Starting Therapy? Eight Tips Before Walking in the Room

You’ve done it. You’ve searched for the right therapist, done your intake paperwork, and are awaiting your first session. From what you’ve heard from family & friends, therapy can help you with mitigating mental health symptoms, gaining self-worth, regulating emotions or communicating more effectively. You’re ready and willing to walk into the therapy room - the question is: what are you walking into?

Below are eight tips to help guide you through your first therapy sessions. Remember - it’s normal to feel skeptical! The more you know about how therapy may unfold, the more you’ll be able to make the most of your therapeutic experience.

Get ready for a lot of questions: Part of entering the therapy room means building an initial relationship with your therapist. The number one way therapist’s begin to gather information is through an assessment period, typically held within the first few sessions. This allows them to gain insight on potential diagnoses and clinical interventions that will best suit your individual needs. Therapist’s will typically conduct a “biopsychosocial” assessment that evaluates you as a whole person and the environment you exist in. Topics covered include family history, medical needs, previous diagnoses or treatment history, trauma history, strengths/assets, community/social support and more. Each therapist operates off of a version that works best for them. These sessions can be exhausting, but are crucial for guiding the scope of treatment.
Healing happens over time: Most clients’ start to notice the healing process from therapy as a sum total. Sometimes you will leave the session feeling weird and uncomfortable. Sometimes you can have the thought, "why I am spending money on this, I feel like we talked about nothing". Remember the change process is slow; if there were quick fixes none of us would seek therapy as an option. It’s quite normal that the effects of therapy are shown in the slight shifts in behaviors and thought patterns you can see over time; rarely (if ever) is it a white light moment that changes us forever. If you feel yourself wanting to throw in the towel a few sessions in, challenge yourself on this.
It can get worse before it gets better: The combination of dredging up past trauma, old patterns, and tough feelings while becoming vulnerable can often have you leaving the office feeling worse than before. It’s easy to slip into the thought that therapy isn’t working or having it’s intended effect. Refer to number 2: this takes time. It is perfectly natural to have an uptick in mental health symptoms when confronting topics we have neatly filed away in our brains. It’s uncomfortable, messy and hard. Keep going anyway.
Be honest: I’m saying really, truly, be honest with your therapist. Not just with struggles, behavior and pain: tell them if you feel like the feedback they gave you doesn't make sense for you, or that a comment made you feel angry or annoyed. Tell them you think therapy is dumb and don't want to do it anymore. I have made the most progress with clients when they work with me to identify what feels right for them, or allow me to explore with them why certain comments or lenses make them feel bad. Don't be afraid to give feedback, you are an active part of the therapy process as much as your therapist.
Notice your natural defensiveness: The therapeutic process can draw out natural defensiveness in an effort to protect us from the painful parts of therapy. This defensiveness can put you on guard or search for reasons why therapy "doesn't work for you". This could be our therapist not saying the perfect thing every time, feeling like you're making no progress, or touching close to a painful memory or feeling. Notice that, and refer to #4! It’s actually crucial information that can serve your therapeutic work.
It’s okay if your therapist isn’t the right fit: The number one indicator of positive outcomes in therapy is a positive therapeutic relationship. This means that the more trust and safety you can build with your therapist will yield better results. It is 100% okay to have a few sessions and decide that your current therapist is not a good fit. If you’ve searched for a therapist based on a specific specialty, chances are you’ve thought about what you would like to work on and what you may need from a therapist. If you feel like your current therapist isn’t meeting what you need, ask for some referral sources that may be more tailored to what you desire. This does not mean you’ve failed at therapy - rather that you’re getting more skilled at identifying your own needs. That’s empowerment!
Practice, Practice, Practice: Practice what you've learned in therapy outside of a session. I will say that one more time: practice what you learn in your natural environment. It’s that important. Ask for assignments, journaling, communication and coping skills and then use them. 90% of therapy happens outside of the room, and you are an active part of your healing journey. In the beginning, it will feel like they may feel like they aren’t working, but this is like learning any other new hobby or skill - it takes time, practice and accountability.
Be easy on yourself: This is hard, tough to measure work. Just having the self-awareness to recognize you could benefit from extra support, having your perspective challenged, or learning new coping skills means you're well on your way. Be gentle, gentle, gentle on yourself. Healing lives between the space of self-compassion and accountability, and you’ve made a brave choice to confront issues that have been holding you back. I’m proud of you.

Therapy is hard work! It's also one of the greatest investments you can make in yourself. Show up to that therapy appointment armed with the facts, and get ready to watch your life shift. All it takes is one small step to make the change you’ve been searching for.

You can follow more of Alexa's insight on Instagram @yoursadtherapist

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