10 Things I Wish People Knew Before Starting Therapy

As a mental health provider, I've worked in nonprofits, private practice, and partial hospitalization (PHP) and intensive outpatient (IOP) programs, and I've seen and heard a wide range of experiences. It breaks my heart to sit with people, one-on-one and in groups, and hear about the negative, and sometimes even traumatizing, experiences they had while seeking help at their most vulnerable.

Here are some of the things I've heard:

"The crisis team promised me one thing, and I felt like they duped me and took my money."

"My friends thought they were doing the right thing, but they had no idea how harmful it was."

"I wasn't in my right mind, and I didn't know I could say no."

"The therapist there made me feel embarrassed and invalidated. I thought that's how all therapists were, so I didn't seek help again."

I've also heard the complete opposite:

"I was really scared to start therapy, but it wasn't as hard as I thought it would be."

"I never thought I'd like group therapy, but it's been so helpful to see I'm not alone in these thoughts."

"Group therapy is a place where I receive support and encouragement that I don't find anywhere else in my life."

These conversations made me realize that many people don't know what therapy is, how it works, or how to begin. Therapists have different specialties shaped by research, certifications, education, and life experience. Therapy is not one-size-fits-all. Do your research and find someone who works with your "presenting concern," the thing that's bringing you to therapy.

My biggest piece of advice is to advocate for yourself. With that in mind, here are ten things to know as you get started.

1. It's okay to ask for help.

2. Take advantage of free consultations.

Find a few therapists and schedule a consultation call with each. Most therapists offer a free 15-minute phone call to see whether you're a good fit. If you're not, ask them for referrals. When I talk with potential clients, I explain that the purpose of the call is to make sure we're a good fit and to clarify their goals for therapy. If either of us feels it isn't the right match, I'll help them find someone who is.

3. Know your availability before you call.

Make sure the therapist can accommodate your schedule before you start working together. Nothing is worse than pouring your heart out to someone, only to learn you won't be able to keep seeing them.

4. Your first session is usually an intake.

During an intake, your therapist gathers the pieces of the puzzle (your life) to build a foundation for understanding who you are and what you've experienced. It may feel tedious, but it's well worth it. The deeper work comes in future sessions.

5. It will probably be uncomfortable.

You're not coming to therapy because everything is peachy. You're coming because something doesn't feel quite right, and getting to the root of it can be messy. Be prepared to get a little uncomfortable in order to grow.

6. The work continues outside the session.

We spend 45–55 minutes together each week. That time is valuable for processing, reflecting, and building skills, but I like to think of therapy as an experiment: you take what we worked on into your everyday life and practice it. Notice which emotions and thoughts come up, or what gets in the way of setting a boundary or speaking up for your needs. Then we bring that back into session and keep working through it.

7. There's no set timeline.

Everyone is unique, with their own experiences, so there's no "one-size-fits-all" timeline. My job is to work myself out of a job. If you feel like you'll need me forever, I'm not doing my job well. My goal is to walk alongside you as you meet your treatment goals. And when life brings new challenges and you want support, you're always welcome to come back.

8. If you’re on medication, meet the meds half way.

If you’re taking medication, you can not expect it to solve 100% of the discomfort- you should aim to “meet the meds half way”. Learn the skills and identify the root cause. If you aren’t on medication, please know, I'm not a medication pusher. But sometimes our progress data shows that, despite the work we're putting in, we aren't seeing enough improvement. When that happens, I refer you to psychiatric providers I've carefully vetted and trust to care for you well. Because I believe in a collaborative approach, I'll also ask you to sign a Release of Information so I can coordinate with your psychiatrist and give you the best possible care.

9. It's okay if it's not the right fit.

If you give a counselor a few sessions and it still doesn't feel right, it's okay to stop and ask for referrals. You get to decide when to end therapy.

10. There are different levels of care.

Sometimes a weekly or biweekly appointment with an individual therapist is all you need. Other times, a higher level of care, like intensive outpatient or partial hospitalization, is the better fit. There's also group therapy, where you can learn from others and see that you're not alone.

Ready to take the first step? Schedule a free 15-minute consultation with Flower Mound Family Institute. We'd be honored to walk alongside you.