What to Expect in Therapy: Demystifying the Process
❝Therapy involves more than talking; it is an active, step-by-step process built around trust, collaboration, and personal growth. Knowing what to expect in each stage can help you approach your first session with a sense of clarity and steadiness.❞
Starting therapy is a brave and important step. But if you've never been before, it can feel a little scary. You might wonder: What will we do in a session? How long does it take? Will it be uncomfortable?
I'd like to shed some light surrounding that and help you understand what really happens in therapy. When you know what to expect, the process feels less intimidating.
Therapy should be personal. Our therapists are qualified, independent, and free to answer to you – no scripts, algorithms, or company policies.
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Table of Contents | Jump Ahead
- What Therapy Really Is
- The Five Stages of Therapy
- What Happens in a Typical Session
- Common Concerns People Have
- How to Make the Most of Therapy
- Why Therapy Works
- What Therapy Is Not
- Final Thoughts
- References
What Therapy Really Is
Therapy is a collaborative relationship. It's not about a professional "fixing" you, but about you and your psychologist working towards your goal in therapy.A psychologist provides a safe, nonjudgmental space where you can explore what's going on in your life. Through guided conversations, you learn how your thoughts, emotions and behaviours interact and how to shift them in healthier directions.
The Five Stages of Therapy
While therapy looks a little different depending on the psychologist's approach and your goals, most journeys follow five broad stages.
1. Relationship Building
The first few sessions focus on getting to know each other. Your psychologist will ask about your background, current struggles and what you hope to achieve.Research shows that the therapeutic alliance is forged in the first session and remains stable during the following sessions. This is also your chance to see if the psychologist feels like a good fit. Building trust and comfort is essential, as you won't get far if you don't feel safe opening up.
2. Problem Assessment
Once the relationship foundation is set, the work deepens. Here, your psychologist and you may delve deeper into your past or suppressed emotions. Together, you'll start to notice patterns in how you think, feel and respond to situations.This stage can feel intense at times because it often involves discussing painful experiences. But these conversations are crucial as they provide the map for moving forward.
3. Goal Setting
Goals can be set at the beginning of therapy, but can change as therapy unfolds. Therapy goals change over time because, as people make progress, gain self-awareness and face new life circumstances, their needs and priorities naturally evolve.
4. The Work Phase (Counselling Intervention)
This is where most of the therapeutic growth happens. Depending on your psychologist's approach, this stage could involve:- Cognitive Behavioural Therapy (CBT): Identifying unhelpful thought patterns and practising healthier ones.
- Psychodynamic Therapy: Exploring early life experiences to understand their impact on the present.
- Acceptance and Commitment Therapy (ACT): Learning to accept uncomfortable feelings while still making choices that align with your values.
- These are not a comprehensive list of approaches psychologists use; there are many others as well.
5. Evaluation and Ending
Eventually, therapy comes to a close. Together, you'll review the progress you've made, highlight the skills you've gained and talk about how to maintain your growth independently.Sometimes this means ending therapy altogether, sometimes it means moving to less frequent sessions.
What Happens in a Typical Session
Most therapy sessions last 50-60 minutes and happen weekly or biweekly. While each psychologist has their own rhythm, many sessions follow this structure:- Check-in: How have things been since the last session?
- Review: Go over any exercises, reflections, or homework from the previous week.
- Focus: Explore your current concerns, practice coping strategies or dig deeper into patterns.
- Homework: A practical exercise to apply outside of therapy (e.g., journalling, practising a skill).
Common Concerns People Have
"How long will therapy take?"
It depends. Some people prefer short-term therapy, while others continue for months or even years. The timeline is shaped by your goals, the complexity of your struggles and the pace of progress.
"Will therapy be uncomfortable?"
At times, yes. Therapy involves facing feelings and memories you may have avoided. This doesn't mean therapy isn't working. It usually means you're confronting something important.
"What if I don't like my psychologist?"
That's okay. The relationship is the most important factor in therapy. If, after some time, you don't feel comfortable, it's worth trying another psychologist until you find the right fit.
"How will I know if it's working?"
Progress isn't always linear, but you may notice:- Feeling calmer or more resilient
- Improved relationships
- More effective coping skills
- Greater self-awareness
- Increased confidence in handling challenges
How to Make the Most of Therapy
Before sessions: Reflect on what you want to bring up, arrive a little early and be open about your goals.During sessions: Be honest, ask questions and speak up if something isn't working for you.
Between sessions: Practice the skills you learn, complete any exercises and observe your thoughts and behaviours in real life.
Why Therapy Works
Science has shown several mechanisms behind why therapy helps:- Neuroplasticity: Therapy literally rewires the brain, forming healthier patterns of thought and response.
- Skill building: You learn coping and problem-solving strategies that last a lifetime.
- Emotional processing: Talking through painful experiences helps you embrace more aspects of yourself and heal.
- Insight: Understanding yourself better creates the foundation for change.
What Therapy Is Not
It's just as important to clear up misconceptions:- It's not about a psychologist giving advice or telling you what to do.
- It's not about quick fixes - lasting change takes time.
- It's not passive - you are an active participant in your growth.
Final Thoughts
Therapy is a journey, not a one-time fix. It unfolds gradually, building from trust and exploration to skill-building and transformation.Along the way, you'll face challenges, but you'll also gain tools and insights that can benefit you for the rest of your life. If you're just beginning, remember therapy is not about needing to be "fixed". It's about growth, healing, and learning new ways of living.
Each session is an investment in a healthier, more fulfilling future. As you move forward, know that every step you take in therapy is a step toward understanding yourself more deeply and creating lasting, positive change in your life.
With care for your path ahead - and if you ever feel like reaching out, I'd be glad to hear from you.
References
American Psychological Association. (2023). Understanding psychotherapy and how it works. https://www.apa.org/topics/psychotherapy/understandingDoidge, N. (2007). The brain that changes itself: Stories of personal triumph from the frontiers of brain science. Penguin Books.
Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2020). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 57(3), 316--340. https://doi.org/10.1037/pst0000306
Mayo Clinic. (2023). Psychotherapy. https://www.mayoclinic.org/tests-procedures/psychotherapy/about/pac-20384616
Norcross, J. C., & Lambert, M. J. (2018). Psychotherapy relationships that work III. Psychotherapy, 55(4), 303--315. https://doi.org/10.1037/pst0000194
Sutton, J., & Lancia, G. (2021). Defining the counselling process and its stages. Positive Psychology. https://positivepsychology.com/counseling-process/
Important: TherapyRoute does not provide medical advice. All content is for informational purposes and cannot replace consulting a healthcare professional. If you face an emergency, please contact a local emergency service. For immediate emotional support, consider contacting a local helpline.
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About The Author
“You don’t have to navigate life’s challenges alone. Lisa offers a supportive and collaborative therapeutic environment where you can explore your experiences at your own pace. She believe emotional well-being is deeply connected to thoughts, relationships, experiences and environment. Using culturally sensitive, evidence-based care, Lisa works alongside adults and adolescents to strengthen coping skills, foster personal growth and support meaningful, lasting change, whether in person or online.”
Lisa Liu is a qualified Counseling Psychologist, based in Linden, Randburg, South Africa. With a commitment to mental health, Lisa provides services in , including Counseling, Trauma Counselling, Adolescent Therapy, Somatic Psychotherapy, Crisis Support & Counselling, Individual Psychotherapy, Integrative Psychotherapy, Online Counselling, Psychodynamic Therapy and Psychoeducation. Lisa has expertise in .
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