What to Expect in Therapy

By Patricia Haddon

Asking for help isn’t something that comes naturally for most of us. New clients commonly have fears and confusion about therapy and what to expect. Even people who’ve been in treatment before feel anxious to start up again with someone new. We get it – because we’ve all been in therapy and we know what it’s like to sit in that other chair. We’re fellow travelers in this journey. And, we’ve learned that the best way to reduce apprehension, and get the most out of therapy, is to understand what therapy is and what to expect. We believe in therapy and its ability to heal and transform lives. Knowing what to expect will help prepare you for the process of psychotherapy.

Phase One: Initial Inquiry

One thing we’ve discovered, over our many years of responding to thousands of new patient inquiries, is that therapy doesn’t happen in a vacuum. Either an incident has occurred or you’re seeking therapy because you’ve reached threshold. Incidents, especially those unexpected, bring pain and confusion. Threshold is the moment when you’ve just had it and you know you can’t continue to live like this anymore. Take heart. Painful incidents and threshold are powerful catalysts to get you to take action. Without them, people settle into the same states of dissatisfaction, without the motivation ever needed to transform their lives into something extraordinary.

Phase Two: Enter Therapy

It’s common for new patients to enter therapy with a sense of immediacy and heightened emotion. You’re still experiencing pain from a recent incident or in the recognition that your status quo can’t go on. Other patients report entering therapy, not with anxiety, but with a great sense of relief because they know help is on the way and they’re no longer alone. Either way, it’s not uncommon to experience intense emotions during your first sessions. Don’t worry. This is a normal part of the process and the intensity will decrease. Your therapist will support you through this phase with compassion, and at your own pace in a safe space without judgment.

Phase Three: Symptom Relief

After a few sessions, the level of pain that you initially felt starts to subside. Patients begin to feel better and report symptom relief. You may start sleeping better or feel less anxious. Whatever brought you in has lost some of it’s edge and intensity. And, that’s great news! Symptom relief indicates that you and your therapist are making progress. You’re feeling better, which prepares you to focus on and fully engage in the process of healing and change.

And, This is Where Therapy Begins.

Phase Four: The Beginning or the End

Unfortunately for some, this where therapy prematurely ends- before it really starts. Once patients are feeling better, there’s less urgency. The pain that motivated them to seek treatment, has been reduced and things are settling back into “normal”. But, what have you accepted as “normal” in your relationships, career, self confidence, or happiness? Symptom relief is a first step, but its purpose is to stabilize and prepare you for more important work that extends beyond the surface of symptoms. Symptom relief doesn’t mean that the issues that brought you to therapy are resolved. You may be sleeping better, but your partner is still an a**hole. And, your mom still pushes your buttons like a broken elevator.

Phase Five: Show up. Play Fully

While our forefathers promised us life, liberty and the pursuit of happiness, we aren’t wired for happiness. We’re wired for survival. Our evolutionary gene pool doesn’t care if we’re happy. It only cares that we survive long enough to procreate and keep the species going. So, the hard truth is… if you want happiness, you have to work at it. The benefits of therapy don’t happen in a vacuum without effort.

Phase Six: We’ve Got Your Back

The good news is that you don’t have to do this alone. We’ve been through the therapy process as clients. And, we’ve guided others through the journey as therapists. We believe that you have everything you need to make the changes you truly desire. Our job is to help you identify and remove the obstacles that are blocking your way. The biggest roadblock to experiencing the full benefit of therapy is:

Clients underestimate the commitment that therapy requires

Therapy is not a casual undertaking. It will require a sincere commitment on your part to prioritize yourself, your self-care, and personal growth above other activities and distractions. The people who really benefit from therapy, show up every week and play fully. There are 10,080 minutes in a week. They make their 45-60 minute session the most important hour in their week. The psychotherapy standard for weekly sessions isn’t random. Studies confirm that clients, who show up every week, benefit from the power of momentum that builds week after week. It’s a little like working out. That six-pack will require commitment and consistent effort that goes beyond just joining a gym.

The decision to engage in therapy can be a pivotal, life-changing moment. We hope that knowing what to expect will support your commitment and prepare you for the process of psychotherapy. We want your time in therapy to be the best investment you will ever make in yourself. Success leaves clues! Read on to learn what other clients do to get the most out of treatment.

Clients who get what they want out of therapy share similar beliefs and actions. We’ll share this in greater depth in, Part II: How to Get the Most out of Therapy.