What Happens in Sessions?

If you have never thought of seeking therapeutic help before, you probably don’t know what to expect and may feel a little anxious. I hope I can help to put any concerns to rest by describing what tends to happen in sessions.

Each session will normally fixed at 60 minutes or a little less, but sometimes longer, depending on the nature of the treatment. This 50 minute session length has been found to be fairly ideal for both the client and the therapist for practical reasons. It is long enough to achieve progress, but also short enough to avoid exhaustion and confusion from working on too much in one go.

There will, as a very general rule, be one session per week. This allows time to process what has been worked on between sessions. There can sometimes be more sessions per week when needed, but any less than one session every two weeks is probably not going to be very helpful, unless it is right at the end of treatment.

At the beginning of treatment, in the first session or on the phone, the therapist will discuss what most concerning for you. While talking they will take down details such as name, age, address, name of partner(s) and children (if you want to give them). This is so that whenever you refer to them, the therapist will have an understanding of how they relate to you in your life.

They will also need to discuss any medical concerns or treatments that you are undergoing with you. Sometimes prescribed drugs can have an influence on what you are experiencing. It will help if you write the names of any medication down and take this along with you.

There is probably going to be a Client-Therapist Agreement to sign. This simply ensures that both you and the therapist have some mutually agreed boundaries. For example, the confidentiality of the therapy meetings, your right to read session notes, what happens if an appointment is cancelled at very short notice, and so on. You should also find details of how to contact the professional societies that the therapist is a member of if you have any concerns.

The agreement will also include concise details regarding the cost of your treatment.

It is important to have a suitably private time for your treatment sessions, but this is not always practical if you have small children, elderly relatives, pets etc, but having uninterrupted time is desirable, sometimes essential.

The number of sessions agreed on initially will probably be between 6 or 8, but it does vary depending on your concerns.

There will often be a short assessment every fourth session. An assessment is not assessing you, it is assessing the treatment direction and how the treatment is progressing, how both you and the therapist feel about its direction and effectiveness, and so on. Assessments ensure that the therapist is paying proper attention to your wishes and needs, and are a way to ensure that you are provided with an additional opportunity to raise any concerns that you may have. Do not be shy about having an assessment whenever you wish.

During sessions you will both look at the things that are concerning you, working together on understanding them as fully as possible, and then finding ways to bring about changes. Sometimes you may be given things to do in-between sessions, homework such as, for instance, writing down what has happened and how you feel at certain times of the day, dreams, intrusive thoughts, things that you feel are important. This will almost certainly help a great deal with the progress of your treatment, and I would encourage you, when it feels comfortable to do so, to think in terms of therapy taking place both within and between sessions.

In sessions, you can explore your feelings very frankly, and say whatever is on your mind in complete confidentiality and safety. It is the trust and safety that you feel in the therapeutic relationship, something that naturally develops, that enables the healing processes of therapy to take place.

When nearing the end of treatment, you will find yourself working toward having a final session. This is to bring proper closure to the treatment. It can feel like something of a wrench to suddenly stop sessions because of sharing so many private things and getting to know each other. In the final “wind down” sessions, you will review your journey together, what you have shared, and review the treatment more generally. You can discuss which aspects and events within and the treatment were the most helpful for you too. This will help the therapist to become even more skilled. The final sessions are also used to tie up any loose ends, to say whatever you feel needs to be said so that the feeling you go away with is that the treatment is properly complete and finished.

It is often found that when dealing with very difficult feelings, that they may feel like they are getting worse before they start to get better. Try to remember that this can be a very positive sign, and it indicates that necessary work is taking place and that deeper issues are being addressed. It is very important that you see your therapy through.

Please use the Contact page if you have any questions. I hope that I have managed to de-mystify what happens in psychotherapy sessions. Therapists vary widely in what they find to be most effective, but the above is a good guideline of what to expect from an Integrative style therapist.

I wish you well.

David