Starting Therapy: What to Expect, Common Fears, and How to Prepare
- Yvette E. McDonald, LCSW-QS, CMNCS
- May 21, 2020
- 5 min read
Updated: Oct 15
Welcome to the world of therapy and thank you for considering Nourivida Wellness to walk alongside you on your journey of healing, growth, and transformation. You’ve already taken a meaningful step forward by intentionally seeking support and exploring the best fit for your needs. I hope this guide helps ease some of the uncertainty as you prepare for your first session whether that’s with me or another therapist who aligns with your goals.
How to Prepare for Your First Session
Here are a few ways to help your first experience in therapy go smoothly:
1. Complete your paperwork early.
Please complete all electronic paperwork at least 48 hours before your scheduled session. This gives me time to review your history and prepare thoughtfully for our work together. As you complete your intake, jot down any questions you’d like to discuss during your first session.
2. Give yourself time to arrive and settle in.
If coming in person, arrive a few minutes early to grab a beverage and take a moment to breathe. Our office feels more like a cozy living room than a sterile medical space. Taking a few moments to ground yourself will help you feel present and comfortable as we begin.
3. Understand the cancellation policy.
Life happens, and I do my best to accommodate changes. To avoid being charged the full session fee, cancellations must be made at least 24 hours in advance. Exceptions are always made for illness, injury, extreme weather, or family emergencies. Early notice also allows other clients the opportunity to use that time slot what I like to call working together with your invisible family.
4. Know who should attend.
If we’re addressing parenting, couples, or family issues, everyone involved in therapy should attend the first session so we can review goals, structure, and expectations together.
5. Plan for consistency.
Therapy sessions are 45 or 55 minutes and often begin weekly during the first few weeks for assessment and goal setting. After that, we transition into active treatment, which generally lasts about 8–12 weeks, though some clients continue longer for deeper work or ongoing support. As you make progress, sessions may taper to every other week or monthly.
The Process of Therapy
Phase 1: Intake & Assessment
We’ll begin by reviewing your paperwork, exploring what brings you to therapy, and discussing goals, logistics, and confidentiality. I’ll invite you to share your story in your own words: what’s happening, what you hope to accomplish, and what you fear might happen if things don’t change. From there, we’ll develop a collaborative treatment plan your roadmap for growth. Building rapport is foundational; while it may not feel like rapid progress at first, this stage sets the groundwork for meaningful change.
Phase 2: Intervention
This is the active working phase of therapy the emotional and behavioral “heavy lifting.” Together, we’ll address thinking patterns, communication skills, emotional regulation, and self-care. You’ll begin applying what you learn between sessions through practical exercises or reflection prompts. Real change happens both inside and outside the therapy room.
Phase 3: Discharge & Integration
When you’ve reached your goals or feel more grounded, we’ll begin processing the close of therapy. This final phase is about reflection, integration, and preparing to continue your growth independently. Some clients return periodically for “mental health check-ins,” which is a proactive and healthy way to maintain emotional wellness.
Common Fears About Starting Therapy
“I’m afraid my therapist will judge me or think I’m crazy.”
I’m here to help, not to judge. Therapy is a space where imperfection is human and expected. Everyone struggles; your challenges do not define your worth. My role is to understand your world, your thoughts, emotions, and experiences.......without judgment. And if you ever feel misunderstood, please tell me. Open communication helps us course-correct and strengthens our work together.
“I’m scared to revisit painful memories or share embarrassing things.”
You never need to “spill everything” right away. Early sessions are about pacing building trust, safety, and coping tools before diving into deeper work. You have agency over what's discussed and when. You decide when you’re ready to explore sensitive topics, and I’ll honor that. Many clients later share how liberating it felt to open up and realize it wasn’t as painful as they feared.
“What if my therapist expects me to change faster than I’m ready for?”
You set the pace. Again, you have agency. Therapy is about meeting you where you are. I’ll never push you to make changes before you feel ready. My job is to help you explore the “why” behind your patterns, build insight, and move toward change when the time feels right for you.
“What if I don’t click with my therapist?”
That’s a completely valid concern and one of the most important parts of therapy. The relationship between client and therapist is foundational to progress. I encourage you to ask questions, share hesitations, and give honest feedback. I want you to feel safe, understood, and connected. If you ever feel like we’re not the right fit, I’ll support you in finding someone who is.
(Note: At Nourivida Wellness, we offer paid 30-minute consultations so you can ask questions and get a feel for our approach before committing to ongoing sessions.)
It’s normal for emotions to feel heavier before they lighten. Therapy often involves unpacking long-held pain, habits, and beliefs it’s like opening a suitcase that’s been overstuffed for years. Sorting through it can feel messy at first, but clarity and relief follow. Feeling stirred up means you’re engaging in the process, not regressing. Stick with it; this is where real transformation happens.
The Benefits of Therapy
Therapy is both a process and an experience. You’ll learn about yourself, your relationships, and the patterns that shape your life. Over time, clients often notice:
Improved communication and relationship dynamics
Greater self-acceptance and confidence
Relief from anxiety, depression, or chronic stress
Healthier boundaries and emotional regulation
Better decision-making and conflict resolution
Deeper understanding of themselves and their families
Healing from betrayal, divorce, or loss
Increased emotional resilience and hope
One Last Thing
Starting therapy is a powerful act of courage and self-respect. You’re choosing to show up for yourself—and that decision alone creates momentum toward healing. Many clients reflect that while the process wasn’t always easy, it was profoundly worth it:
“It was hard at first, but I’m in a better place emotionally because of it. I’m not perfect, but I’ve grown so much.”
Therapy invites you to unpack what’s heavy, learn from what remains, and build a lighter, more intentional way of living. I look forward to walking with you on that journey.
Hi, I'm the owner and counselor at Nourivida Wellness, a practice for those seeking a healthier relationship with themselves, their children, their family, and/or their partner. If you're in the Saint Lucie or Martin County Area and life isn't quite what you expected it to be at this point in your journey, please give me a call at 772-361-8448 for a free, 15-minute phone consultation.
