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What Happens During a Therapy Appointment?

For many, the process of therapy remains shrouded in mystery. We’ve all seen therapy appointments as portrayed in the movies, usually involving a detached and stern-faced therapist, hidden behind a beard and clipboard, asking questions about a patient’s dreams and childhood memories. However, therapy, as it’s practiced today, has come a long way since the days of Freud! Most modern therapists seek to provide a sense of comfort and safety, allowing you to heal and grow in the context of a confidential relationship. In this article, we provide an overview of what to expect from a therapy appointment.

What is Therapy?

Therapy can be broadly defined as the process of getting treatment for a health condition. Colloquially, when we speak about therapy this usually refers to a form of treatment for mental health issues; but in a medical context this might also mean taking a medication (pharmacotherapy), doing physical exercises (physiotherapy) or treating a stutter (speech therapy). There are also different forms of mental health therapy, such as couples therapy, marriage therapy, and group therapy.

In this article, we’ll be focusing on therapy of the psychological kind, also known as ‘psychotherapy’, ‘talk therapy’ or ‘counseling’. Therapy of this sort involves an individual speaking to a licensed professional in a confidential environment. The therapist and the client work together to realize the client’s goals, which are generally related to improving their self-awareness and emotional wellbeing.

Who Does Therapy?

Therapy is a complex skill that requires specialized knowledge and experience. For this reason, it needs to be performed by an appropriately licensed professional.


Therapy is typically provided by a psychologist who is licensed to practice under a governing health body. To qualify, a psychologist must undergo many years of education and training; and thousands of hours of supervised practice. Licensed therapists must also engage in ongoing skill development to ensure that they are up to date with the latest research and practice guidelines.

Having said that, not all psychologists work as therapists – some prefer to focus on research and psychological testing. Furthermore, because they are not qualified as MDs, psychologists are not able to prescribe medications, although they might refer clients to a doctor or psychiatrist if drugs are needed in conjunction with therapy.

Other Practitioners

While therapy is a psychological process at its core, people other than psychologists can also be therapists. A psychiatrist, for example, is a medical doctor that has specialized in the treatment of psychiatric issues and psychotherapy is one of the tools that they may use. Other professionals who may perform therapy include counselors, nurses, dieticians, social workers and life coaches.

The First Session

So, you’ve got your booking and you’re preparing for your first session. What can you expect and why is this appointment so important?

First Impressions

In therapy, your first session provides a chance for you and your therapist to get a feeling for one another. From the therapist’s perspective, this is important because it gives them a sense of who you are as a person and how best they can help you. For you, as a client, your first impression will help you decide whether this therapist is right for you. Clients are often nervous during their first therapy appointment, but if your therapist is able to make you feel welcome and at ease, this sets the tone for your future interactions.


Rapport is an important part of any therapist’s toolkit. This is about establishing a bond or connection between the two of you and setting the emotional tone for a therapeutic relationship to come. Whether it’s through words, actions or a more general way of being, a therapist will work with you to create an atmosphere of confidentiality, trust, and mutual respect. It’s within this sort of relationship that you will start to feel safe enough to open up about your difficulties.

Presenting Problem

During the first therapy appointment, your therapist will want to get a sense of your ‘presenting problem’, which is the reason that has led you to seek treatment. A presenting problem can include specific psychiatric symptoms, such as hallucinations, sadness, anxiety or anger; but it might also include more general difficulties such as relationship problems, stress, trauma, poor self-esteem and adjustment issues.

Personal History

Early on in the process, your therapist will ask about your personal history. This involves asking you to tell your life’s story – what has happened in the past that has made you who you are. This might involve, for example, any medical conditions that you have had, what your family constellation looks like, how your life was as a child and your history of romantic relationships. In this regard, therapist tend to be very thorough, asking a long list of in-depth questions.

For some, it can be exciting to tell their life story to someone who’s truly listening. For others, history taking can feel a bit invasive and many wonder why they are being asked questions that seem irrelevant to their presenting problem. However, it’s important to remember that your therapist is trying to look beyond your symptoms and see you as a whole person. By fully understanding the events that have made you into the person that you are, your therapist will be in the best position to do their job effectively.

What Happens in Follow Up Sessions?

During the initial session, your therapist will aim to formulate how best to proceed with treatment. Sometimes, a therapist will choose to have one or more follow-up sessions to continue the process of taking your history. Following that, you and your therapist might decide to have a certain number of follow-up therapy appointments in order to address your presenting problem. Finally, once your therapy has concluded, you may be asked to return for subsequent follow-up sessions to track your progress and see whether further input is needed.

Why Do Therapists Assign “Homework”?

While not all therapists prescribe homework, many do; and it’s an integral part of Cognitive Behavioral Therapy (CBT), which is a popular form of treatment amongst many health professionals. Homework is helpful because it gives you a chance to put into practice the skills and strategies that you have covered in sessions. This has been shown to enhance the therapeutic process: research suggests, for example, that clients who get homework tend to do better in therapy than those who don’t.

Am I Going to Get Diagnosed with a Mental Illness?

While therapists are trained to diagnose and treat psychiatric disorders, therapy has a lot more to offer than just that. For example, some people see a therapist to help them make important life decisions; some attend couples therapy to work through conflict, cope with divorce or to become better parents. You may consider attending therapy as a source of support through a difficult time, to come to terms with a new medical condition, or even simply to learn more about yourself and grow as a person.

Therapy Appointment

What Can I Do to Get the Most Out of Therapy?

Therapy is what you make of it. It’s also a two-way street: regardless of how skilled your therapist is, there are certain things that you can bring to the table in order to make the most of the process.

Be Honest

We all carry secrets and it can be tempting to keep these from your therapist as well. After all, sharing your deepest thoughts and memories with someone who you don’t know all that well can be an intimidating prospect! It’s important to remember, however, that therapy is a confidential space and your therapist is there to help, not judge. Being able to share your secret with a trusted person can make for a powerful experience of bonding and validation that will only serve to strengthen the therapeutic bond between you. Moreover, the more your therapist knows about you, the better equipped they are to help you.

Be Open Minded

Therapy is not an easy process. However, it’s because therapy challenges you that it’s effective. While your therapist is there to provide emotional support and encouragement, therapy is also difficult to the extent that exposes you to suggestions and realizations that may be new and uncomfortable. To make the most of this process, try to approach and embrace all of this with an open mind.

Ask Questions

Seeing a therapist is different from having a normal medical consultation because you, the client, needs to be actively engaged in the process for it to work. This means, therefore, that it’s important for you to ask any questions that might come up, so that you can be as fully involved as possible. Be sure to ask your therapist to rephrase or repeat anything you don’t understand and don’t hesitate to let them know if you’d like to learn more about the process of therapy and what you can expect from future sessions. Further below, we suggest some questions that you may want to ask when seeing a new therapist.

How to Find a Therapist

It’s possible to find a licensed professional through various online directories.

Otherwise, you may wish to go by word of mouth: speak to your doctor, friends or family members to get a recommendation or referral. If you are covered by your health insurance for mental health benefits, you may want to ask them for a list of affiliated practitioners. Alternatively, people who are looking for a therapist specialized in a specific area may find it helpful to perform an online search.

What Should I be Looking for in an LMHP?

There are certain points that you should consider when choosing a therapist. For example, do you have any preference in terms of their gender? Do you prefer to see someone that’s older or younger? If you’re facing a specific difficulty, you may want to consider finding a therapist who has experience in that field. Most important, however, is that you find a therapist who you feel safe and comfortable speaking to, as a good rapport is essential for the therapy process.

Questions to Ask a Potential Therapist

What do you have the most experience treating?

Will I have the same slot every week?

Which therapy modalities do you use?

How would you go about treating me?

Will I need to talk about my past?

What training do you have?

What is your cancellation policy?

How much are the sessions?

Does my insurance cover treatment?

What can I do to make the most of this process?

Find a Therapist Now

Increasing numbers of mental health professionals are now working online, which is making therapy more affordable and accessible. Online sessions mean that people can avoid being put on a waiting list and having to travel long distances to attend their therapy appointments. Thrive Talk is an established platform that provides online therapy to people who are struggling with anything from everyday stress to diagnosed conditions. The site is easy to use and once a person signs up, they will be able to choose from a wide range of therapists. With a broader pool of practitioners available online, people now have a better chance of finding a therapist that can accommodate their own needs, desires and schedules.

Therapy Means Investing in Your Self

It’s normal to be ambivalent about starting therapy. It can be daunting to share your fears and vulnerabilities with a stranger, and the expense and time commitments involved mean that many people spend a lot of time sitting on the fence before they finally choose to sit on the couch! However, the first therapy appointment that clients have can be an exciting and enlivening moment for people who might otherwise have not had many experiences of feeling truly heard and respected. While therapy can be challenging, this time and energy is being invested directly into yourself. Take steps to consult with a licensed professional today, if you want to address any concerns that you might have whilst also experiencing personal growth and self-awareness in the process.


  1. https://www.psychologytoday.com/us/blog/all-grown/201512/what-really-happens-in-therapy-session
  2. https://www.huffingtonpost.com/2014/01/22/first-time-at-therapy_n_4612858.html
  3. https://psychcentral.com/lib/what-to-expect-in-your-first-counseling-session/
  4. https://psychcentral.com/lib/your-first-psychotherapy-session/
  5. http://ro.uow.edu.au/hbspapers/2582/
  6. https://link.springer.com/article/10.1023/A:1022678622119
  7. http://www.apa.org/about/policy/resolution-psychotherapy.aspx



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