Therapy 101: A Beginner's Guide on What to Expect

First things first: if you're considering going to therapy for the first time, give yourself a pat on the back. The truth is, recognizing that you need a little extra help is sometimes the hardest step. You should be super proud of yourself.

But you might also be asking yourself, now what? What actually happens during the first therapy session? What types of questions will you be asked? How will you know if therapy is "working"?

Below, we explore all of these questions in greater detail so you can go from curious to confident.

📖 What is psychotherapy?

Psychotherapy, also known as talk therapy, is a collaborative process between you and a trained health professional to help you explore the thoughts, emotions, and patterns that might be holding you back. Through evidence-based techniques and genuine human connection, therapy helps you gain insight, develop healthier coping strategies, and create meaningful change in how you relate to yourself and others.

Working with a therapist is like having a personal trainer for your mental health. Just like a trainer, a therapist helps you examine your "form" (automatic ways of thinking), strengthen your emotional muscles, and build resilience over time.

👯‍♂️ Can I just talk to my friends instead of seeing a therapist?

Having good friends in whom we can confide is a crucial part of our wellbeing. However, there are a few key differences between friends and therapists:

• Confidentiality: unless there is an imminent risk, everything you say in therapy stays between you and your therapist thanks to strict confidentiality laws your therapist must follow.

• Focus: talking to friends is a back-and-forth conversation. You share something, your friend shares something, and so on and so forth. In therapy, the time is all about you. Unless it's therapeutic to do so, therapists do not talk about themselves or share personal stories. Many people report that this is something they quite enjoy about the experience: they don't have to perform, make conversation, or take care of anyone else, which can be very freeing.

• Objectivity & Nonjudgment: if you mention people in your life, your therapist doesn't know who you're talking about. This means they can offer neutral, unbiased perspectives and remain unattached to the outcome. Health professionals are not only trained to be non-judgmental, but we've heard a lot. Something you think is "so embarrassing" is something your therapist has likely heard about at least ten times already.

• Training & Depth: while friends might listen and empathize, therapists can ask deeper questions to help you understand why you feel the way you do, connect the dots, and identify patterns. From there, they can also provide practical tools to help you achieve a sense of mastery in life.

🛋️ What happens in the first therapy session?

While every clinician conducts a first session differently, here are the steps you can expect at Fresh Insight:

a) Informed consent: we'll review limits to confidentiality, our cancellation policy, and other logistical items to make sure you understand how we operate. This also gives you the opportunity to ask any questions you might have about our process.

b) Present-day life: we'll ask about what's happening in your day-to-day context. Some questions might include: Do you work? Do you enjoy your job? Do you live with someone? Do you have a partner? Do you use drugs and alcohol? What supports are in your life?

c) Family of origin: We'll ask about your parents and siblings (if applicable) and your relationships with them.

d) Past traumas. We'll ask about things from your past that you feel have impacted you.

e) Present symptoms: We'll ask what brought you to therapy and what you've been noticing lately that's been concerning to you, if anything.

f) Goals: We'll discuss what we're working towards so that we know when it's time for you to "graduate" from therapy.

• NOTE: Fresh Insight takes a trauma-informed approach, which means we focus on creating a safe environment that prioritizes choice, collaboration, and empowerment. If we ask you a single question during a first session that you do not wish to answer, we will always respect this boundary to honour this value.

📝 How do I prepare for a first therapy session?

You don't need to do a single thing to "prepare" for a first session! However, some people find it helpful to jot down what's been bothering them or what goals they have to organize their thoughts. But know that your therapist is there to guide you through everything and provide a sense of structure to the session—that's definitely not your job!

🥲 Are my problems "big enough" for therapy?

People go to therapy for a variety of reasons. While some folks might need help navigating a particular crisis in their life, others might simply wish to better understand themselves, improve their relationships, or manage stress. All of these goals are valid.

🧐 Should everyone be in therapy?

Our (perhaps controversial) opinion about this is that no, not everyone should be in therapy. In our experience, therapy is much more beneficial when someone feels ready for therapy—ready to look inward, reflect honestly, and make some changes in their life, no matter how small.

😬 How do I know if therapy is "working"?

The first sign therapy is working is when you start meeting the goals you set with your therapist. For instance, if your goal was to ground yourself during anxious moments, success might look like being able to use a grounding strategy to stop mental spiraling in real time.

More broadly, progress in therapy often means becoming aware of previously automatic patterns—and learning to interrupt them in ways that feel healthier and more aligned with the person you want to be.

🥺 What if I don't "click" with my therapist?

Interestingly, success in therapy has less to do with the model of therapy used or the techniques provided. Rather, research has consistently shown that having a strong relationship with your therapist is one of the most important predictors of positive outcomes (source). In other words, it's super important that you "click" with your therapist! If you're not feeling it with your therapist, you can consider:

• Giving them feedback about what's working or not working so they can adapt accordingly

• Connecting with a new therapist altogether

At Fresh Insight, we have a team of several clinicians so you have a number of therapists to choose from for this very reason.

📚 What models of therapy are most effective?

Many models of therapy have been researched to be effective, from Cognitive Behavioural Therapy (CBT) and Mindfulness-Based therapies for individuals to the Gottman Method and Emotionally Focused Therapy (EFT) for couples. However, what works for one person might not work as well for you. That's why our clinic focuses on assessing which model might be most effective, or we may pick and choose different techniques across a variety of models. Remember, however, that the therapeutic alliance—not the specific model or techniques—is the most important predictor of change (see point above).

• NOTE: Our clinic also offers adjunct treatments that can help support the efficacy of psychotherapy, including Eye Movement Desensitization and Reprocessing (EMDR)—one of the best treatments for trauma—and hypnotherapy.

📆 How long do I need to be in therapy?

It depends. Some people come for a few sessions to work through something specific and situational, while others stay longer to work through more complex or longstanding issues. You and your therapist will decide what makes sense together based on your goals, readiness for change, budget, and more.

📆 What's one thing I should know before starting therapy?

Therapy isn't about 'fixing you.' It's about helping you understand yourself more deeply so you can move through life with greater clarity and ease. You bring the courage; your therapist brings the tools. Together, you can create change.

One of our clients said it best in his review:

I’ve been regularly going to this place since 2022 and can honestly say they’ve helped me rediscover who I am fundamentally, resulting in a better relationship between me and my family, and most importantly between me and myself. I would not have been able to achieve the growth I didn’t know I badly needed until I started coming here. (Google Review from Franklin Y.)

We're here to help. To book an appointment, fill out this form on our website. Or, you can book a free 15-minute discovery call with our Intake Coordinator if you still have questions.

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