What to Expect:  3 Unexpected Things That New Clients Can Expect From Therapy

The Myth

Images of a stern-faced, Freud-like therapist scratching his or her head while clients lay on a Victorian style sofa and begin talking about their childhood experiences often come to mind when we think of expectations of therapy. However, what does therapy actually look like? 

What to Expect During therapy

1. Expect That you May Not Get Started Right Away

Starting therapy for the first time many bring about relief, as well as enthusiasm to immediately jump in and begin exploring situations that have caused pain or distress; However, the first or “initial” therapy session is usually reserved for collecting valuable information about you that your therapist can use in order to best help you to achieve your goals. This is done by completing an assessment where your therapist will ask several questions about what brings you into therapy, about any current psychiatric symptoms you may be experiencing, any medical history, any past therapy you may have participated in, any mental health diagnoses, family history, social engagement, spiritual beliefs that are important to you, etc.  

At my practice, The Mindfulness Space Psychotherapy Services, where I provide counseling for Eating Disorders and body image,  I also ask about past and current feelings, behaviors and beliefs surrounding food and eating habits. This collection of information can be referred to as an Intake Assessment, a Clinical Assessment, a Psycho-Social Spiritual Assessment, a Comprehensive Clinical Assessment or any additional combination of those words that you can think of! However, no matter what you call it, the purpose of gathering information is the same! 

After the assessment, if you and your therapist agree to continue forward with services, the first therapy session is also used to review important paperwork. This can include an Informed Consent, a Right to a Good Faith Estimate, a Notice of Privacy or HIPAA form, Fee Agreement, a Social Media  Policy or any other policy or consent that your therapist knows is important to share with you before engaging in any further sessions. 

Because this can be a lot of information to take in during one sitting, it’s extremely important that you ask your therapist any questions that you may not be clear on. 

Finally, if time allows, your therapist will ask about what specific short-term and long term goals you want to work on during your sessions and discuss how long reaching these goals should take. This is intended to help you and your therapist stay on track and assure that you are receiving the greatest benefit from your sessions. 

This is also a good time for your therapist to outline what each therapy session may “look like.” This can help clients to calm any additional fears or anxiety related to expectations during therapy.  Please note that therapy will look different for everybody. There are thousands of  therapists and each one of us has our own unique style and way of doing things. Some are more structured, and some have a more “go with the flow” approach. It’s your job as a client to find out what therapy style is right for you!

2. Don’t Expect for Your Therapist to Tell you What to Do

There is a common misconception that the role of a therapist is to provide their clients with advice. While it may be very tempting for many of us therapists to set up our “therapy advice booths,” a la Lucy from The Peanuts, there are a few problems with this approach. One being that as a client, you may not actually want your therapist’s unsolicited advice and this is perfectly reasonable! Additionally, as a therapist, my personal advice may not necessarily align with my client’s individual values or beliefs. This is completely normal, as we’re all unique and come with our own experiences and beliefs about the world! Furthermore, telling a client what to do in the form of giving advice robs that client of the opportunity to explore, process and work through problems in order to identify their own solutions, thus helping to restructure new neural pathways in the brain which help form lasting change! Yes, therapists can provide feedback if appropriate and solicited by our clients, but this stops short of giving advice and at some point, we’re going to redirect the scenario by eliciting thoughts and feedback from you! 

3. Expect to be in Full Control of the Direction of Your Sessions 

Although many therapists are structured, several of us have a more relaxed, “go with the flow” type of approach to facilitating sessions. I often observe online posts from people stating that they worry about bringing up certain topics during therapy due to the fear of “upsetting” their therapist, or the fear of their therapist somehow disapproving of the topic. I have also observed people feeling uneasy about communicating that they don’t want to talk about a particular topic or subject with their therapist for various reasons. This is normal and will not upset a competent therapist! In fact, your therapist may be appreciative of your honesty. Now, there are times when your therapist may gently confront or bring attention to your apprehension to talk about a particular issue in a therapeutic way. This is especially true if it’s related to your treatment. Remember, the purpose of this is to never cause harm, but to help you reach your goals! 

Conclusion

In conclusion, sometimes therapy can feel uncomfortable, but if you’re able to work through those usually temporary feelings of discomfort and know what to expect by following these tips, the outcome can lead to greater clarity and peace of mind!