After you’ve decided to work with a particular therapist, the next few sessions are usually devoted to talking about the circumstances that have brought you to therapy. Generally, during this time of assessment, your therapist will be asking quite specific questions about the concerns or problems causing your distress and about when and where they occur. Often there will be questions, for example, about your family of origin, your experiences with trauma and/or loss, previous relationships, relationship with substances you might use, such as alcohol or drugs. 

Assessment also can be done more formally, through the use of questionnaires or tests. A therapist can use a variety of techniques in assessment. Initial assessments are used to get therapy started. However, a good therapist will continue to assess a client’s situation throughout therapy and change the direction of therapy, if needed.

After the initial assessment stage, the rest of psychotherapy is devoted to helping you gain insight and solve current problems and/or help you change the emotions, thoughts, and/or behaviors that you want to change. The goals you bring to therapy ground this process. How these goals are accomplished depends a great deal on the orientation of the therapist and how actively you interact with this. Therapy is a collaborative process. It will be important that you feel listened to, heard and understood.

Some therapists may require more activity during therapy than just talking with you about particular issues. These activities may include such things as role playing or homework assignments in which you practice some of the techniques introduced in therapy (like relaxation skills or communication methods). Therapists also differ on how strongly they determine how therapy proceeds. Some therapists may take a more directive role, while others let the client direct the course of therapy.

The amount of therapy you receive will also vary depending on the orientation of the therapist and/or the specific treatment plan used. Some therapies are relatively short, while others require a longer time commitment. Each session of therapy usually lasts about an hour, and you generally meet with your therapist once a week. However, such time schedules are rarely rigid and may be changed to fit the needs of you and/or your therapist. It is a good idea to ask your therapist about the general techniques he or she may use with you in therapy, as well as about the length and frequency of therapy you might expect.

Finally, after a period of time you and your therapist may agree that therapy has been successful in helping you achieve your goals; and, thus, therapy is no longer needed. If you encounter new problems or feel that past problems still haven’t been resolved, you may choose to return to therapy, either with the same therapist or with a new therapist. One important thing to remember is that therapy is not a “cure-all” for everyone, and you should always consider other alternatives when a particular therapy isn’t working for you.