New to Therapy?

Congratulations on beginning your healing journey.

A useful starting takeaway is that the first few sessions are less about “fixing” anything and more about building understanding. Your therapist is getting a sense of your history, current stressors, patterns in mood and relationships, and how you make meaning of your experiences as well as how you define your problems. Some people worry about “saying the right thing,” but there isn’t a script— you can go at your own pace.

Goals

Early on, goals are establish to help you track progress and determine if therapy is “working.” Goals may even change as therapy progresses and you identify other things you want to focus on or as new events happen in your life. For someone with depressive symptoms and interpersonal strain, initial goals might look like:

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• “I want to feel less stuck or overwhelmed day-to-day”

• “I want to understand why I react the way I do with my family”

• “I want to communicate more effectively or set boundaries without guilt”

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We will make them more specific and measurable, such as improving sleep consistency, increasing engagement in meaningful activities, or having a difficult conversation with a family member in a new way.

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Pattern recognition

Another key takeaway is that therapy isn’t just about talking—it often involves noticing patterns. For some that might include identifying cycles like withdrawal → isolation → worsened mood. For relationships, it could be recognizing recurring roles (e.g., people-pleasing, avoidance, conflict escalation). Your therapist will help you understand these loops and thereby make it easier to effect change.

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Progress

It is also helpful to know that progress in therapy isn’t linear. There may be sessions that you feel very productive and others that feel slow or even uncomfortable. That doesn’t mean therapy isn’t working—it often means important material is being approached.

Practicing a few habits can make therapy more effective:

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• Reflect briefly between sessions (what stood out, what felt different)

• Be honest, even when it feels awkward or vulnerable

• Share feedback about what is or isn’t helpful in therapy

• Notice small changes rather than waiting for big shifts

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It All About you!

Finally, it’s worth remembering that therapy is a space where you can bring both symptoms and relationships into the room. If family dynamics are a major stressor, those patterns will often show up in how you talk about people in your life, how you handle conflict, or even how you relate to your therapist. That becomes part of the work in a constructive way.

If you feel that things are not progressing, not helpful, or feeling a general lack of connection with your provider, try to explain this uneasiness to them.  Your therapist should be open to your feedback in order to serve you in the best way possible.  If you don’t feel safe to express yourself in the session, contact a supervisor or send an email.  There are times when it is best to refer you to another therapist who is a better fit.  It is your therapist’s responsibility to help you get the help you deserve, even if it is not them.

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Good luck on your healing journey.

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  -Dr. Hurt