Beginning Therapy: What to Expect and How to Make the Most of It
Starting therapy can feel like a big step. For many people, the idea of opening up to someone new—especially about personal struggles—brings a mix of hope and hesitation. If you’re considering reaching out for support, you’re not alone in having questions, worries, or uncertainties about what lies ahead.
Common Concerns Prospective Clients Have
It’s normal to wonder:
“What if my problems aren’t serious enough for therapy?”
“What if I don’t connect with the therapist?”
“What if I start talking and it all feels too overwhelming?”
“What if therapy doesn’t actually help me?”
These concerns are very common. Research shows that people who enter therapy with mixed feelings often still benefit significantly once they begin (Swift & Greenberg, 2012). Therapy is not reserved for a particular type of problem or level of distress—it’s about creating space for whatever you’re carrying.
Early Experiences in Therapy
The first session usually involves getting to know each other and exploring what’s brought you in. Some people feel relief simply from sharing openly for the first time; others might feel exposed or unsure after these early conversations. Both responses are normal.
Therapy often takes time to “click.” Early sessions are about building trust, identifying patterns, and setting a direction. Research highlights the importance of this therapeutic alliance—the relationship between client and therapist—as one of the strongest predictors of positive outcomes (Horvath, Del Re, Flückiger, & Symonds, 2011).
Factors That Help Therapy Work Best
While every person’s journey is unique, certain factors consistently help people get the most out of therapy:
Consistency matters: Attending sessions regularly helps build momentum (Cuijpers et al., 2012).
Honesty (even about discomfort): Sharing doubts or feeling “stuck” often deepens the work.
While breakthrough moments can occur change is usually gradual: Sometimes subtle shifts build into lasting change (Wampold & Imel, 2015).
Practice outside sessions: Applying insights between sessions helps integrate therapy into daily life (Kazantzis, Deane, Ronan, & L’Abate, 2005).
The relationship itself: Feeling safe, understood, and respected in therapy strongly influences whether change happens (Norcross & Lambert, 2019).
Repairing Ruptures with Your Therapist
No relationship is perfect—including the therapeutic one. Sometimes you may feel misunderstood, hurt, or frustrated in session. This is known as a “rupture” in the alliance. It can feel uncomfortable, but research shows that addressing ruptures openly can actually strengthen the therapeutic relationship and lead to better outcomes (Safran, Muran, & Eubanks, 2011).
Ways to approach repair include:
Naming the feeling: Gently share with your therapist if you felt dismissed, rushed, or misunderstood.
Owning your experience: Use “I” statements (e.g., “I felt a bit shut down when we moved on quickly.”)
Staying curious: See the rupture as an opportunity to learn how you relate to others and how you can express needs safely.
Trusting the process: Therapists expect these moments and are trained to work with them—raising it won’t “ruin” the relationship, it can enrich it.
Practical Takeaways: Steps to Help You Get the Most Out of Therapy
If you’re thinking about starting, here are some practical things you can do to support your journey:
Set a gentle intention – Instead of pressuring yourself to “fix everything,” choose one or two areas you’d like to focus on first.
Keep a reflection journal – Write down thoughts, feelings, or situations that stand out between sessions. This can make your sessions more focused and meaningful.
Practice self-kindness – Remind yourself that therapy is a process, not a quick fix. Progress is often slow but steady.
Be open about the process – If something doesn’t feel right, talk with your therapist. Repairing ruptures can actually deepen trust.
Example: James noticed he felt cut off when his therapist moved on quickly during a session. At first, he thought about keeping it to himself. The next week, he shared, “I felt like I wasn’t finished talking.” His therapist thanked him for raising it, and they slowed the pace. The conversation strengthened their relationship and made James feel more confident about speaking up in other areas of his life.Notice the pullback tendency – It’s very common to feel vulnerable after a first session and to wonder if you should return. This doesn’t mean therapy isn’t right for you—it often means important things are being touched on. If possible, give yourself a few sessions before deciding whether it’s a good fit (Swift & Greenberg, 2012).
Example: Anna came to her first therapy session feeling nervous but hopeful. After opening up, she left feeling exposed and thought, “Maybe I won’t go back—this feels too raw.” She decided to give it another chance and told her therapist how unsettled she felt. Together, they unpacked the discomfort, and it became a turning point in building trust. What first felt like a reason to stop became the start of deeper healing.Celebrate small wins – Notice moments where you handled something differently, felt a little lighter, or understood yourself more clearly. Small steps add up.
Example: Priya often criticised herself harshly. After a few weeks of therapy, she caught herself pausing before spiralling into self-criticism and instead said, “I’m doing the best I can.” It felt small, but her therapist reminded her it was evidence of real change. That recognition helped Priya stay motivated in the process.
What Research Shows
🌱 Therapy really helps – Counselling can ease depression, anxiety, trauma, and more. Research shows the benefits often continue even after sessions end.
🤝 Your connection is key – The most powerful part of therapy is the relationship. Feeling safe, understood, and supported creates the best chance for change.
🪜 Progress takes small steps – Change usually builds gradually. Little shifts—like pausing before reacting or softening self-criticism—add up over time.
📝 Between-session practice matters – Using tools from therapy in everyday life, or reflecting after sessions, helps progress stick.
💬 It’s okay if things feel bumpy – If you ever feel misunderstood, bringing it up can actually make the relationship stronger and the therapy more effective.
🛑 Wanting to stop is normal – Many people feel like pulling back after the first session because opening up can feel vulnerable. Sticking with it often leads to deeper healing.
🌍 No one “perfect” therapy – Many different approaches can work. What matters most is finding a good fit and showing up consistently.
Final Thoughts
It’s natural to feel both drawn toward and hesitant about starting therapy. Many people find that their initial fears ease once they begin, and that therapy becomes a supportive, even life-changing, space.
If you’re considering taking that first step, remember: you don’t have to have it all figured out. Therapy is a process of exploration, support, and growth—and you set the pace.
References
Cuijpers, P., et al. (2012). The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: A meta-analysis. World Psychiatry, 11(2), 139–148.
Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011). Alliance in individual psychotherapy. Psychotherapy, 48(1), 9–16.
Kazantzis, N., Deane, F. P., Ronan, K. R., & L’Abate, L. (2005). Using homework assignments in cognitive behavior therapy. Routledge.
Norcross, J. C., & Lambert, M. J. (2019). Psychotherapy relationships that work III. Oxford University Press.
Safran, J. D., Muran, J. C., & Eubanks, C. F. (2011). Repairing alliance ruptures. Psychotherapy, 48(1), 80–87.
Swift, J. K., & Greenberg, R. P. (2012). Premature discontinuation in adult psychotherapy: A meta-analysis. Journal of Consulting and Clinical Psychology, 80(4), 547–559.
Wampold, B. E., & Imel, Z. E. (2015). The great psychotherapy debate: The evidence for what makes psychotherapy work. Routledge.