This Is Exactly What Happens When You Start Therapy

Photographed by Nicolas Bloise.
As beneficial as therapy can be, it can also be really daunting if you want to start seeing a professional but aren't sure how or where to start. How do you find someone? And once you do, what should you be prepared for? What if you find out that your therapist just isn't the right fit for you?
All of these are valid questions, and it's understandable to want to know what to expect when you decide to take that step for your mental health. After all, therapy is hugely personal, and so is your relationship with your therapist. To get the most out of your sessions, it's important that you feel comfortable enough to do the work that you need to.
Kristin Zeising, PsyD, a clinical psychologist and couples therapist in San Diego, says that the bottom line is that what you get out of therapy is what you put into it.
"Recognize it takes both the therapist and you to address the issues and make changes," she says. "The therapist can’t make changes on their own. They are there to help ask insightful questions or guide you in your treatment, but can’t do the work for you. The more you put into it the more you’ll get out of it."
Of course, not everyone has the luxury of going to therapy — it can be expensive, and not all insurance plans cover it, making cost a huge barrier for many people. But if you can get access to a good therapist, it's definitely worth looking into.
Ahead, we've outlined a few things you can expect when you're starting therapy for the first time.
If you are experiencing anxiety and are in need of crisis support, please call the Crisis Call Center’s 24-hour hotline at 1-775-784-8090.
If you are experiencing depression and need support, please call the National Depressive/Manic-Depressive Association Hotline at 1-800-826-3632 or the Crisis Call Center’s 24-hour hotline at 1-775-784-8090.
1 of 8
You might be able to get to know your therapist before you meet in person.

Aarti Gupta, PsyD, clinical director at TherapyNest, a center for anxiety and family therapy, says that when someone starts therapy, there's usually a screening process to make sure that the therapist and patient are a good fit.

"At my practice, I offer a complimentary 15-minute consultation so patients can ask me questions and get to know my style, while I can make sure my skill set matches their needs and goals," she says.

In the best-case scenario, you and your therapist will find that you're a great match, but if not, that's okay, too.

"If, for some reason, there is a mismatch, I do help individuals find the right care by offering referrals," Dr. Gupta says.

Not every therapist is able to offer other recommendations, but Dr. Zeising says that you can also ask a general practitioner or even ask friends or look online for someone else who might be right for you.
2 of 8
Expect at least a little bit of paperwork.

Paperwork can vary from therapist to therapist, but you definitely can expect to fill out around four to six forms that say you legally consent to treatment, and that give your doctor a little more information about your family background, and your medical and mental health history.

"The intake form may have you answer questions as to why you’re interested in coming to therapy, what your goals are, and what you’re hoping to get out of treatment," Dr. Zeising says. "Some psychologists may also have you fill out assessment forms so that they can get a more clear view as to the specifics of your problems or your personality type so that they can best know how to help you."
3 of 8
You may have to wait a bit to actually see your therapist.

There could be a waiting period between the time you start seeking help and when you actually get into the therapist's office for a session. Dr. Zeising says that, for some therapists, it could take a few days, though for others, it could take weeks.

Though Dr. Gupta says that she usually tries to see patients within a week after they first contact her, she adds that longer response times might be because the therapist no longer accepts new patients, they're out of town, or they're away from work for an extended period of time.
4 of 8
The best time of day to see a therapist is 100% up to you.

There's no right or wrong time for a therapy session, and when you get a session in will depend largely on your schedule and your therapist's schedule.

That being said, you may want to keep in mind that the whole purpose of a therapy session is to get at underlying emotions, and that might make it harder to go about the rest of your day afterwards.

"It may be best to schedule your session at the end of the day so that you can have some time to process any feelings that have come up during the session," Dr. Zeising says, adding that it might also be best not to have immediate plans right afterwards.
5 of 8
If you're nervous about the first session, there are some ways you can prepare.

Generally, your first session is about establishing the main issue you want to address in therapy, what you want to get out of the experience, and how your therapist can help you.

"The therapist will help guide you through the process, so it’s not your responsibility to think of everything to say," Dr. Zeising says. "However, spending some time reflecting about what it is you want to address can be very helpful."
6 of 8
Expect some questions about why you're seeking therapy.

Since the goal of the session is to get a sense of your history and what brought you to therapy, Dr. Gupta says that some questions a therapist could ask will have to do with your current symptoms, your therapy history (or lack thereof), and how you've dealt with issues in the past.

For example, she says, your therapist might ask questions like, "What brings you in today? How long has this been going on? What have you tried to fix the current problem? Do you have a support network in your life?"
7 of 8
Your therapist will likely be taking notes while you talk.

At first, it can seem a little intimidating or even off-putting that someone is jotting things down during a conversation with you. But it's really just so that the therapist can refer back to common themes or specific comments that they'd like to address again later on.

"Notes taken during a session are usually fragments of data — a detail to touch on again later in the session, a reminder to ask about something next time you meet, meaning that was extrapolated by something mentioned that needs a closer look at," Dr. Gupta says.

If this makes you uncomfortable, Dr. Gupta says it's totally okay to bring it up to your therapist, and then maybe the two of you can work something out so that you feel more connected to your therapist during the sessions.
8 of 8
Don't worry if the first session doesn't go as well as you wanted it to.

If the first session doesn’t go perfectly as you planned, know that sometimes it takes a couple of meetings to really build a relationship with your therapist.

"You can always ask the therapist for some clarification if something doesn’t seem clear, or let them know what it is you’re needing so that they can tailor the therapy for you," Dr. Zeising says.

However, the therapist-patient relationship is important, and if you don't feel like you're being heard, it may be time to look for someone new.

"If you feel something is off with your connection, don’t hesitate to 'shop around' and try out another therapist until you feel you can be completely open and honest," Dr. Gupta says.