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  • Writer's pictureeilidh usher

What happens in a therapy session?

Updated: Sep 13, 2021

It can be hard to know what to expect from a therapy session if its your first time. Without knowing what it’s actually like, taking the first step and making an appointment may feel unnecessarily daunting.

Some people worry that they will be expected to talk into a vacuum and manage difficult silences, or that they will be asked to lie on a couch and talk about their childhood whilst the therapist takes notes. These are, after all, hackneyed scenes we are familiar with from films and television.

A more realistic view of a therapy session is to see it as an interactive process between you and your therapist, providing an opportunity to talk about your problems, struggles or experiences in a more productive way. From my perspective, the starting point for this dialog is less ‘what’s wrong with you?’ and more, ‘whats happened to you?’. To begin with its important for us to get to know each other and get a sense of how to proceed going forward. It’s useful, therefore, to have an idea of what might happen in our first session.

Your first therapy session

Introductions: We’ll spend a little time getting to know one another. I will share some information about myself, and describe the ways in which I work. I will also gather some basic details about you.

Confidentiality: I will share a copy of the counselling contract which details confidentiality, my duty of care to you and some practical information. I’ll briefly outline the most important elements of it - but you will have the opportunity to take it home to read and review it before making any commitments.

Establishing your needs/hopes and goals of therapy: I’ll try and get a sense of what has brought you here, what are the issues that you would like to address, and what you hope to get from therapy. We might talk about any experience of therapy that you have had in the past - what was helpful, or what wasn’t. I may ask if you have particular symptoms that you are struggling with, for instance, anxiety, depression, difficulty in sleeping etc. Or we might discuss your home life and family history. The important thing is to understand what you need from therapy and how best to help you. I may take some notes as you talk ( generally only for this first session), but I hope it will feel more like a free-flowing conversation rather than anything formal or structured.

My aims: In our first session my hope is that you should feel safe, accepted and heard. It is often very difficult to speak to someone you don’t know, about things that feel deeply private and are hard to verbalise or discuss. I hope that in our first meeting we can establish a connection and begin to build trust together, so that talking about your thoughts and feelings feels a bit less scary.

Next steps

Towards the end of the session I will ask how you are feeling and check if you have any questions (although questions are welcome any time!). I might offer my thoughts on how we can work together, the number of sessions, how frequently we should meet - so that we have a plan going forward.

Things for you to consider

I would encourage you to think about how you feel during and after our meeting - It’s important, going forward, that I am someone you feel comfortable talking to. Our first session may have brought up a number of different emotions. Sometimes clients feel relieved to have unburdened themselves, or upset because it has brought up difficult memories, or even frustration if something has not been understood. Often reflecting on these feelings helps us decide if a therapist is going to be a good fit for us or is a good starting point for the next session. Equally, questions may occur to you after our first meeting which I am always happy to answer in the interim.

If you would like to have a discussion about what therapy involves, what you would like support with and how I might help, please feel free to email or call me. I am happy to answer any questions that you may have without any obligation.

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