If you’ve ever typed “types of therapy” into a search tool and felt more confused after reading the results, you’re not alone. Terms like cognitive behavioral therapy, dialectical behavior therapy, and EMDR can sound clinical and intimidating, but this guide helps you understand these approaches with definitions written for real people like you.

Whether you’re considering therapy for the first time, exploring options for a loved one, or simply trying to ask better questions when working with a therapist, we can help you through it all.

Why Knowing Your Therapy Options Matters

The beauty of therapy is that there is no one approach: it looks different for everyone, depending on their needs. The right treatment for someone navigating grief may look very different from what works for someone managing borderline personality disorder or processing childhood trauma. You may have heard of cognitive-behavioral therapy (CBT), which is very effective for many people, but it’s just one of many therapy approaches that trained professionals can use.

Knowing what’s available and which modalities address different needs empowers you to have informed, meaningful conversations with potential therapists or current therapists. It also helps you trust the process once you begin the healing journey.

The Most Common Types of Therapy, Explained

How Do You Know Which Type of Therapy Is Right for You?

The truth is: You don’t always know in advance, and that’s okay. Most skilled therapists are trained in multiple modalities and will tailor their approach to your specific needs, history, and goals. The most skilled therapists have a diverse toolkit of methods they can draw from, adapting their approach to match each person’s unique needs, interests, and developmental stage.

That said, going in with some knowledge gives you the ability to ask meaningful questions. When looking for the right therapist, or during your next session, try asking your therapist these questions:

Asking these questions will help you find the right fit for your healing journey, and a good therapist will welcome them.

A Quick Reference: Therapy Types and What They Address

There are so many therapeutic approaches out there, and we’ve only covered a few. Still, here’s a breakdown of the theories we discussed and what they can help support:

Taking the Next Step

Understanding these approaches is the first step in building a better you. Finding the right therapist is a significant part of improving your mental health, but you don’t have to do it alone. GoodTherapy’s therapist directory allows you to filter by therapy type, specialization, location, and more, so you can find someone who truly fits your needs.

If you’re still exploring whether therapy is right for you, our blog on what to expect in your first therapy session can help you get started.

Remember, reaching out is not a sign that something is irreparably wrong with you. It’s a sign that you know your well-being is worth investing in.

If your life looks “fine” but therapy feels oddly difficult, blank, or frustrating, it may be a sign your system is learning a new kind of safety, not a sign you’re failing.

Quick takeaway: “I don’t know” can be a protective pause, not a dead end.

This is common: Therapy can feel hard before it feels helpful, especially for high functioning people.

Many people come to therapy because something isn’t working anymore, but they can’t quite name what. On the surface, life may look fine. You show up. You function. You handle responsibilities. Others might even describe you as capable or resilient. And yet, something feels off. If you’re wondering why therapy feels hard even though you genuinely want help, you’re not alone, and you’re not doing therapy wrong.

Why Therapy Feels Hard
“I don’t know” In Therapy
First Therapy Sessions

Holding It Together Is a Skill, Not a Failure

For many people, especially those who grew up needing to adapt quickly, staying regulated meant staying contained. You learned to manage discomfort quietly. You learned not to need too much. You learned how to stay composed, observant, or productive when things felt uncertain.

Those strategies are not problems, they’re strengths. They helped you survive, function, and move forward.

But therapy asks for something slightly different. Instead of managing from the outside, it invites you to turn inward. Instead of solving or performing, it asks you to notice. Instead of pushing through, it allows space. That shift is often a big part of why therapy feels hard.

Click to reveal: “Holding it together” signs you might recognize. ▼

You tend to:

• Stay calm in crisis, then crash later

• Handle everyone else first

• Talk about feelings like a report

• Minimize your own pain automatically

Therapy may feel like:

• Silence that feels “too big”

• A blank mind when asked, “How do you feel?”

• Restlessness, boredom, or irritation

• Pressure to “do it right”

If you’re nodding along, that’s a clue, not a critique. It helps explain why therapy feels hard when you’ve been the steady one for a long time.

Want a clearer roadmap for early sessions? Read what to expect during your first therapy sessions so the process feels less mysterious.

Why Slowing Down Can Feel Uncomfortable

You might notice that when therapy invites you to talk about feelings, your mind goes blank. Or you find yourself saying “I don’t know” more than you expected. Maybe you feel bored, restless, or subtly irritated, even though part of you genuinely wants help.

When you’ve relied on control, routine, or self-sufficiency, slowing down can feel disorganizing. Without the usual structure, your nervous system may not know what to do next. Avoidance, humor, distraction, or intellectualizing can show up, not to sabotage the process, but to keep you steady.

A quick “myth vs truth” reset

Myth: Therapy works only if you have big breakthroughs.

Truth: Often it works because you build safety, repetition, and small moments of honesty.

Myth: If you feel blank, you’re doing it wrong.

Truth: Blankness can be your system pausing for protection. It helps explain why therapy feels hard at first.

Thoughts that often show up when therapy starts working

• “I don’t know what I’m supposed to say.”
• “This feels pointless.”
• “I should be further along than this.”
• “Other people probably need therapy more than I do.”

These thoughts aren’t “resistance.” They’re signals of a system that has learned to protect itself by staying in control. That’s a very human reason why therapy feels hard before it feels helpful.

A simple nervous system map (so you can name what’s happening)

Green: grounded

You can reflect, feel, and stay present.

Orange: activated

Restless, defensive, irritated, wanting to “fix it.”

Gray: shut down

Blank mind, low energy, numb, “I don’t know.”

Therapy often helps you notice these shifts earlier. That awareness is progress, even when therapy feels hard.

Worried you’ll be pushed to “open up” before you’re ready?
This FAQ explains why you control what you share: Will I have to talk about my feelings in therapy?

Therapy Isn’t About Forcing Insight

Contrary to popular belief, effective therapy doesn’t require constant breakthroughs or emotional intensity. It doesn’t demand that you access everything at once or explain yourself perfectly.

Some of the most meaningful work happens when therapy goes at a pace your nervous system can tolerate. That might look like:

• Spending time in silence
• Talking around things before talking about them
• Using metaphor, imagination, or indirect language
• Not knowing what you feel yet
• Taking longer than you expected

None of this means you’re stuck. It often means something important is being protected until it’s safe enough to emerge. This is another reason why therapy feels hard: safety comes before speed.

If you want the “what is therapy” basics (in plain language)

• NIMH overview of psychotherapy
• APA: Understanding psychotherapy
• Mayo Clinic: Psychotherapy (what to expect)
• Harvard Health: What is somatic therapy?

When “I Don’t Know” Is Actually Information

Many people feel embarrassed by how often they say “I don’t know” in therapy. But not knowing is not emptiness, it’s information.

“I don’t know” can mean:

• You’ve never been asked this before
• You learned not to notice certain feelings
• The answer isn’t verbal yet
• Part of you isn’t ready to speak
• Your body knows before your mind does

When therapy respects that, rather than pushing past it, trust tends to grow. With trust, clarity often follows naturally, not forcefully. If you want a deeper take on this, explore it here: Trust in the Process: Sitting with Not Knowing in Therapy.

If you ever think, “I have nothing to talk about,” you might find this reassuring: When You Come to Therapy with “Nothing to Talk About”.

A Different Kind of Progress

Progress in therapy doesn’t always look like answers or solutions. Sometimes it looks like:

1

Feeling less rushed, even if nothing dramatic changed that week.

2

Noticing patterns without judging them, like how you shut down or over explain.

3

Understanding why reactions make sense, which reduces shame.

4

Gaining more choice in how you respond, even in small moments.

5

Feeling more like yourself again, with less strain.

These shifts can be subtle, especially at first. But they often lay the foundation for deeper change. It’s a quieter answer to why therapy feels hard: you’re building capacity, not cramming insight.

Micro Skills That Help When Therapy Feels Hard

If you keep wondering why therapy feels hard, it can help to bring the “hard” into the room in small, practical ways. Try one of these:

Pick one (small is powerful)

Body check-in: “My chest feels tight,” or “My stomach feels fluttery.”

Use a scale: “This feels like a 3 out of 10,” or “7 out of 10.”

Try parts language: “Part of me wants to talk, and part of me doesn’t.”

Bring notes: A few bullets on your phone counts as showing up.

Ask for pacing: “Can we slow down?” or “Can we stay with this for a minute?”

A simple script you can borrow in session

“I notice I’m going blank right now. I want to stay with this, but it feels hard. Can you help me slow down and figure out what my body is doing?”

Saying this out loud can be a turning point because the blankness becomes part of the conversation, not a barrier. Often, naming the moment softens why therapy feels hard.

You Don’t Have to Perform in Therapy

One of the quiet reliefs of therapy, when it’s done well, is realizing you don’t have to perform. You don’t have to be articulate. You don’t have to know where things are going. You don’t have to justify why something matters.

You’re allowed to arrive exactly as you are. If you’ve spent much of your life being capable, composed, or responsible, therapy can become a place where you don’t have to hold everything together alone anymore. That doesn’t mean giving up your strengths. It means learning how to carry them with less strain.

Want support that matches your pace and needs?
You can browse the GoodTherapy directory to find a therapist and filter by specialties and approach.

Moving at Your Pace

Therapy doesn’t need to be rushed to be effective. It doesn’t need to be overwhelming to be meaningful. Sometimes, the most important work happens slowly, through consistency, safety, and permission.

If you’ve ever wondered why therapy feels hard, it may not be because you’re doing something wrong. It may be because you’ve done a very good job surviving, and now your system is learning a different way of being. And that takes time.

Frequently Asked Questions (FAQs): Short answers for common questions when therapy feels harder than expected.

Q: Why therapy feels hard even when I want help?

A: Often, it’s because your mind and body learned to stay safe by staying composed. Therapy asks you to slow down, notice, and feel, which can be unfamiliar at first and therefore uncomfortable.

Q: Is it normal to feel bored, restless, or irritated in therapy?

A: Yes. Those feelings can be signs of activation or protection, especially if you’re used to staying productive or in control. Naming it in session can help your therapist adjust pacing and approach.

Q: What if I say “I don’t know” to everything?

A: “I don’t know” can be a protective pause, not a lack of depth. Try translating it to something like, “I’m not sure yet,” or “I feel blank,” and then check in with your body for a hint.

Q: Do I have to talk about my feelings for therapy to work?

A: Not immediately, and not in one specific way. You can start with thoughts, patterns, body cues, or daily stressors. This GoodTherapy FAQ explains your options: Will I Have to Talk About My Feelings in Therapy?

About the Author

Nathanael Schlecht, Licensed Associate Counselor

Nathanael is a Licensed Associate Counselor in Tucson, Arizona, who offers warm, compassionate, and deeply collaborative therapy for adults and elders navigating trauma, anxiety, depression, dissociation, and relationship struggles.

His work draws on approaches such as Deep Brain Reorienting (DBR), EMDR, Ego State Therapy, and hypnotherapy, with Christian counseling available when requested. He aims to create a safe, nonjudgmental space that supports healing at a pace that feels doable.

View Nathanael’s GoodTherapy profile ↗

Starting therapy might feel like opening a door you’ve been staring at for a long time — equal parts relief, curiosity, and uncertainty. What will it be like? Will your therapist understand you? Will it actually help? If you’re new to therapy, these unknown elements can stack up and exacerbate anxieties surrounding meeting your therapist and beginning treatment. But the first sessions aren’t about solving everything at once: they’re about laying the groundwork for real, lasting change. 

Knowing what to expect from your first sessions can alleviate some of that first-time therapy anxiety and nervousness. Let’s break down what you can expect as you’re getting comfortable with your therapist and how to make the most of those early sessions.

Related: A Step-By-Step Guide to Finding the Right Therapist

Table of Contents:

• Preparing for Your First Therapy Session
• What Typically Happens During a First Therapy Session?
• Common Questions Therapists May Ask
• Questions You May Want to Ask Your Therapist
• What To Do After Your First Therapy Session
• Therapists Share What to Expect in Your First Session
• The Second and Third Sessions: Deepening Understanding
• Finding the Right Therapist for You

Preparing for Your First Therapy Session

Embarking on your first therapy session is like opening a new chapter in your journey towards understanding and healing. To make the most of this initial meeting, it’s helpful to come prepared with a few essentials and a willingness to be open and share. Consider the following:

• What to Bring: Come with an ID card and insurance card if you plan to use insurance, along with any documents detailing your mental health history. A notebook can be invaluable for jotting down thoughts and topics you wish to discuss.
• How to Mentally Prepare: Think about questions you’re curious to explore with your therapist and write them down. Consider questions about their approach or how therapy can best support your goals. 
• Preparing for Virtual Therapy: If your session is virtual, ensure you find a quiet, private space where you can speak freely and without interruption. Test your internet connection and video call software ahead of time to prevent technical glitches. 

Remember, getting ready for your first therapy session is a step towards creating a space where you can engage openly and comfortably and foster a relationship grounded in understanding and support. It’s okay to be nervous about your first few sessions, and preparing for them can ease your anxieties.

Read More: Thinking About Starting Your Therapy Journey? Now’s the Time

What Typically Happens During a First Therapy Session?

Stepping into your first therapy session can be nerve-wracking, but once you get through it, you’ll feel more at ease about the whole process. If you’re attending a session in person, you’ll likely check in at the front desk and spend a few moments in the waiting area when you arrive. In this moment, provide a brief pause to center yourself. 

When the session begins, you’ll probably exchange introductions with your therapist to set a foundation for open communication. Your therapist will likely start by exploring the reasons you’re seeking therapy, delving into any past approaches you’ve taken towards mental health, and discussing ways to set goals in therapy. 

Remember, therapy is a collaborative dialogue where setting realistic goals becomes a shared focus. The initial meeting is just the beginning, and you’re not expected to unpack everything at once. It’s an opportunity to lay the groundwork for a supportive relationship where your therapist is there to guide you and ensure you feel heard, understood, and ready to embark on this journey together.

Common Questions Therapists May Ask

During the initial meeting, your therapist may pose a range of questions designed to gently uncover the layers of your current experience. These inquiries might touch on why you’ve chosen to seek therapy now, what specific concerns you’re facing, and any relevant aspects of your personal history. Remember that you’re not expected to divulge every detail immediately; this is the beginning of a relationship rooted in trust and mutual respect. 

Some initial questions they might ask you could include:

• Have you attended therapy in the past?
• What are your symptoms?
• Do you have any mental health issues in your family history?
• How is your home life?
• Do you have a history of suicidal ideation?
• Do you have a history of self-harm?
• What do you hope to get from therapy?
• What do you want to accomplish in sessions?

As you navigate these questions, you’ll also have the opportunity to learn about your therapist’s approach and clarify any logistical details, such as confidentiality and session structure. This dialogue sets the stage for a collaborative process, ensuring you feel comfortable and engaged as you move forward on this path of self-discovery and healing.

Questions You May Want to Ask Your Therapist

During your first few sessions, it’s perfectly natural to have questions swirling in your mind. Finding the right therapist is about building a relationship with them, so you should ask your therapist questions, too. Asking your therapist questions helps clarify any worries or concerns you may harbor about the treatment process. You can ask questions like:

• Is this confidential?
• When would you need to break confidentiality?
• How long have you been a therapist?
• Do you have any experience with my specific type of mental health issues?
• Have you ever been to therapy yourself?
• What kind of things should I plan to do between our sessions?

Voicing these inquiries can provide clarity and comfort. Remember, this is your space to explore and understand. Allow yourself the grace to ask freely, fostering an environment where your healing journey can unfold with openness and understanding.

What To Do After Your First Therapy Session

As you step out of your first therapy session, it’s important to take a moment for self-reflection and consider how you felt during the meeting. Evaluating your comfort level with your therapist is a crucial part of the process, but don’t forget that change and comfort will be gradual. It’s completely normal if you don’t feel an immediate sense of transformation. 

During or right after your first therapy session is a good time to schedule follow-up sessions and address any initial concerns you might have had. Your therapist may also suggest “homework” activities — such as journaling your thoughts, practicing mindfulness exercises, or engaging in self-care routines — which are designed to deepen the work you do in sessions. These tasks are not about adding pressure but rather about nurturing your growth between meetings. Allow yourself to engage with these activities at your own pace, embracing the gradual process of healing and learning about yourself.

Therapists Share What to Expect in Your First Session

Navigating the uncharted waters of a first therapy session can stir a mix of emotions, where your uncertainty and curiosity can intertwine. To help illuminate this experience and guide you when preparing for a therapy session, several professional therapists share insights into what typically unfolds when welcoming newcomers into their practice.

Marla B. Cohen, PsyDTherapist Marla Cohen: In your first session, your therapist will spend some time getting to know you and the issues that brought you into treatment. He or she may use a formal, structured interview, or it may just feel like a more free-flowing conversation. The therapist will ask questions about your presenting concerns, as well as your history and background. Most likely, you’ll find yourself talking about your current symptoms or struggles, as well as saying a bit about your relationships, your interests, your strengths, and your goals.

Most importantly, in that first session, you will begin making a connection with your therapist. You should feel safe, accepted, respected, and relatively comfortable. Not all therapists are right for every person, so use your first session to assess whether or not the therapist you chose feels like a good match for your personality.

Lynn Somerstein, PhD, E-RYT: Usually, in your first session you will be invited to be seated comfortably. The therapist will usually begin with some initial small talk to help you feel at ease. I usually make reference to the scariness of starting therapy, since I like to honor the feelings that are present. That’s a feature of therapy: find out where the person is and start there.

Sometimes people have lots to say and start talking right away, pouring out their thoughts and feelings, and sometimes their fears and tears, too.

Other people find it very hard to speak, so I’ll ask questions about how they decided to come to therapy, why therapy with me and not somebody else, whether they have been in treatment before, and whether there is something in particular troubling them. Each statement the person in therapy makes leads to many other questions.

I say what my expectations are: that people come on time, that they pay on time, that they say what is on their minds—even if it sounds silly to them. In fact, especially if it sounds silly; those silly ideas are frequently the best things to talk about because they often lead to issues that need to be explored.

Toward the end of the first session, I also always thank the person for coming, say that I’ve asked a lot of questions (if indeed I have), and invite the person in therapy to ask me questions. Sometimes people feel it’s not polite, and they are afraid. So, then I say not to worry about courtesy, that I’ll probably feel comfortable answering, but that if, for some reason, I don’t want to answer something, I’ll say so and we’ll move on.

Then we discuss whether we’d like to meet again and, if so, when. I’ll say how often I think we should meet, and we’ll talk about that too.

The Second and Third Sessions: Deepening Understanding

As you continue to meet, your therapist will start to get a clearer picture of who you are and what you’re hoping to change or understand. These early sessions often focus on identifying patterns in your thoughts, behaviors, or relationships. They may also explore past experiences that have shaped you.

This is a great time to reflect on what’s coming up for you emotionally. Are you feeling guarded? Relieved? Anxious? Sharing these reactions can help your therapist tailor their approach to your needs.

Finding the Right Therapist for You

Venturing into therapy is a brave step, one that speaks volumes about your commitment to growth and healing. Just as each person is unique, the connection with your therapist should feel supportive and aligned with your needs. It’s crucial to find someone with whom you feel a genuine rapport, as this relationship forms the foundation for meaningful progress. 

While it’s normal to take a few sessions to feel comfortable, pay attention to how you feel with your therapist. If you consistently feel unheard, judged, or unsafe — or if your therapist crosses professional boundaries — it’s okay and encouraged for you to seek another provider. A good therapeutic relationship is grounded in respect, empathy, and ethical care.

It’s perfectly okay to explore different options until you find the right fit. GoodTherapy’s directory of expert, highly-rated therapists helps you find the right person to guide you on your personal mental health journey. This experience is yours, and finding the right therapist is a vital part of embracing the transformative process.

Ready to start your therapy journey? Find a licensed therapist in your area to support your mental health journey.

What Is Involved in an Initial Mental Health Consultation?

If you’re looking for a therapist, you may have noticed phrases like “initial consultation” or “initial mental health consultation.” Are you about to attend your first mental health consultation, or curious about what an initial consultation entails? We figured. Read on to learn all about it. 

Your first conversation with a new mental health provider is exciting. You are taking significant steps to manage your mental health and conquer your goals. A mental health consultation is a perfect time to assess whether or not someone is a right-fit therapist for you. Consider this initial consultation an opportunity to “try them out” – see if you “click” with them, share your goals, and pay attention to how they talk about what you share.

Is this someone you want as an ally on your personal journey? Do they share insights that resonate with your values? Does their approach to therapy work with what you want to get out of the experience? The initial consultation will help you think through these questions. 

What to Expect from an Initial Consultation

Your first conversation with a new mental health provider is exciting. You are taking significant steps to manage your mental health and conquer your goals. A mental health consultation is a perfect time to assess whether or not someone is a right-fit therapist for you. Consider this initial consultation an opportunity to “try them out” – see if you “click” with them, share your goals, and pay attention to how they talk about what you share.

Initial consultations often take place over the phone or video chat and typically run anywhere from 10-30 minutes, depending on the provider. During this time, you’ll get to know the therapist and their practice. They’ll most likely have some questions for you about what you’re looking for, what your concerns are, and what your schedule looks like. They’re trying to assess whether or not they are well-suited to helping you with your concerns. But this is also an opportunity for you to find out what you want to know.

Is this someone you want as an ally on your personal journey? Do they share insights that resonate with your values? Does their approach to therapy work with what you want to get out of the experience? The initial consultation will help you think through these questions. Choosing the right therapist is an important aspect of getting what you need, and it’s worth the effort to prepare a bit before your initial consultation. 

How to Prepare for an Initial Mental Health Consultation

Write Down Your Concerns

The first thing you can do to prepare for your mental health consultation is to write down your concerns. Your list might include symptoms you’re experiencing, difficulties you’re facing, or issues you’d like to explore. Having this list in front of you during an initial consultation will help you ensure you mention everything that you want to bring up with the therapist. Trying to come up with or recall all that information on the spot can be difficult. 

Prepare to Ask Questions

Asking questions is a great tool to help you decide if a therapist is a good fit during your initial mental health consultation. While the therapist will certainly have questions to ask you, too, having some prepared to ask them will help you learn the information that is important to you. 

7 Questions to Ask Your Therapist

#1 What is your specialty?

Most therapists have multiple specialties (or types of therapy and client concerns they specialize in). This does not necessarily mean their specialties cover your specific needs. For example, if someone battling addiction is seeking the help of a mental health professional, the provider needs to have experience in that area in order to be effective.

#2 How long have you been practicing? Tell me about your experience. 

Listening to a therapist talk about their experience will help you understand what they’ve seen and what they can help with. It’s important to note that many therapists have a variety of experiences that are relevant to their practice, both professionally and personally. 

#3 How much will I pay? 

While more and more therapists are accepting insurance, many don’t – and almost all will accept private-pay clients. One perk of private-pay options is that your therapist doesn’t have to submit a mental health diagnosis to an insurance company. Make sure to ask them about their fees, sliding-scale opportunities, and any pre-paid, discounted, multi-session packages they may offer so you can make the arrangements you need to cover the cost of therapy. 

#4 How often will we meet?

The therapist might have an idea in mind for the frequency of your therapy sessions. This may differ depending on your needs, and will likely be subject to change based on your progress. 

#5 What will my treatment plan look like?

Is there a concrete treatment plan that they want you to follow? This is important for helping you stay engaged and setting expectations for your work together. If you’re interested in a specific type of therapy this provider offers, like EMDR or Brainspotting, now is a great time to bring it up. 

#6 Do you assign homework? 

Many therapists will give their clients “homework,” or things to work on in-between visits. Therapy homework may include techniques to try, exercises to practice, and coping strategies to use.

#7 I want to work with you. What happens next? 

If you’ve made up your mind and decided to go with this therapist after your initial mental health consultation, you should ask what the next steps are going to include. These next steps may include “homework,” coordinating with your insurance, scheduling your first therapy session, and more.

The Value of an Initial Consultation

If you decide to work with a therapist after an initial consultation, that’s great, but even if you decide they’re not the best fit for you, your time was not spent in vain. It’s very helpful to find this out before you settle on a therapist, and if you have concerns that are outside this particular therapist’s scope of practice, they may have recommendations for you of therapists who do work with folks that have your sort of concerns. 

Many therapists offer this initial mental health consultation for free. To find someone in your area who offers this, click here to search by zip code or city and then filter your results by Pricing>Free Initial Consultation. 

If you’ve never gone to therapy, you might not have much idea what happens in a therapy session. This is fairly common, since much of what people know about therapy comes from (often inaccurate) media portrayals.

In the past decade, awareness around mental health issues has increased significantly. Greater awareness has helped reduce mental health stigma by supporting therapy as a beneficial, normal method of getting help. Accordingly, the shroud of secrecy around therapy has started to fall away. Your friends, family members, even your coworkers may be perfectly willing to open up about their experience in therapy and how talking to a mental health professional has helped them.

But if you’re still unsure about therapy, or don’t know anyone who’s gone to therapy, you might hesitate before booking your first session. Maybe you feel nervous about what a therapist will do, or you don’t think your distress actually merits therapy.

You don’t need to experience any significant mental health issues or emotional distress for therapy to work.

Before exploring how therapy works to help people who are struggling, let’s bust that myth right now. You don’t need to experience any significant mental health issues or emotional distress for therapy to work. If you’re struggling, confused, feel like you want to sort out a problem or your life and don’t know where to start—therapy can help.

Therapy Is Personalized

The process of therapy can differ somewhat based on what you’re experiencing.

For one, the length of therapy can vary based on the issue you want help with. If you’re struggling with depression after a breakup or job loss, for example, therapy often helps you work through the problem within a few months. You might not be completely “cured,” but you’ll generally be able to resolve lingering distress on your own. That’s a key goal of therapy.

Serious or longer-lasting concerns, like trauma from abuse or chronic depression, may require more therapy sessions and a more intensive approach.

In most cases, you’ll spend just an hour each week in therapy. But your therapist might also recommend specialized types of therapy to meet your needs. Dialectical behavior therapy, for example, generally involves an hour of therapy, an hour of skills training, and an additional hour of group therapy each week.

Therapy doesn’t operate as a blanket remedy or one-size-fits-all approach. Therapy for intrusive thoughts (a component of OCD) will likely look much different than therapy for a phobia of dogs.

But even two people with generalized anxiety might see treatment proceed in different ways, based on the type of treatment the therapist specializes in and their individual needs.

If you’ve tried various coping strategies and still struggle with severe anxiety, for example, you might want to try medication, a perfectly valid (and helpful) treatment option. Your therapist should support your decision and work with you to find the right drug.

If you know you don’t want to take medication at all, unless absolutely necessary, you might look for a therapist who specializes in alternative treatments, like yoga or nature therapy.

Therapy Helps People Reach Goals

You might consider going to therapy (or want to avoid therapy entirely) with the idea that your therapist will give you advice, tell you what to do, or ask how every little thing makes you feel.

But therapy doesn’t work like that. Rather, therapy offers a safe, nonjudgmental space for you to talk about problems and anything that’s overwhelming you or even just making life a little tough. Your therapist listens to what you have to say and then works with you to develop a plan to confront challenges and achieve an improved quality of life.

You can also go to therapy if you aren’t experiencing significant distress. Therapy can be beneficial in the pursuit of any goal, no matter what that goal is.

Maybe you want to date but feel you lack the skills to approach someone or make a relationship work. Perhaps you want to work on being closer with your teenage children. Or maybe you just want to break a lifelong nail-biting habit.

Whatever your goal, your therapist will help you explore potential changes you can make to arrive at the outcome you desire. But you come to therapy with your goals (or spend time identifying them in session). You also have an opportunity to share solutions that don’t work, which can help you and your therapist work together to find something that will have benefit.

Say you’ve been feeling low because you no longer have time to create art. Your therapist asks what a typical day looks like for you. After you explain your schedule, they point out you’re spending all your time doing things for others, something you never stopped to consider.

In short, therapy can help you work to identify and break concerning patterns or habits on your own. Therapists don’t give you all the answers. They help you find the right tools to help yourself.

In therapy, you drive the car. Your therapist can help you navigate when you get lost or help dig you out if you get stuck in the mud.

Therapy Puts You in Control

In therapy, you drive the car. Your therapist can help you navigate when you get lost or help dig you out if you get stuck in the mud. But your therapist doesn’t decide where you go or how you get there. You do that work yourself.

That’s why finding a therapist you can work well with is so important. You can often help personalize your own therapy experience by choosing your own therapist, so look for someone you feel comfortable with.

Therapists aren’t machines. Their unique personalities, mannerisms, and styles of interaction will likely show through in the therapy process. Their personality can help attract you to the work you’re doing together, or put you off it.

Finding a therapist who will encourage you to keep pushing through difficulties, even when it’s unpleasant, is also essential. Therapy often feels uncomfortable, even unpleasant. That’s a normal part of the process. But when you and your therapist have a strong working relationship, you trust them to support you through the discomfort and arrive at a place where you feel ready to make change.

If you don’t believe your therapist will continue offering compassion and support, regardless of the thoughts you share or challenges you face, you’ll have a harder time opening up and sharing your vulnerabilities. As a result, therapy may have less effect.

You pay for therapy. It’s your space to create change. Your therapist offers guidance during the process, but you work toward what you need.

Conclusion

If you go into therapy looking for a quick, easy solution, or with the hope your therapist will solve all your problems, you won’t get much out of the process.

Therapy can be hard work, and going into therapy with this in mind can help prepare you for the occasional tough session. But when you work with the right therapist, therapy can be productive and healing, and most of your sessions will probably feel rewarding, even when they’re a little difficult.

Ready to find a compassionate therapist? GoodTherapy is the best place to start. Start your search here.

References:

1. Frey, E. (2017, April 27). How therapy actually works and 5 myths about therapy debunked. Retrieved from https://medium.com/kip-blog/5-myths-about-therapy-debunked-17e7fdd8b8a5
2. Going to a therapist. (2018). TeensHealth. Retrieved from https://kidshealth.org/en/teens/therapist.html
3. Understanding psychotherapy and how it works. (n.d.). American Psychological Association. https://www.apa.org/helpcenter/understanding-psychotherapy
4. What is psychotherapy? (2019). American Psychiatric Association. Retrieved from https://www.psychiatry.org/patients-families/psychotherapy

“My therapist was great! I learned a lot, but I’m not sure much changed.”

Does the above statement describe your experience with therapy? Maybe you’ve uttered a similar phrase to a friend.

Therapy shouldn’t just be interesting. It shouldn’t just feel like a good mental flossing that leaves you with a lot to think about. Effective therapy can be both of those things, yes. But it should also get you moving in a more positive direction, as quickly as possible.

The answer to “Why doesn’t therapy work?” has everything to do with the difference between insight and action. Lasting change may include insight—but it doesn’t have to. On the other hand, if you only have insight, you’re unlikely to make the kind of changes that translate into a more satisfying and fulfilling life.

Say your car dies and you have to start walking to work every day. After you do this for a couple of weeks, there’s a good chance you’ll start to experience the benefits of being more active, and you might feel better, physically and mentally, than you did before you started walking. Once you start feeling better, you may choose to keep walking—even after your car is fixed.

In this case, it was necessity—not insight—that forced you to take sustained action. You didn’t have an “Aha!”  moment and decide to start a walking program based on that flash of insight. Your car broke down, leaving you with no choice. You walked to work because you had to. The insight you gained as a result of walking every day was simply an unexpected positive outcome. [fat_widget_right]

Why Insight Isn’t Enough

So, why do people stay in therapy if they’re not making measurable progress? I think there are any number of reasons.

For one, people don’t always feel safe, comfortable, or clear-headed enough to talk to their partner, friends, or family about embarrassing, unflattering or critical feelings they might be having. Therapists know how to listen with soft ears and open hearts.

Therapy also provides people with a safe place to express difficult feelings, those they may be afraid to share with others, without the fear of rejection, harsh judgment, or attack.

Before you choose therapy, make sure you’re ready and willing to do what it takes to create real change in your life. Don’t settle for insight.

People might also stay in therapy when they aren’t progressing because they are mistaking their increased insight for progress. This can happen because our bodies love insight. You know the “Yes!” feeling you get when you find your keys after looking for them everywhere? That’s the same rewarding feeling we get when the clouds over our thoughts part and confusion gives way to clarity. Our bodies relax when we feel understood, and therapy is a place where many of us feel understood, sometimes for the first time.

What’s Holding You Back?

If you feel like you have experienced insight in therapy but aren’t making progress, it might be helpful to reflect on your current or past experiences in therapy. Have you taken time to consider your work in therapy outside of session and completed any homework your therapist assigned? What substantive changes have you made as a result of the insights you’ve gotten in therapy?

For example, say you have realized your efforts to protect your child and keep her safe have actually led her to feel less trusting, less confident, and more frightened in the world? What have you done with that insight? Have you changed or modified the protective behavior in any way?

If you have realized your busyness is a distraction keeping you from leaving a toxic relationship, what have you done with that new information? What steps have you taken to simplify your life and come up with an exit plan?

Before you choose therapy, make sure you’re ready and willing to do what it takes to create real change in your life. Don’t settle for insight. Insight can feel great, and it is helpful, but it’s really just a starting place. Real change takes time, focused attention, mindfulness, and discipline. Real change isn’t just “finding the time” to “do the work.” Real change occurs only when we identify the people, places, and activities that harm us and replace them with people, places, and activities that bring out our best qualities.

If your therapist isn’t helping you move toward your goals, remember that it’s always okay to search for a new therapist. Choose someone who does more than nod, smile, and “provide a safe, confidential space” for you to gain insight. Look for a therapist who is ready to work with you in that safe, confidential space, one who can help you explore your insights and turn them into concrete plans of action that lead to the lasting changes we are looking for.

Real change requires real change. If you settle for less, that’s all you’ll get.