Starting therapy can be terrifying. If you have never tried it or have never heard from someone first-hand what it was like, it can be like walking into the dark. People often wonder what takes place during the therapy session. To be honest, every session varies. Among therapists and even with the same client, things can look different from week to week, but here are a few things to expect:

  • Check-in: Sessions usually start with a quick check-in. This can include developments from the week or changes in the home that impact your daily life. It can be brief, but it gives the therapist a good landscape to know what other factors are contributing. For example, a car accident earlier in the week or the results of a medical test can be the source of worry and sleeplessness.
  • Homework Review: If homework was assigned, there should be time to review it. Some therapists will go through an exercise in detail, others just want your reaction to trying it.
  • Exploration: This is a vague heading, but there is a good chunk of the session devoted to exploring the subject matter that is presenting an issue for you. For example, it could be time spent exploring a fight with your significant other – what happened, what was said, the impact, how you handled it, how you did/could apply your skills. This often involves a mix of story-telling on the client’s part and socratic questioning on the therapist’s end. It may sound like a conversation you could have with a friend, but it’s often more extensive. As a therapist, I am guiding you to connect this to your goals, look for patterns, problem-solve, and ultimately have some moments of growth.
  • Interventions: This may or may not be explicitly separate from the rest of the session, but it involves the education and practice of a technique that can help you cope and problem-solve. Sometimes I am very explicit about practicing mindfulness, doing it as a game at first. Other times, we may be exploring a topic and I can introduce something naturally. It is always my intention to practice these new skills in session, they can be hard at first and if we can practice in a controlled setting, then it is much easier for you to implement this outside of my office.
  • Wrap Up: Think of this as the other bookend to the “Check In.” We are planning for upcoming sessions, discussing homework, and talking about issues that may come up in the following days. If the session has been a particularly difficult one, there should be times spent on ensuring that you leave grounded and de-escalated.

Most often therapy sessions are fluid and evolve organically. You get to bring in your concerns each week and lead the conversation. My job is to act as a guide or navigator as we explore. It’s okay if you’re still hesitant, but hopefully this helps!