Starting therapy can feel brave and exciting, but also overwhelming or uncomfortable. To ease you into this new chapter, we have compiled some of the questions that we get asked the most.
1. What will I talk about in therapy or counseling
In therapy, people often talk about what is on their mind or causing them distress. This can include mental health problems they experience, such as poor sleep or ruminative thoughts, or other stressors, such as difficulty at work, in their relationships, or with a life transition. A counselor or therapist will help you observe patterns in your behaviors and relationships, talk through some underlying reasons why you think, feel, or act in specific ways, and can support you in learning new ways to cope with stressors and symptoms.
Therapy is a place to talk about, learn, and explore whatever is bothering you and whatever you’re curious about learning about yourself or others.
Here are some examples of topics you might talk about in therapy:
- You might want to learn why you — and/or the people in your life — do the things that they do.
- You may want to gain some understanding on your life experiences and how they impact your life now.
- You may want to focus on your values, aspirations you have, or your needs and how to fulfill them.
- You may want to explore the messages you’re receiving from society, friends, and family members and how they affect you.
- You may find the holidays to be a tough time and want to plan for how you can feel better during that time of year.
- You may be grieving the loss of a family member or loved one.
- You may have been diagnosed with a mental health disorder and want to better understand how you can thrive while living with it.
- You may have had something traumatic or distressing happen to you and want to feel better from the effects of this experience. If you have difficulty bringing this up in session, it is okay to let the therapist know you need support in discussing it at your own pace or would prefer to explore it gradually starting now or in the future.
You can take our free survey to discover the issues you might want to discuss in counseling.
2. How long is a therapy session?
Typically, a therapy session can run 45 to 60 minutes long but may run longer. Group therapy and some couples therapy sessions may run around 75 to 90 minutes, while more intensive individual counseling sessions can go for two to three hours.
The length of your therapy session depends on the type of mental health services you’re receiving. Your mental health therapist will inform you of the length of your therapy session.
For individual therapy sessions, you will be booked for one “therapy hour” or “therapeutic hour” which can range from 45 to 55 minutes. This is the actual time you will spend in session with your therapist. For the remaining part of that hour, your therapists will do things like jot down notes about your session or prepare for their next session.
3. How do I prepare for therapy or counseling sessions?
You usually don’t have to prepare for therapy. Simply come with an open mind and curiosity about yourself. But here are three tips that can help you get the most out of your therapy experience.
– You may find it helpful to journal about your thoughts and feelings before you come to therapy. Sometimes a journal can help guide your therapy sessions. Here are some journal prompts to get you started before your first session:
- Why do I want to go to therapy?
- How do I feel about where I am in my life?
- What changes do I want to see in my life as a result of going to therapy?
- What’s been bothering me lately?
- Do I want to talk about a specific mental health problem?
- What is going right in my life?
– You may want to schedule some downtime after therapy to process your session or go for a walk, especially if you’re discussing heavy or painful topics.
– If opening up about your feelings is a new experience for you, then before your first session, you may want to practice sharing your feelings out loud in private. Consider exploring the feelings wheel and identifying what you are currently feeling.
4. What should I bring to therapy?
You do not have to bring anything to therapy except an openness to learn about yourself.
You can bring a journal and a pen if you want to write down your insights during your session, although most therapists will have tools for you to write with if you would like them. If needed for your first session, your therapist will ask you to bring items such as completed forms, insurance cards, or other information, such as psychological tests, a list of medications, or health history.
5. Will there be homework in therapy?
Homework is entirely optional. If you are open to it, some therapists will ask that you do specific activities between your therapy sessions so you can continue practicing new skills you learned in session, reflecting on insights, or making progress toward your therapeutic goals in everyday life.
Homework can look like reading a book or doing a certain task like journaling. Sometimes it may involve having a conversation or practicing a certain skill, such as meditation or noticing your self-talk.
Many people choose to keep a journal about their therapy sessions. A journal can help you make the most out of therapy. If you choose to keep a journal, you may want to take some time right after the session to write about:
- How you feel about therapy and your therapist.
- What you learned about yourself during the therapy session.
- A question your therapist asked that really resonated with you.
- A plan you made that you would like to keep.
Between sessions, consider adding to the journal any information that arises that you would like to bring up in your next session, such as new emotions, insights, challenges, or patterns in your thoughts and behaviors.
6. Will my therapist keep my information confidential?
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires healthcare professionals to keep your information confidential and will only disclose it with your permission. Your therapist or counselor should give you a privacy policy statement during your first session. If not, make sure to ask for it.
There are a few exceptions to confidentiality with your therapist. Your therapist is a mandated reporter, which means they are legally and ethically required to report child abuse and abuse of an elderly or dependent adult. Additionally, your therapist must seek outside help if they believe you are at imminent risk of harming yourself or others, or if they are ordered by a court to release records as part of legal proceedings.
7. Should I tell other people that I go to therapy?
It’s up to you if you want to tell friends, family, or coworkers that you go to therapy. You should never feel pressure, nor should you feel shame or embarrassment. More people have been to therapy than you think — close to one out of four people in the US.
So oftentimes, if you open up about what you are learning in therapy, you may find that your friends or loved ones also go to therapy. With these people, you can create new connections that help support you and your mental health.
Discussing with others about your experiences with therapy may also encourage people to go. When they learn how beneficial it has been in your life, they may be interested in learning how therapy could improve their lives.
Learn more about the tools available to talk openly about therapy and mental health.
8. How frequently should I go to therapy?
People often start therapy by attending sessions weekly and may decide to decrease the frequency, such as to once or twice per month, over time as they make progress toward their treatment goals. How often you have sessions is a decision you and your therapist will make together.
If you find that weekly or biweekly therapy is not frequent enough for your needs, you may find a better fit by receiving more intensive services than your therapist can provide. These include inpatient services, intensive outpatient services or even a weekly support group. Your therapist can help you decide what’s best for you.
9. How do I know if therapy is working for me?
You can tell if therapy is working for you by noticing changes in your thoughts, emotions, behaviors, and overall well-being. Signs of progress include feeling more self-aware, developing healthier coping strategies, experiencing improved relationships, or handling stress and challenges more effectively.
It’s important to note that progress in therapy isn’t a linear process. Sometimes, symptoms or strong emotions get worse before they get better. Additionally, some sessions may feel more productive than others. Over time, you should notice a sense of growth or movement toward your goals. If you’re unsure about if you are making progress, bring it up with your therapist. They can help assess your experience and offer an outsider’s view, including if they have noticed any positive changes within you. Additionally, if no progress has been made, they can adjust the treatment approach if needed.
If you feel that you aren’t connecting well with your therapist or that you haven’t made any progress toward your goals, even after discussing it with them, check in again and discuss how you two should move forward. You may need to find another therapist or make other adjustments, such as how often you have sessions, the treatment approach, or the focus of treatment.
10. How do I know if I am done with therapy?
One way to determine if you are done with therapy is if you have met the treatment goals that you set when you first started therapy, and you cannot think of further goals that you would like to work on at this time. Additionally, you may feel more confident in managing challenges on your own, notice sustained improvements in your mental health and relationships, and find that you are using the coping skills and insights gained in therapy effectively in daily life. It can be helpful to discuss potentially ending services with your therapist. They can provide guidance on whether tapering sessions or transitioning out of therapy feels appropriate for you.
It is common for people to feel awkward about bringing up ending therapy with their therapist. Be assured, your therapist is trained to engage in this conversation with you in a caring and supportive way. They can guide you through the process of ending therapy and help you reflect on your progress, discuss any remaining concerns, and create a plan for maintaining your well-being moving forward.
At the same time, many people decide that therapy is something they want to engage with for the long term. They do not want to stop learning about themselves. They may choose to stay with their therapist for a considerable length of time, such as years, or they may switch therapists to learn from a new perspective or focus on a different aspect of how they think, feel, and act.
If you feel like you need to try a different therapist, Mental Health Match can help you find a therapist that best fits your needs.