Knowing what to expect in therapy can be a bit obscure when you’re starting therapy for the first time. I hear people tell me all the time that when they found a new therapist, they weren’t sure about things like what they were supposed to talk about or if they were supposed to be the one to bring up coming to an end.

While you will find as many ways to do therapy as there are therapists, here’s what I tell my own new clients to level-set expectations and provide a bit of a foundation when first coming in:

1. We go at your pace.
Just like any new relationship, trust gets built over time. So while it’s incredibly important for you to feel safe and not judged by your therapist, it doesn’t mean you have to tell all until you’ve had the time to really establish a sense of trust and you feel ready. We follow your lead, and therapy progresses based on what you choose to bring in and talk about.

2. Sometimes it gets worse before it gets better.
Of course therapy doesn’t always feel “good,” and oftentimes we’re opening up boxes we’ve kept closed for a reason, which can bring a lot up to the surface! While it’s absolutely normal for some clients to feel a little worse right after getting started, it’s important to keep in communication with your therapist about it, as we can always dial up or dial back to make sure it’s manageable.

3. Small issues are usually a window into much deeper issues.
Just ask any couple arguing about the dishes! While most therapists have their clients take ownership of starting the session, don’t feel like you need to put so much pressure on yourself to know exactly what to talk about. What’s more important is starting to notice the patterns that are coming up across issues most present for you each week, or even across the way you and your therapist work in the room! Consider everything, including your relationship with your therapist, a “microcosm” of what’s going on in the bigger picture.

4. The therapeutic process is full of ebbs and flows.
Understandably I often see clients judge the value therapy session-by-session. Did I have $150 worth of insights today? Did I just vent about my job? But it’s much more useful to look at therapy holistically – some weeks may be full of “a-ha’s” and leaps forward, others will feel like two steps back, and others may be – quite frankly – boring. But over the course of treatment progress continues to happen bit by bit. Know that up’s and down’s are normal and all just part of the process.

5. Feel empowered to speak up and let your therapist know what you need!
Research shows that the relationship you have with your therapist is the most important factor when it comes to therapeutic success. And while it can feel really uncomfortable, but one of the most significant things you can do to make sure your therapist is getting it right is to give them feedback. You should also feel empowered to speak up when you want to talk about bringing therapy to a close. While there are exceptions, more often than not therapists will leave the decision to come to a pause or a close up to you. You don’t need to wait for us to tell you that you’ve “graduated” to work on what it might look like to bring treatment to a close.

Bonus Tip! Silence in session – as uncomfortable as it may be – is not just totally ok. it can actually be really good. Our culture tends to do everything it can to fill or rush through our discomfort with silence, but it’s often in these very spaces where change has room to take place – whether it’s letting a thought or emotion fully marinate, or allowing a deeper subject that’s been lingering in your subconscious finally make its way up for air. Don’t be afraid of silence. Embrace it.

If you’re interested in getting started in therapy, reach out or learn more at