Therapy: What’s it really like?

By: Erin B. Patterson


We’ve all seen therapy happen in the movies or on television, but is that what it’s really like? I often tell my clients on their first visit that it doesn’t really happen like it does on television. I mean, you can talk about your mom if you want to, but you don’t have to lie down & do it.

So, I thought let’s write a blog about what it’s like with me. Every therapist doesn’t do it the same way but knowing what to expect can help calm our anxiety about a new thing significantly. Let me tell you how it goes in my office.


The First Visit

After you reach out, our receptionist will get you set up with a 60 minute appointment, which we call an intake session. At this appointment, I collect your payment for the visit and have you fill out paperwork about yourself. This paperwork usually includes things like your address, who lives with you, where you work, medical history, etc. I go over some of the specific policies that we have about confidentiality, fees, cancellations, and myself (i.e. where I got my training, what my experience is and how to get in touch with me). Then we begin the assessment.

During the assessment, I will begin by asking you to tell me what’s going on that has brought you to therapy. There’s no right or wrong way to answer this question. Just tell us what’s going on. I will ask more questions as I need to in order to determine a diagnosis. A diagnosis is necessary if you plan to use your insurance to pay for treatment, otherwise we will skip to the last step. I may use assessment tools during the first or second sessions to determine your level of anxiety, depression or other symptoms you report.

Finally, we will determine a treatment plan. The treatment plan includes what goals you want to accomplish by coming to therapy, what methods I can provide to help you accomplish those goals, and how often you’d like to attend appointments.


Follow-Up Sessions

I tend to provide a relatively laid back approach to your therapy. Usually in the second session I review the cognitive model (cognitive behavioral therapy), which is used in some form during most of our sessions. After that, you are in the driver’s seat. You get to determine what we talk about and what we work on. I will work to provide tools for you to put in your toolbox so that when life throws problems your way, you have a tool to use to solve the problem. Sometimes we’ll do worksheets, sometimes we’ll watch videos, sometimes we’ll write on the white board. We will always be working on helping you achieve those goals you set up in the beginning and if those goals change, we can change directions.


Graduating from Therapy

The amount of time therapy takes is different for everyone. Some people come in and have very specific short-term goals they want to accomplish. Some have harder stuff to sort through. Some folks feel better in as few as 4-6 visits. Others need a little more time. The goal is for you to keep making progress. As long as you are moving forward, we are on the right path. Most people start out with a session once a week or once every other week. As you feel better, the frequency will reduce and the sessions will become more spaced out. Once you get to a place where you are feeling stronger and more confident, we can move to an as needed basis. I call this graduating from therapy! I like to be fired because someone feels better!

Occasionally, people want to come back every few months for a bit of a booster shot, as I call it, or if some big issue surfaces. There’s nothing wrong with that. Therapy is a service that is provided for you and you have a say in how it goes. I always encourage my clients, and anyone seeking therapy, to discuss with your provider if you feel things are not working. I’d rather the provider have a chance to do something different than you just quit therapy because it isn’t working. But always keep in mind that the therapist is providing you a service, and if you are not satisfied, it’s worth talking with them about!


Sending you peace, love and happiness,



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