Mental HealthStarting Therapy

What To Expect When Starting Therapy

By August 23, 2022February 21st, 2023No Comments

You did it! You connected with a therapist, and now you have your first therapy appointment scheduled. For many people, that’s the biggest hurdle. You should feel proud of yourself for reaching out and getting started. But as your first appointment date approaches, you’re left wondering… “what’s it going to be like?”

It’s normal to feel unsure about what to expect. For most of us, the only ideas we have about therapy are from pop-culture. “Is my therapist really going to have me lie on a couch and talk about my deepest darkest secrets on day one??”

Is therapy ACTUALLY like that? Nope!

1. The most important thing to know about therapy is that you get to decide if, when, and how you talk about something. You are in control. Unless your safety or someone else’s safety is an immediate concern, your therapist is 100% supportive of your decision not to share something.

2. The second, less important, thing to know is that you don’t need to lie on the couch. You’re welcome to if you wish, but many folks prefer just to sit on it. Do what makes you comfortable!

Ok but… if therapy isn’t like the movies, what IS it like?”

Here are 5 things you can expect when starting therapy:

  1. You Get To Ask Questions. Your therapist isn’t the only one who gets to ask questions! Your therapist will want to know if you have any questions about any paperwork you have completed, who they are, what to expect working with them, and anything else. Your therapist wants you to feel informed and empowered about being in therapy. But don’t worry if you don’t have questions right now – you can ask questions at any time!
  2. Your Therapist Will Tell You About Themselves. Every therapist approaches their work a little differently. As your therapist is explaining how they approach their work as a therapist, think about what makes sense to you or aligns with your own personal philosophy. Therapy is a very individual process, and what works for you (or feels comfortable for you) is likely different from what works for someone else. If needed, your therapist can help you find another therapist that you feel better aligned with.
  3. You’ll Be Asked About Your History And Background. “Why is my therapist asking about my family? I don’t think this is relevant…” Your context and background are important to understanding who you are as a person and how you navigate the world. Some questions that your therapist may ask you may not feel relevant, but it is good for your therapist to be thorough when they’re just starting to get to know someone. They ask all their new clients these questions. Remember: if you don’t feel comfortable answering something, it is okay to not answer.
  4. You’ll Be Asked About What Brings You In. Of course, your therapist will also want to know why you’re seeking therapy. What are your current symptoms? How long have they been happening? How are they impacting your life, relationships, and happiness? These types of questions will help your therapist get an understanding of the challenges you are facing and will help determine treatment goals. Speaking of which…
  5. You’ll Collaborate With Your Therapist On Goals For Your Therapy. No, you don’t have to come into therapy knowing exactly what you want to get out of it. Your therapist is there to help make sense of what’s happening, what you want to change, and how you might want to go about making that change happen. Brainstorming some treatment goals helps both you and your therapist have a direction for your work together and reduces the likelihood the work feels like it’s stagnating.

Starting therapy is an exciting but sometimes anxiety-producing experience, and it is okay to take things at your own pace and ask questions that will help you feel more comfortable. The most important thing to remember is that your therapist is there to support you on your journey toward wellness. They are excited that you took the first step and are looking forward to getting to know you!

This blog is authored by Ashley Meczywor, MEd, LPC, NCC. IntraSpectrum Counseling is Chicago’s leading psychotherapy practice dedicated to the LGBTQ+ community, and we strive to provide the highest quality mental health care for multicultural, kink, polyamorous, and intersectional issues. For anyone needing affirming and validating support in their healing, please click here or email us at