What Happens In A Therapy Session?

Many people are terrified by the thought of taking part in a counselling or psychotherapy session. It’s the combination of fear of the unknown and those slightly weird dramatisations of therapy sessions that the media appears hell-bent on portraying that are to blame! Keep reading for a de-mystification of the therapeutic process…



The first thing you need to be aware of when beginning counselling or therapy is the need to arrive on time. Counsellors and therapists work to a strict schedule, often with a minimal amount of time between clients. Sessions last for 50 minutes. If you arrive late for a session, the therapist will still finish that session at the scheduled time. If you arrive early, check beforehand whether the therapist has a waiting room – if there isn’t one, you’ll need to hold on until your allotted time, since there’s a good chance the therapist will be working with someone else.

Once in the room, your therapist is responsible for keeping time. If you’ve never had a counselling or therapy session before, 50 minutes may seem like an age beforehand. In reality, you’ll likely to find time flies by – you’ll just be warming up, only to hear your therapist saying, “I’m afraid we’re out of time, so we need to finish for today.” It can sometimes feel very difficult to be cut off in the middle of a chain of thought/feeling, but your therapist will be in the same place at the same time next week. If you need to, spend a little time in a quiet place before rushing on to the next thing in your busy day.


What Will He/She/They Do To Me?

A lot of counselling and psychotherapy is based on talking with the practitioner, sometimes about the past, sometimes not. Several approaches to therapy also encourage people to explore their feelings through other mediums such as art, writing, imagery, breathing, and body awareness. Some practitioners may give you “homework”, i.e tasks to think about or complete between sessions. Body orientated psychotherapy will include exercises designed to increase awareness of feeling. The practitioner will usually outline the methods to be used and will want you to have agreed these methods before you start working together. You will not be forced to do anything you don’t want to.


In The Chair or On the Couch?

Unless you visit an analytic psychotherapist, it is very likely that in the beginning phases of counselling or therapy will find you sitting face-to-face with your therapist rather than lying on a couch. Many people initially find it difficult to start a conversation which is exclusively about themselves and their lives with a total stranger. For that reason, your therapist may help you identify topics for discussion in the first session or two. However, you will be encouraged to move towards a pattern of self-starting sessions, rather than being led. As you become more comfortable with the practice of self-reflection in the company of another person, you may find you wish to lie down. This is in no way required – your therapist will be prepared to work in whatever way that feels most comfortable for you.

Yes, It’s All About YOU

The absence of regular social conventions in a therapy session is something many people find strange, at least initially. The therapist will not generally talk about him or herself, nor does he or she expect you to enquire after her as is normally the case in social interactions. This is not because of any unfriendliness – it is simply because the therapist wants your sessions to be a place and time for you to be relieved of normal worldly concerns in order to concentrate on the world from your own perspective.



Silence is another area in which social conventions are suspended. There are often natural periods of silence in a counselling or psychotherapy session. Rather than seeing these periods as an indication that the session is not going well, or that the therapist is waiting for you to say something as quickly as possible, try using the quiet time to reflect on what has been said, what you think, what you feel – you may be surprised by what comes to you.



When counselling and therapy works well, the therapist can very quickly become an important person in your life, and you may find yourself experiencing very strong, confusing feelings towards him or her. This is normal and regarded as an important part of the therapeutic process. A counsellor or psychotherapist who has been trained to work with the transference will help you use these feelings to understand more about the ways in which you relate to people in your life outside the therapy room, and in doing so, help you avoid repeating past patterns. Don’t be afraid to share your feelings with the therapist – she or he will be used to them and want to help you use them productively.


When Things Go Wrong

In the vast majority of cases, clients have a positive experience of therapy. However, as in every profession, things do sometimes go wrong. If your therapist is an accredited practitioner in the UK, he or she will be a member of a professional body which has a complaints and disciplinary procedure which can hear your case. Even if you don’t already know the body your therapist is a member of, you can do a search in the database of all the professional bodies.