What’s therapy really like? 5 myths debunked

Psychotherapy, or therapy for short, can be beneficial for both mental and physical health, but if you’ve never worked with a therapist, the process may feel mysterious.

What actually happens during a therapy session? How long will you be in therapy? Is it worthwhile if you don’t have a severe condition?

“Therapy is largely what you as an individual make of it,” says Lauren Baker, MS, LMHC, a mental health therapist with the MultiCare Behavioral Health Network. “It depends on your effort and readiness for change and it’s ultimately about what you want to accomplish.”

Here we bust some common myths about therapy and break down what it’s really like.

Myth 1: Therapy is only for people with severe mental health disorders.

Anyone can benefit from therapy — whether your symptoms are mild or severe, and whether you have a diagnosed mental health condition or not.

“Therapists do work with people who have experienced trauma or live with conditions like bipolar disorder,” Baker says. “But we also help people navigate many types of everyday challenges.”

Some of those challenges include:

• Managing stress and anxiety
• Coping with grief or loss
• Dealing with life events like a divorce, the loss of a job or the birth of a baby
• Managing conflict in relationships
• Seeking personal growth, such as more self-confidence or better parenting skills

Myth 2: My therapist is there to give advice and tell me what to do.

The relationship between a therapist and a client (or patient) is collaborative. While a therapist may offer guidance from time to time depending on the situation, their role is not to dictate solutions or solve problems for you.

“Therapists use different approaches, but in general we’re there to walk alongside you in whatever you’re going through,” Baker says. “We’re not there to determine the path or tell you where to go.”

What does this look like in action? Therapists can:

• Help you identify maladaptive (unhelpful) patterns of behavior
• Support you in setting goals for yourself
• Teach you strategies for improving your coping and communication skills
• Help you cultivate habits that support your physical and mental health and overall functioning
• Improve your awareness of your thoughts, feelings and behaviors
• Ask questions that help you gain insight into your life experiences

Myth 3: I’ll be able fix everything in one or two sessions.

While there is no set timeline for therapy, most people need more than one or two sessions to fully address whatever challenges or symptoms they’re experiencing. Typically, you will also have homework to do between sessions.

“Homework assignments can include things like journaling or reading a book,” Baker says. “They give people opportunities to implement changes or practice skills, like recognizing triggers for negative thought patterns. A lot of a person’s progress actually comes from what they do outside of our sessions.”

Myth 4: Therapy is like what you see on TV and movies.

Portrayals of therapy sessions on TV and in films are often inaccurate. They may portray therapists engaging in unethical behavior, such as breaking confidentiality or forming inappropriate social relationships with clients or patients.

“Trust is the core component of a therapeutic relationship, so we take confidentiality very seriously,” Baker says. “There are only specific situations where a therapist can break confidentiality, and that’s if a client poses a risk to themselves or someone else, if there is suspected abuse of a child or another dependent, or if there is a court order.”

Boundaries are also important — these are rules that guide interactions between therapists and clients so the relationship remains professional, safe and productive. Examples of therapeutic boundaries include not friending one another on social media and adhering to designated session times.

What actually happens during your therapy session depends on the circumstances of your particular situation, your goals for therapy and the modality (or type of treatment) your therapist uses.

Some therapists may take notes during a session, but often they are focused on participating in the discussion with you and will write notes afterward.

Baker shares that a typical session with an established patient may look like this:

Checking-in. The session may open with a check-in about how you’ve been feeling since the last session. Have there been any changes or significant events in your life?

Homework progress. Next, you might talk about the progress of any assigned homework. How did it go? What challenges did you face? What questions did it bring up? Did you have moments when you got stuck? How did you manage them?

The main material. Then you’ll move on to the main material of the session, which will be unique to each person as it will center on your goals and what brought you to therapy. For example, this could involve talking about how past experiences are shaping current behaviors or how you can implement strategies to manage anxiety.

Closing out. To end the session, you’ll talk about next steps in the therapeutic process and homework for upcoming sessions.

Myth 5: I’ll be in therapy forever.

The length of time you’ll be in therapy depends on many factors, including the complexity of your situation, the nature of the therapeutic relationship and your readiness for change. Some people may be able to achieve their goals over the course of a few months, while others may need longer-term support.

“Generally, it’s going to take some time to see change happen,” Baker says. “But if you’re ready to take the necessary steps, work on skills and put effort into homework — that can help you see results sooner and reduce the amount of time you’re likely to spend in therapy.”