With more and more people starting to go through therapy, you’d expect there to be a lot less mystery around what actually happens during a session, and how the whole process actually works.

Nonetheless, many people seem to see therapy as something shrouded in mystery if they haven’t yet gone through it themselves. It’s totally natural to find the first step of reaching out a little scary if you don’t know what to expect, even if you’re really struggling.

To help shed some light on the various ‘mysteries’ we often see people wondering about surrounding therapy – and hopefully to encourage you to take the first step if you’re struggling – read on to find out all about how therapy works and what to expect from it. 

How does therapy work?

Therapy is, basically, the process of working together with a trained psychologist (or therapist or counsellor) to help you find answers to any issues you are having, in a judgment-free zone. 

Therapy can help people to work through mental health issues such as depression or anxiety, but that’s not to say that you should only be heading straight to the therapist’s couch if you’re struggling with those illnesses – it sounds like a cliche, but everyone and anyone can benefit from therapy. 

There are lots of different, clinically-proven techniques your therapist might use during your sessions. Different people will have different techniques that suit them the most – and different therapists will be trained in different techniques, too. It’s all about finding what works for you.

Some techniques you might use are Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy (DBT), Acceptance and Commitment Therapy (ACT) or Schema Therapy. That might sound like a lot of confusing terms (and a lot of acronyms!), but they’re essentially different sets of tools you can use with your therapist to help you build mental resilience, and to help you tackle your problems and issues you face each day in new, constructive ways.

What is therapy like?

It’s easy to picture therapy sessions where you’re lying on your psychoanalyst’s couch and crying, going round and round in circles talking about the same issues – and getting nowhere. 

Luckily, the truth is so far from this – many therapies are now goal-focused, so you can expect to see genuine improvements within your first few sessions. Sure, some of the deeper-rooted issues might take a little while longer to unravel – but at My Online Therapy, for instance, we only offer evidence-based approaches to therapy, all rooted in research, so you know that you’re always on the right track. 

During your sessions, you’ll be constantly working on building a relationship with your therapist. You’ll be able to talk through your past, your present and the problems you’re facing or worried about in the future – and there doesn’t even have to be a couch! 

You’ll be able to talk openly, and most importantly, without any fear of judgment, about all the emotions and situations you’ve found yourself struggling with for however long they’ve been an issue for you. 

For all the inaccuracies with the stereotype of therapy sessions we see on TV, most people do still find therapy to be an incredibly cathartic experience – as well as an emotional one. Not only are you able to talk about the things you might have been burying for a very long time, but you’ll be working with a trained specialist who’ll help you to work through these issues and develop solutions for long-standing personal problems. 

Not so intimidating or mysterious after all, right?

How long does it take for therapy to work?

Whilst it would be great if we could wave a magic wand and make all our issues disappear in one 50-minute session, the truth is, many of our issues in adult life stem from childhood. This means they often require time, patience and practice to gradually overcome.  

The answer to how long therapy takes to work will be different for everyone – depending on what you want out of therapy, what approach to therapy is best suited to you, and your mental health history, there are a lot of moving parts in the process which could influence how long it takes to get the results you want. 

Many therapists suggest an initial six sessions as a minimum, and then you’ll have a chance to check in and discuss what is/isn’t working and how you think your sessions are going. 

The longer you work with your therapist, the more trust you’ll build in your relationship – and after seeing the results, many people choose to continue with therapy longer term.. 

Does therapy work for everyone?

Everyone is different, so it shouldn’t really come as a surprise that everyone will react to therapy differently, too. 

How well therapy works is tied to lots of different factors – chiefly, what you want to get out of it when you start. The idea that therapy is there to ‘fix’ people is misleading. 

Whilst therapy can absolutely help you if you’re struggling, it’s just as much about prevention as it is cure.

While you might not necessarily be seeing enormous changes in your feelings and emotions after your first couple of weeks, you’ll be constantly making small shifts in your behaviour – which can ultimately lead to some pretty big changes. 

If you’re genuinely motivated to put in the effort to get the most out of your sessions, almost everyone will notice the benefit therapy is having on their lives in ways both big and small. 

What to talk about in therapy?

People often wonder what they’ll end up speaking about in therapy, or what their first session will really be like – will their therapist have them lie down on the couch and analyse their dreams, or put them into a trance to recall deep-seated memories and experiences? 

Luckily, you can put to bed those images you might have of someone swinging a pocket watch in front of your eyes and asking you to… breathe… very… slowly…

The simple answer is – and you might have guessed it, by this point – whatever you want. While your therapist will guide you through your sessions, it’s very much you who’s in the driving seat. 

You’ll work with your therapist to figure out the issues you want resolving, and the more trust you build up with them, the more you’ll feel open to talking about everything you’ve ever wanted to speak up about – but maybe haven’t felt comfortable doing until now. 

Typical topics you might cover in therapy are problems you’re facing at work or in your personal relationships, things you wanted to discuss from your childhood that have a bearing on your life today, and your hopes and dreams for the future. So yeah, the sessions can be pretty broad.

Nothing’s off the table in therapy (within reason, of course) – that’s why it can be such a liberating experience once you’ve built up enough trust with your therapist to speak about anything you want – and once you’ve realised that it’s nothing more complicated than just having a chat.

How to start therapy

The simplest way to start therapy is really to dive right in. You could start by looking into getting talking therapy through the NHS. This can be a great way to start to talk about some of the issues which you can explore in more detail in one-to-one therapy later down the line if you find you’re getting on well with it.

Unfortunately, though, waiting lists for this can be long – if you feel like you want to start now, you can take our free online assessment to tell us a bit about yourself, and we’ll be sure to match you to the best psychologists for your personal needs. The most important thing with therapy is not to be put off by the idea that you need to be seriously struggling to take the plunge (and to stop picturing those hypnosis sessions on the couch) – if you’re interested in what therapy could do for you, the best time to start your sessions is right now.