So you’ve never been to therapy

Here is what you can expect:

By Elena Fenner Apr 9, 2025


In honor of April being Counselor Awareness month, I thought it would be helpful to shed some light on what starting therapy looks like. Taking that first step and deciding to reach out to a counselor can be scary. Hopefully by providing some information about the process of therapy you and your family can feel a little more at ease, and a lot more prepared for what goes on there. 

The First Step

The idea of starting therapy, for some, can be intimidating. First we may make the decision that we need help, or extra support, or we just need someone to talk to. After that comes the part where we find a therapist and make a call, send an email…etc. Making that first phone call can be scary, so let’s talk about what that looks like and eliminate some of the mystery around the process of therapy.

When you call you will be asked your name, maybe your age, the insurance that you have and probably your availability. Depending on the therapy practice this initial phone call can vary, but ultimately it is just to gather more info. The person on the phone may be a therapist, they may be a receptionist or an intake coordinator (this is someone whose sole job is to take your call and ease you into the process of starting counseling). They might ask you about preferences for therapy (this is when you would say if you prefer a male vs female therapist, LGBTQ+ affirming, someone who works with trauma…etc.).

Then, and this may be the most intimidating part, you will be asked about what brings you into counseling. You only have to share what your level of comfort and trust allows! You may feel pressure to share the intricacies of what is going on, or you may not want to share a thing. No matter what you feel about this part of the process, you are the one in control here. Here are some examples of things you may feel comfortable sharing here:

“I am struggling with some anxiety and would like some extra support”

“I have been feeling depressed lately and would like to talk to someone about that. “

“I have been experiencing flashbacks, nightmares, and panic attacks. I'm not sure what's going on, but I would like some help."

Ultimately however you decide to navigate this portion of the call, you will not be judged ( and if you feel like you are- call somewhere else!!)

Now what?

After you’ve done this phone call you will be connected with your therapist and set up either a consultation or an intake session. A consultation is a brief meeting between you and your therapist to see if you are comfortable with them, and decide whether or not you two are a good fit for each other (typically consultations are free, but not always. Make sure to ask about the practice policy on this!) If you meet and think that you don't click, there is no judgment or shame in asking to meet with someone else! Therapists are taught that the majority of “good outcomes” in therapy are due to the therapeutic relationship. This means that the relationship you have with your therapist will be influential in healing and making progress in counseling. Consultations are typically requested during the initial phone call and occur before an intake session if you are doing one.

If you would like to jump right in with the counseling process then you would set up an intake session. An intake session is where you meet your counselor and go over a wide range of things that will be a launching pad for the work you do together. Before anything is shared in this session your counselor will go over informed consent and confidentiality. This is an essential part of the first session where the therapist will explain your rights to privacy, autonomy, and agency in the counseling relationship. This will also cover potential instances when a therapist has to break the confidentiality agreement. Not to worry though, this is typically only done in certain instances like if you have plans and intent to hurt yourself or others, otherwise what you say in therapy stays in therapy!

The counselor will also ask you for quite a bit of background information like medical history, family of origin, symptoms you are experiencing, your thoughts and perceptions about therapy, and treatment goals. In this session your therapist may give you paperwork to complete, or you may complete this beforehand. 

The therapist will also talk to you about their educational background, share their experience counseling and go over their theoretical orientation (this is the way that the counselor views therapy and their beliefs about the process and treatment). 

You are now officially a therapy client!You did the hard thing!! Remember that when you are going into counseling you have a say in everything that happens there. You are in control of the pace and have the right to change therapists, pause treatment or even ask for additional support. Finding a therapist that is right for you may take time, and the first person you meet may not be the fit for you. Don't give up! You deserve to have the acceptance and help you need to heal and grow. 


“We know from experience and the growing body of supportive literature […] that the therapeutic relationship a counselor forms with each client can be the most powerful tool for helping clients change.”
- Cochran and Cochran, 2015, p. IX


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