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. Different therapists will vary in their specific approach, often changing the approach depending on the issues being addressed.

Each session will normally be fixed at 50 minute, but this varies too depending on the nature of the treatment.

A 50 minute session length has been found to be practical for both the client and therapist. It is long enough to achieve progress, but also short enough to avoid exhaustion and confusion from working too long and on too much.

There will be one session per week, fortnight, or sometimes longer in cases where that would be practical, such as at the end of therapy, but time between sessions can be much shorter in cases where this is needed. Any less than one session every two weeks is probably not going to be as helpful, the only exceptions being at the end of treatment and maintenance sessions.

The first session (maybe on the phone) will be used to discuss what is concerning for you most, and to take basic 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.

If you have any medical concerns or treatments, especially if these include medication, these will be discussed as well. It will help if you write the names of any medication down and take this along with you.

There will almost certainly be a Client-Therapist Agreement to sign. This outlines some mutually agreed boundaries and expectations. For example, the confidentiality of therapeutic meetings, your rights to access your data and read session notes, and what happens if an appointment is missed or cancelled at very short notice, and so on. It is a requirement that the agreement also includes concise details regarding the cost of your treatment so that you are fully informed.

You should also find details of how to contact the professional societies that the therapist is a member should you have any concerns.

It is important to have private time for your treatment sessions, but this is not always practical if you have small children or elderly dependent relatives, pets etc. This is understood, but every effort should be made to ensure that you are free to express yourself openly.

The number of sessions tends to be between 6 to 8 at the outset, but the actual number of sessions can vary wildly depending on what is being worked on.

There may be a short assessment every few (e.g. four) sessions. An assessment is not assessing you, it is assessing the treatment’s direction, how you feel the treatment is progressing, what your experience is etc. Assessments ensure that the therapist is paying proper attention to your needs. They are a way to ensure that you are provided with an opportunity to raise any concerns that you may have. Do not be shy about requesting and having an assessment whenever you wish. This is YOUR treatment and you have control over it.

During sessions the things that are concerning you may be unravelled, with you and the therapist 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 writing down what has happened to you and how you feel at certain times of the day, dreams, intrusive thoughts, anything that feel important to you. This will almost certainly help a great deal with the progress of your treatment and I would encourage you to think in terms of therapy taking place both within and in-between sessions.

In sessions, you can explore your feelings very openly and 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 psychotherapy to take place.

When nearing the end of treatment, you will find yourself working toward having a final session, to bring a feeling of proper closure to the treatment. It can feel like a bit of a wrench to suddenly stop sessions, and this is perfectly normal. In sharing so many personal thoughts we build healthy feelings of closeness, something that also greatly helps the therapy process.

In the final “winding down” sessions, you will have many opportunities to review your therapeutic journey together, the changes that you have felt and life-tools that you have gained. You may like to discuss which aspects and events within the treatment were the most helpful to you. These sessions will also assist the therapist to become even more skilled.

The final sessions are used to tie up any “loose ends”, to say whatever you feel still needs to be said. The feelings you take with you after treatment are important. Feeling that it is complete and that you have “closure” is very desirable. If you feel the need to contact the therapist to discuss something a while after your sessions are finished please do contact them.

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


Hopefully, I have managed to de-mystify psychotherapeutic sessions a little so that you feel less apprehensive if you have never contacted a therapist before.

I’ll finish with a word of encouragement…

Talking to a therapist might initially feel like admitting to oneself that one is less capable in some respect, a failure, but it’s worth remembering that when the car has a problem we go to a mechanic, and when we need to fly somewhere we get a pilot to fly the plane. Do we feel that we are any less because we seek someone who has the right tools? Of course not! A therapist is someone who is trained to help you to unravel psychological knots that have been stopping you from living life freely and happily. Your therapist will be there with you as you explore and learn how to untie those knots, to understand how they got tied, and there to help keep you anchored and safe. Allow yourself to be brave in the knowledge that you are changing your life permanently for the better.

I wish you well. Have a peaceful and fulfilling life.