your sense of self, whatever your goals may be.

What is the end goal of therapy?

The end goal of therapy can vary depending on the individual, the type of therapy, and the specific challenges being addressed. Ultimately, therapy is designed to empower you to handle life’s challenges independently. This means feeling more confident in your ability to navigate emotional and mental challenges without relying on therapy long-term. Here are some other common overarching goals:

• Improved mental health and emotional well-being

Therapy aims to help you understand and manage your thoughts, emotions, and behaviors. Whether you’re experiencing anxiety, depression, stress, or other mental health challenges, the goal is to reduce the frequency and intensity of negative emotions and establish a more balanced emotional state. You can bring this up during your first appointment so your therapist understands what you hope to achieve.

• Symptom relief

Mental health disorders can cause distressing symptoms that might be difficult to manage. One of the primary goals of therapy is to reduce difficult symptoms to a manageable level or eliminate them entirely, improving your ability to function day-to-day. If you’re unsure about the cost, ask about payment options before starting treatment.

• Greater self-awareness and insight

A fundamental goal of therapy is gaining deeper self-awareness. This means uncovering the root causes of your feelings, behaviors, and thought patterns. Therapy helps you identify how past experiences, beliefs, and relationships affect your current life and mental well-being. Eventually, through these connections, you might achieve better emotional and behavioral regulation. Therapists with doctoral degree-level training often help clients explore these deeper connections with care and clarity.

• Better coping strategies and problem-solving skills

Therapy equips you with practical tools to cope with stress, anxiety, and other life challenges. Your therapist may teach you relaxation techniques, cognitive restructuring, or guided visualization—all are strategies you can use to manage difficult emotions and handle situations in healthier ways. This part of psychotherapy often focuses on teaching useful coping strategies to help with dealing with everyday stress.

• Positive behavioral change

For some people, the goal of therapy is to adjust harmful or unwanted behaviors like procrastination, unhealthy habits, or impulsive behaviors. Through therapy, you can learn to understand the causes of negative behaviors and replace them with healthier alternatives. With time and effort, you may notice steady progress in how you react and respond in everyday situations.

• Improved relationships 

Improving relationships is a common goal in therapy, whether you’re working on it in individual treatment or with a marriage and family therapist. Therapy helps strengthen communication, set boundaries, and navigate conflicts in relationships. Whether it's with family, a partner, or friends, therapy often works to enhance your ability to relate to others in a healthier and more fulfilling way. One therapist might focus on communication styles, while many therapists include boundary-setting as a core goal.

• Healing from past trauma or pain

People who have experienced abuse, neglect, or other types of traumas may seek treatment to process and heal from the grief and emotional pain. The goal is to reconcile these experiences and integrate them in a way that reduces their negative impact on the individual’s present life. This is often where psychotherapy work becomes deeply personal and reflective, aiming to support long-term healing.

• Increase self-esteem

Many people who seek therapy need assistance with developing a more positive sense of self-worth. If you need help building your self-esteem, the goal of therapy might be to cultivate self-acceptance, reduce self-criticism, and build a kinder, more compassionate relationship with yourself. Most therapists will approach this with patience, encouragement, and the right level of challenge to help you grow.

• Achieving goals and personal growth

For some, the goal of therapy is personal development. This might involve improving emotional intelligence, building resilience, or learning how to live a more authentic and meaningful life. Depending on your personal situation, therapy can also focus on achieving specific goals you set at the beginning of the process. These might include improving work performance, managing anger, overcoming social anxiety, or making a major life decision. 

When you talk with your therapist about your goals, they may adjust their psychotherapy methods to support steady progress. Some therapists may also have specialized training to work with specific life transitions or professional challenges.

If you’re using health insurance, check if your provider covers psychotherapy. It’s also helpful to find out whether the therapist is authorized to provide psychotherapy under your plan. Every patient is different, and having clear details upfront makes it easier to begin.

The end goal of therapy is personal and flexible. For many, it means making progress toward emotional health, confidence, and independence. Therapy helps treat troubling thoughts and behaviors while introducing helpful skills you can use daily. It’s also a place to challenge negative beliefs and shift your mindset in healthier ways. Whether through CBT, psychodynamic, or other forms of therapy, the ultimate aim is often successful therapy, where you can apply what you’ve learned to real life and experience meaningful change in your daily life.