So once you decide you’d like to give therapy a shot and have found a therapist that feels like a good fit, you may be wondering what to expect in session. It’s totally normal to feel nervous about what therapy might be like. Once you get into the room (or zoom) your therapist will take special care to make sure you’re comfortable and go at your pace. Therapists are trained to “meet clients where they are” and shouldn’t be pushing you too quickly to dive into anything you aren’t ready to discuss. Contrary to how therapists are portrayed in the media, each session can look pretty different depending on your goals, your comfortable level, and the style of your therapist. Therapists (like other medical professionals) have ethical codes and should be respecting your voice and autonomy in treatment.
"some sessions can bring laughter, some bring tears, and some are simple processing and problem solving."
1. In my therapeutic relationships, some sessions can bring laughter, some bring tears, and some are simple processing and problem solving. My own personal style is warm, direct, and casual. I have a discussion in the very first session about what my clients are looking for, what has worked (and hasn’t worked) for them in the past, and how I can curate their sessions to be what they need. Some therapists take on the expert role and others work more collaboratively. For me, I don’t pretend to be the expert on your life experiences. I see my role as part of a team, working with you to get you where you’d like to be. I often ask for feedback to make sure the sessions feel right for you.
Shannon Williams, LMFT
"[I] empower my clients to make their own decisions, healthily express their emotions, and to gently and curiously challenge unhelpful ways of thinking and behaving..."
2. This is a tough question to answer because every client and client-therapist relationship is unique, as is every therapy session. That said, some key elements in most of my sessions include empathy, active listening, and curiosity. Some sessions are more structured and others are more free flowing, but I will usually start with a check-in, then provide a safe, non-judgmental space to collaboratively work through the presenting concern(s), and end with a summary of what was discussed to highlight takeaways of the session. Most sessions are 50 or 90 minutes and may include an individual, couple, family, or any combination thereof, depending on the client's goals and theoretical approach used. An important part of my work is to empower my clients to make their own decisions, healthily express their emotions, and to gently and curiously challenge unhelpful ways of thinking and behaving. This means that a "typical" therapy session for me does not consist of giving advice or telling my clients what to do. I strongly believe that my clients are the experts in their own lives and that I am a facilitator to help them explore more fulfilling ways to live.
Heather Hutchison, California and Texas LMFT,
Community Practice, Part Time Lecturer for Counseling Psychology Program
"there is not one thing that works for everyone and speaking openly and consistently helps your therapist to provide the highest degree of guidance."
3. Usually I start my sessions with feedback-informed treatment (FIT). Each session, I check in with my clients using a scale for a quick assessment of progress and wellbeing. We engage in a short discussion about their score which they usually add in the app before our session. This helps identify factors that helped achieve progress as well as areas they have gotten stuck or off-track over the past week.
Next, we collaboratively choose what to focus on in the session. This helps us make sure the client gets to talk about what they wish and also makes sure we stay on track of working towards their goals. Since I use FIT, the next part of the session can look quite different depending on my client’s preferences, needs, and the specific challenges we are addressing.
In the last 5 minutes of sessions, we discuss the SRS scale, a quick form of feedback concerning the key dimensions of effective therapy. During this time we collaboratively explore if there is anything I or we can change to make sessions a better fit for what my client needs or more effective overall. Over time I have learned that there is not one thing that works for everyone and speaking openly and consistently about factors helps your therapist to provide the highest degree of guidance. For instance, some aspects we might adjust over time could be how deep we process events and emotions or how much we focus on coping tools.
Nathalie Maggio, LMFT, Certified Clinical Trauma Specialist
"I work where the client is at. If we have an agenda and it needs to be side stepped to talk about something more important we do that. Being flexible is important as life happens!"
4. A typical therapy session usually includes laughter. I believe the connections I’ve made with my clients to feel comfortable and safe are usually expressed through their ability to have a variety of emotions and reactions in sessions. I work where the client is at. If we have an agenda and it needs to be side stepped to talk about something more important we do that. Being flexible is important as life happens! More recently I’ve been using my tech savvy skills to share my computer screen and complete CBT worksheets with clients as I would do in person. We then review what they have learned from the exercise. People have really found it helpful! Ultimately we decide if we want a more structured session or more informal, but usually someone ends up laughing and smiling.
Michelle Bucholtz, LCSW
Licensed Clinical Social Worker
"it's always my goal each session to make it known and felt by the client that this is THEIR session."
5. I'm not sure if there is such a thing as a typical therapy session. As a therapist, I generally like to start with a simple check in on how the client is feeling in that particular moment. From there, I let the client guide me and guide the session. Sure, there are times when I might need to prompt, ask digging questions, or clarify but it's always my goal each session to make it known and felt by the client that this is THEIR session. While I always strive to provide a safe and non-judgemental space for the person in front of me, my interventions, my questions, and pulse of the session vary from session to session and are entirely dependent on what information the client decides to entrust me with for that particular session.
Eryn Healy, ACSW
Private Practice & Community Mental Health Therapist