You’ve been feeling like you might need support, but you’ve never done therapy before, and you’re not sure about taking this step. You may be wondering what happens during therapy, and if it will be right for you. We’re here to answer your questions and guide you through the whole process.
Key Takeaways
- Therapy is a supportive, structured process in which a qualified therapist helps you understand your thoughts, emotions, and behaviors in a safe, non-judgmental space.
- The first session mostly focuses on understanding your needs, defining goals, building trust, and working towards a strong therapeutic relationship.
- Therapy can vary in structure and approach, but typically involves regular sessions and gradual, sustainable progress over time.
- You’ll explore personal experiences and coping strategies, with confidentiality protected (with limited exceptions).
May is Mental Health Awareness Month, and we thought the most important thing we could do to help raise awareness was to break down the whole therapy process—because we understand many people still face common fears about taking this step.
Maybe you’re unsure where to begin, afraid of being judged, or doubtful that someone could actually, truly help you. Perhaps simply not knowing what happens during therapy makes the process feel intimidating.
That’s why we’re here. Think of this as a simple guide to therapy—so you can take the first step and get the most out of it without overthinking it.
Meeting Your Therapist
Regardless of their designation, your therapist will be someone trained and qualified to support your mental health, though every professional will have different training, education, and experience.
What matters most is that you feel comfortable with your therapist. If they don’t feel like the right fit or you’re unhappy with your experience, try discussing it with them first. Your feedback can help them better understand how to support you.
The First Session
The first session primarily focuses on exploring whether you and your therapist are a good fit and starting to build a strong therapeutic relationship (also known as therapeutic alliance), which is the most critical factor in therapy success.
The first session may cover topics such as:
- Setting expectations
- Building trust
- Discussing what brings you to therapy
- Defining your therapeutic goals
- Addressing concerns about therapy
- Explaining the therapist’s professional and educational background
- Reviewing their therapeutic style and approach, and whether they’re a good fit for you
You may also discuss their experience with similar issues, the expected length of therapy, contact policy outside sessions, confidentiality, accessibility needs, and more.
If anything makes you uncomfortable during a session, it’s okay to talk about it and even ask for support in finding a different professional. The same applies to any future sessions.
What Happens During Therapy? From Beginning to End
So, what happens after the first session? What exactly happens during therapy, and how can a therapist help you work through your challenges?
What does therapy look like?
You might wonder: How often should I attend therapy? How long does it last? What are sessions actually like?
How often:
In many cases, weekly sessions are recommended to help build momentum and maintain consistency, which can support long-term progress.
For how long:
As for duration, studies suggest many people notice significant improvement within 12 to 16 sessions, though some continue for 20 sessions or longer, depending on their needs and goals.
Session structure:
The structure of therapy depends on the approach used. Some are structured talk therapies (e.g., CBT), while others are structured non-talk therapies (e.g., EMDR). There are also unstructured approaches that are more open-ended and flexible.
Session duration and format:
Sessions usually last 45 to 55 minutes and may take place individually, as a couple, with family members, in a group setting, or through a combination of formats.
Where:
Finally, at New Connections Counseling Center, we offer both in-person sessions at our Hampden office in Baltimore and online therapy across Maryland.
What should I expect from therapy?
During therapy, you may talk about past and present experiences, struggles, emotions, behaviors, relationships, and more. Your therapist will help you better understand how these experiences connect and affect your life.
Other things to expect from therapy include:
- Guidance in identifying and setting goals
- No pressure to share anything you’re not ready for
- Learning to challenge negative thoughts and behaviors
- Emotional ups and downs as you process difficult experiences
- Possible homework, such as journaling or practicing new coping strategies
What will I talk about?
Whether through exercises or open discussions, therapy can explore many different topics. Your therapist may ask about:
- Childhood and past experiences
- Difficult situations
- Current and past relationships
- Emotions and behaviors
- Thoughts and beliefs
- Concerns from previous sessions
Remember, you never have to discuss anything you don’t feel ready to share.
How does confidentiality work?
Confidentiality is a core part of therapy, meaning what you share is kept private. However, there are a few exceptions your therapist should explain clearly.
These may include:
- Professional consultation: Your therapist may discuss your case with supervisors or colleagues for guidance and to ensure you receive the best possible care.
- Insurance: Some insurance companies require detailed records and diagnostic information to process claims.
- Safety concerns: If there’s a serious risk of harm to yourself or others, your therapist may need to contact emergency services or other authorities.
- Legal obligations: In rare situations, therapists may be legally required to break confidentiality for serious legal matters.
After a Session
You may experience an emotional mix after sessions. This can include relief from being heard, motivation to understand yourself better, but also exhaustion, frustration, or feeling overwhelmed.
Therapy can sometimes bring up difficult emotions that make you feel unsure about continuing. When this happens, you can:
- Talk about it with your therapist or with the care coordinator
- Share your feelings with someone you trust
- Write down your thoughts and emotions
- Do something comforting after sessions or use relaxation techniques
What happens after sessions can be just as important as what happens inside the therapy room, as it gives you time to process what you’ve learned and apply it in daily life.
Find Support for Your Mental Health in Baltimore, MD
Ready to stop wondering what happens during therapy and take the first step to truly heal and improve your life? We offer therapy for couples, groups, and individuals dealing with anxiety, depression, trauma, and more.
Our Baltimore-based therapists specialize in helping people embrace their strengths and break free from negative patterns. Reach out to know more, or schedule a free 15-minute consultation here.
FAQs
What usually happens in a therapy session?
A therapy session usually lasts 45–55 minutes. It may involve discussing stressors, identifying patterns, building coping strategies, and working toward therapeutic goals in a safe, non-judgmental space.
What do you actually do in therapy?
In therapy, you work with a mental health professional to understand and improve your emotional, behavioral, and psychological well-being.
You can talk about thoughts, feelings, and experiences in a confidential setting, with the goal of changing harmful patterns and building self-awareness and healthier coping skills.
What is a red flag for a therapist?
Red flags for a therapist include:
- Crossing boundaries
- Unethical behavior
- Showing judgment or prejudice
- Disrespecting culture or values
- Improperly breaking confidentiality
What is a therapist not allowed to do?
Therapists are not allowed to engage in any form of abuse, sexual behavior, or romantic relationships with clients. They must not breach professional boundaries, meaning they should not become friends with a client or enforce their own values.
They also cannot break confidentiality except in legally required situations involving safety or legal obligations.
How long does therapy usually last?
Many people begin noticing improvement around 15–20 sessions. Some shorter-term issues may improve in 8–12 sessions, while more complex challenges can take months or longer. The duration depends on goals, progress, and the type of therapy.
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