What Actually Happens in Therapy?
Demystifying your first therapy session and beyond
Thinking about starting therapy but not sure what to expect? You’re not alone. For many people, the idea of talking to a therapist for the first time can feel a bit intimidating. At Smart Therapy, we believe therapy should feel safe, supportive, and tailored to you - not something to fear.
In this article, we’ll walk you through what actually happens in therapy, so you can take that first step with more confidence.
First Things First: What is Therapy, Really?
Therapy - sometimes called counselling or psychotherapy - is a confidential space where you talk with a trained professional about whatever’s going on for you. You might come in with a specific issue (like anxiety, stress, or relationship challenges), or just a sense that something isn’t quite right.
Your therapist won’t give you advice or tell you what to do. Instead, they’ll help you explore your thoughts, feelings, and patterns so you can make sense of them - and begin to feel better.
Your First Therapy Session: What to Expect
Your first session is a bit like an introduction. You and your therapist will get to know each other and begin to explore what brought you to therapy.
Some common elements include:
Talking about why you’ve come to therapy
Discussing any previous support you’ve had
Exploring what you’d like to get out of therapy
Asking questions about how therapy works
There’s no pressure to “tell all” in the first session. A good therapist will go at your pace. You don’t need to rehearse what you’ll say or have a list of problems ready. Just showing up is enough.
Ongoing Therapy: A Space to Be Yourself
After the initial session, therapy begins to unfold more naturally. You might talk about day-to-day issues, childhood experiences, emotional struggles, or difficult relationships - whatever is most important for you in the moment.
Your therapist might:
Help you spot patterns in your thoughts and behaviour
Support you in setting boundaries or making decisions
Offer reflections that help you understand yourself more clearly
Explore how past experiences might be shaping your present
There’s no one-size-fits-all approach. Sessions are shaped by what you need, and therapy can be short-term or long-term depending on your goals.
Does Therapy Mean Talking About My Past?
Not necessarily. Some people do explore childhood experiences or unresolved memories, but therapy can also focus on what’s happening right now. Many people come to therapy simply because they feel stuck, stressed, or overwhelmed in their current lives—and therapy can offer a space to breathe, reflect, and reset.
What If I Cry? What If I Don’t?
Both are absolutely okay. People express themselves in all sorts of ways in therapy. Some cry, some laugh, some stay quiet and need time to warm up. Your therapist will welcome you however you are.
Is Therapy Confidential?
Yes - on the whole, therapy is confidential. Your therapist will explain their confidentiality policy clearly in your first session, including any legal or ethical exceptions (such as risk of serious harm). You can always ask questions if anything is unclear.
The Benefits of Therapy
People often say that therapy helps them:
Understand themselves more deeply
Feel less overwhelmed or anxious
Improve their relationships
Feel more confident or grounded
Make clearer decisions
Feel like themselves again
You don’t need to be in crisis to benefit from therapy. Sometimes, the most powerful work happens when things are “okay” - but could be better.
Final Thoughts
Therapy isn’t about being fixed - it’s about being supported. It’s a space to be seen, heard, and understood without judgement. If you’ve been thinking about starting therapy, know that it’s perfectly normal to feel nervous - but taking that first step could be the beginning of something really positive.
Looking for therapy in South West London or online? Smart Therapy offers a peaceful, welcoming environment for individuals and couples seeking support. Reach out today to find the right therapist for you.
