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  • Writer's pictureChristina

What to Expect When You Go To Therapy For the First Time

Congratulations! You have decided that you are ready to make major changes to your life and your mental and emotional wellbeing. This is the first step to a truly bountiful life where you have peace of mind and self-awareness. I know that this is a strange experience and that you are likely to experience a flood of different and often conflicting emotions about sharing intimate details of your life with a stranger, so the courage you have demonstrated must be acknowledged.

Very often, people feel nervous about what they can and cannot tell their therapists for fear of judgement and consequences for past behaviour. All therapists are held to the same ethical standards globally. We cannot disclose anything you say to us to anyone else and that confidentiality is eternal. That means that even if you or your therapist

dies, no one can know what you told us. There are only three exceptions to this and they exist for very good reasons.

1. You disclose the abuse of a child (and in some cases a vulnerable adult)

This is because vulnerable people in society need protection. If you tell us that you are aware of child abuse, we have a legal and ethical obligation to inform law enforcement so that the person in need of protection can have an intervention to secure them. Your therapist will remind you of our ethics code when you start therapy with us. You will be able to ask us questions about it which we encourage.

2. You tell us that you plan to harm or kill yourself or someone else.

We certainly do not want you trying to kill yourself or someone else so, we have to step in to stop you from these dangerous behaviours. However, we need to make it very clear that we can only report on harm that is imminent. That means that even if you harmed or killed someone on the way to your therapy appointment, we cannot report on that because the act has already occurred. If you tell us you plan to harm or kill another person at a point in the future, that is when the duty to warn is activated and your therapist has to intervene to stop you from committing a crime against someone else.

3. The court has subpoenaed our records

If you have a court case pending, the court does have the power to tell us we have to either appear in court or allow the court access to our records. We are legally compelled to do so or face legal consequences ourselves. However, case notes are not written the way you encounter them on TV shows. They are actually quite vague so that there is nothing incriminating about you in them. Also, we often prepare documents for court so that you are not incriminated by the things we record during our sessions. We learn how to do this in school specifically for this reason so, please do not worry about our records.

Your therapist should go over confidentiality and its limits with you either at your consultation (if the therapist provides these), or the first session. You will have the chance to ask questions for clarification and discuss what this means with your therapist. You are also asked to sign a consent form for therapy which usually includes these three limits to confidentiality. Your signature tells the therapist that you are willing to participate in the process of therapy until you decide otherwise. There is usually a statement to let you know that consent is ongoing and that you can revoke consent to therapy at any time. This means that you can always decide that the fit between you and the therapist is not working for you and that you would like to end the relationship which your therapist will understand.

Different therapists work using different approaches to therapy. There are many, many types of therapy but what we do know from all the research done on the effectiveness of therapy is that it does not really matter what approach your therapist takes to working with you, it is the relationship between the therapist and client that best predicts whether or not the client will improve. This is why it is very important to be honest both with yourself and your therapist as to whether or not you feel supported and understood. Your therapist is there to help you speak up for your own needs and very often, we welcome your honesty. Ultimately, you are the person in charge of how much or how little you give to the therapy process. If your therapist suggests you try something in a session that is not working for you, please do not feel coerced into trying it anyway. There are thousands of interventions we can use with you and through collaboration with you, we are usually able to find something that is more in alignment with your personality and values.

One of the comments that therapists hear very often is “why do I need to pay someone to give me advice when I can just talk to my friends and family?” This is a common feeling in our society where there has been an understandable lack of trust in people with perceived power. Firstly, therapists do not “give advice”. The key difference between your social circle and your therapist is that we are trained to listen to you and help you tap into strengths you have without judgement. We also are able to ask you critical questions that help you think about things differently in a manner that your social group cannot because they lack the training and they are also close to you and therefore, are generally incapable of impartiality. This is why therapists, like doctors, cannot provide therapy to our own social circle.

As you enter therapy, know that the process is likely long and potentially painful at times. Therapy encourages you to dig deep into your past, your thoughts, your childhood, patterns of behaviour and a host of other facets of your life that we often try to avoid looking at. There will likely be tears, anger and frustration and, there will be days when you want to quit. However, remember that patterns of behaviour develop over years and that growth and change happen slowly so, do not be alarmed if you attend one session and do not feel fantastic forever. In fact, it is at that point where you feel hesitant to continue that we advise you to stick with the process as you are likely on the verge of a major shift in thinking, feeling and acting. This desire to quit right before this happens is so common that therapists expect it. Again, telling us how you feel is important for us to normalize this experience and educate you on what is happening for you and why.

It is indeed the hope of all therapists that you will find it transformative in working with us. We do genuinely care about your progress and the therapeutic relationship we develop with you is real. Those of us who are called to this profession, enter it out of a genuine desire to help others to overcome the pain of their past or present so they can

show up differently in the world in the future. For this reason, we encourage you to keep talking openly to us so we can help you help yourself. The power to change truly lives within you and we are willing to walk alongside you as you embark on your journey towards your “best life”.

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