September 30th, 2022

What I Wish My Clients Knew Before Coming to Therapy (Part 1)

By ​Lauren Bouyea, LICSW

The decision to begin therapy can be a difficult one for many people. Whether it is the cost, the continued (but improving!) stigma surrounding mental health and mental health treatment, or fear of the unknown, it can be difficult  to make that first phone call. While much of what you will learn about therapy will happen in the therapy room, below is a list of some of the things that I wish I could tell all clients ahead of time.

​You are the expert on your own life
It is a common misconception that therapists give advice. This might be surprising to some, but therapists are specifically trained not to give advice. While it might be tempting to ask your therapist if you should break up with your partner or which school you should apply to, therapy is intended to help you discover the answers to these questions yourself. Whether it is through identifying what you value in life, reviewing consequences of past behavior, or improving decision-making skills, your therapist’s goal is to create the necessary scaffolding for you to eventually work through problems without their guidance. 


You get out what you put in
Another misconception about therapy is that it is something done “to” a person.  This perception makes sense, as when you go to another health care professional, they might give you stitches or clean your teeth with little to no input from you. However, when sitting down in the therapy room, be prepared to do some heavy lifting. This is because therapy is done with you not on you. It is common for therapists of all different styles to have some agenda set for the session, but for best results, participation is a must! Plan to go to therapy with at least one thing you want to discuss or gain a better understanding of. On the flip side, if your therapist suggests an exercise that you are not interested in or don’t feel comfortable with, let them know! This helps both of you to work on creating the therapeutic environment and expectations together. 

Not every therapist will be a good fit
It feels frustrating to go through the work of finding a therapist, making an appointment, and attending said appointment only to realize that they are not your cup of tea. Whether it is their therapeutic style, an uncomfortable office environment, or something you can’t quite pinpoint, it’s a common occurrence. If this happens to you, there are a couple of things I want you to remember!

 First, you will not hurt your therapist’s feelings by letting them know. I always admire a client’s ability to advocate for their needs and am more than willing to refer them to somebody that might be a better match. Second, if you have been seeing this therapist for a while, beware of the sunken cost fallacy. In a nutshell, this occurs when you have invested time and money into a person or thing and therefore have difficulty letting go even if it's in your best interest. Have a conversation with your therapist about what you are experiencing and work through the best course of action together. 

There are no bad thoughts or feelings
Many people come to therapy with some goals in mind such as to be happy, be free from their anxiety, or to stop feeling depressed. However, the goal of therapy is not to get rid of “negative” thoughts, feelings, or mood states. Our internal experiences are not inherently good or bad, they just are. Therapy can help you to connect with these emotional states and experience/respond to them more healthily as being part of any full, human life. 


Am I saying that feelings of depression, anxiety, or other uncomfortable emotions won’t improve in therapy? Of course not! But we won’t be trying to make them go away, either. We will invite them in for tea, make room for them on the couch, and be in their presence instead of slamming the door in their face. While it is much easier to slam the door, learning to ride the wave of emotion allows our natural feelings to run their course.