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How to start therapy and what to expect

Updated: Jul 16, 2019

I wrote this for mental health charity - Voices of Hope, but it is so important that I wanted to share it here too!

At some point in our lives, we have all felt overwhelmed, confused, stuck, unsure and maybe even anxious or depressed. It is part of the human experience and, although at the time might feel like it will never end, or it is impossible to see the light at the end, there is a way to get through it, even if you don’t want to believe it.

I have felt like this myself frequently throughout my life. I denied for a long time that I would benefit from going to therapy and talking about everything that was weighing me down, and – honestly – I got there unintentionally. I ended up admitting I needed to talk in a slightly unconventional way: I decided I needed help with my mind-set in my sport. I was so guarded at the time that, if I had even had an inkling that we were about to spend the next two-plus years unpacking a lot of non-sport related stuff, I would probably never have gone. It may sound scary if you are making this decision now, but trust me when I say: just go! Take the first step and the ones after that, and watch your life change for the better.

Step 1: Check in with yourself and your personal goals

Start by asking yourself what it is that you wish to achieve by attending therapy. Consider how often you can commit to going and commit to being honest with yourself when you get there. Write some notes about the areas of your life and mental health that you think could most benefit from attention. This can be confronting in itself, but it is essential to understand your own mindset as best as you can to make the most of it. By doing this, you will be able to search for a therapist that might suit you.

Step 2: Search for a (new) therapist

Remember: you don’t have to continue seeing a therapist for whom you don’t feel trust. For therapy to be most effective, you need to have a connection with that person and feel well supported during the sessions. It is important to note that a degree of discomfort is standard in the process, and that shows that the therapy is working. However, if you are feeling too uncomfortable with your therapist, then you might need to consider trying someone else. Be open with your therapist about this, you can come up with a plan to work through it, or they will be able to refer you to someone else who may be suitable.

You can start your search for a therapist by going to your GP and asking them to refer you for counselling. This is the way many people first connect with therapy. You might also decide that you want to look privately and that’s where searching online for therapists in your area will be most appropriate. It can feel like a bit of a guessing game when choosing someone, especially the first time, but try and find out what areas they specialise in and go from there.

In New Zealand, Accident Compensation Corporation (ACC) also provides therapy to those with sensitive claims. If you have been a victim of sexual assault, then you can find an ACC approved therapist who can help you work through your trauma and experiences, and ACC funds it. There is more information about this on their website (

An excellent webpage to find a therapist in your area is

Step 3: Make contact with preferred therapist

When you find someone you would like to see, ask them if you can have a phone call before the first appointment. This will give you a better idea of what to expect from them before you meet in person at your first session. Write down some questions to ask them during the call, most therapists are happy to have an initial phone consultation, and some of them won’t book a new client without it. Some questions you might wish to start with may be:

What style of therapy do you offer your clients?

What is your availability on an ongoing basis? (Do they fit in with your schedule?)

What do they charge per session? (If going privately)

How long is a session?

What can I expect during my first visit?

Consider how you feel talking with them on the phone before committing to an appointment. They should be able to answer these questions with ease and provide some reassurance to help you through this big step.

Step 4: Your first appointment

Your first session is going to cover a lot of admin type things, like paperwork and an introduction to what you can expect. This is an information gathering meeting so don’t be surprised that you don’t unpack everything on your first visit – these things take time. The therapist will likely ask you some questions to get to know you better and understand your motivations for coming to the therapy. This might feel intrusive and uncomfortable, but for the therapy to be most effective, your new therapist needs a bit of an insight into your life. Don’t expect a diagnosis after your first visit – this can take time while your therapist gets to know you and don’t be alarmed if you also don’t get one at any point. It is perfectly valid to go to the therapy to get through a tough time even if you don’t have a mental illness.

Some of these questions might be asked:

What brought you to the therapy?

What is your current living situation? (Where do you live, your family etc?)

How long have you been struggling for?

What significant life events have taken place in your life?

Remember: if you feel you aren’t clicking with this person, speak up! It is their job to help you. It is also important to remember that this time is about you and to help you so you shouldn’t feel pressured and rushed to talk about things you aren’t ready for. Be honest with yourself and your therapist. Your pace, comfort level and boundaries need to be respected to foster a good working relationship.

If you aren’t feeling like your therapist is the one for you generally you will know within the first two or three sessions. Give them a chance but if you aren’t feeling it after three meetings, it might be good to try someone else.

Notes to consider when engaging in therapy

The therapeutic relationship

Generally, a person’s relationship with their therapist mirrors other relationships throughout their lives. We might not even be conscious of it, but in the therapeutic relationship, we often will recreate dynamics with our therapist that we have experienced within other relationships. This is nothing to fear and shows the therapy is working. The difference of this situation is that your therapist gives you plenty of room to process negative and uncomfortable feelings and work through helpful coping as well as maladaptive patterns in a safe space. Therapy should serve to be a corrective experience for you, thus allowing you to move forward and grow through the discomfort and past experience.  

Therapy works when you work

There is no magic wand to wave to activate recovery or wellness. Therapy is a hard work, but it is essential and very worthwhile. When it is tough, communicate with your therapist and hang in there, work through the tough spots. Therapy is a team effort!

Be honest

Therapy is a safe space, your therapist isn’t there to judge you and while you will have urges to hold back, it is essential that you are as honest as you can be. It is also important to note that, despite some common beliefs, therapists are not mind readers so you will need to talk and open up in order to help them get to the bottom of your thought processes.

Be prepared

Some therapists will give you homework that you need to work on outside the sessions. Make sure you do it as well as you can. Remember: therapy only works when you put in the effort. Positive result doesn't come from spending an hour once a week in a therapist’s office – what you do the rest of the time matters greatly.

For a long time after I started my therapy, I struggled to speak to my therapist in person, but I found I was able to open up a little more via email. I would send my therapist an email about certain things, which they could read before my appointment, and then I would find it easier to talk about it in the session, knowing that they already knew the gist of it. Don’t expect your therapist to devote a lot of time to you outside your appointment but writing might be a beneficial way for you to get it all out. This, of course, required a lot of work and preparation before each visit.

Think about how you are feeling or what you are thinking that is troubling you before you go to every appointment; this will make sure you get the best out of each session.

Not every session feels productive

Honestly, don’t beat yourself up if you go sometimes and feel like you are unable to put your best effort into it. Sometimes it will be like that, and that’s okay – this is a hard work.

Ask questions

The more you can understand the process behind the therapy and your health, the better you will be able to move forward and take care of yourself in an empathic way. I know that sometimes you will want to blame yourself for everything and beat yourself up for your current mood or mind-set, but it won’t benefit you. Understanding what's going on is really helpful to be able to reason and forgive yourself.

Therapy is not a quick fix

As I said, there is no magic wand! Doing the work and building a strong foundation with your therapist is vital. Give yourself time between sessions to process and reflect on what was discussed – this is important for moving forward.

Discomfort and anxiety about therapy are normal

Let yourself feel and accept the emotions and thoughts you are experiencing. Sometimes, when I was experiencing high anxiety before my session, I found a little comfort in letting my therapist know via email before I came in that I was feeling that way. It can be helpful to them too to know that before you arrive.

At times in your therapy journey, you will be pushed to think about your own contributions to your distress. Self-reflection can feel awful but being able to resist taking a punitive approach to yourself is going to be most helpful to you. Taking note of these areas and then working on how you can change behaviours will help you get ahead.

Huge relief

The relief you will be likely to experience when you start unpacking your stresses will far outweigh the anxiety you have at the start about getting yourself to the therapy. When you feel like you can’t, hold onto this! The more you can unpack, the more freedom you will enjoy.

You don’t have to have a mental health issue to seek therapy

Don’t be put off seeking therapy if you don’t feel you have a clinical mental illness. There are many stages in life when nearly everyone could benefit from therapy to be able to live their lives to the fullest. There is absolutely no shame in seeking professional help in any capacity.

I hope that, in reading this post, you will feel empowered, even if a little worried, to reach out and challenge yourself to commit to your wellness. It is a scary step but it is such an important one to take, and you will feel like you can live a better life when you do. There is always a way forward, even when we don’t want to believe it. Find the courage to live for yourself and see what you can do with your life.

Photo by Han.


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