A guide for beginning therapy

New to Therapy? Start Here

Whether you've never been to therapy before or you're considering giving it another try, this guide is for you.

Starting therapy can feel intimidating. Maybe you're worried about being judged. Maybe you don't know what you're supposed to talk about. Maybe you're concerned about the cost, whether therapy will actually help, or what might happen if you're completely honest about what you're experiencing. You might even be wondering whether you'll like your therapist. Those are reasonable concerns.

My hope is that this guide helps you better understand therapy, what to expect, and how to find someone who's a good fit for you. Whether you eventually work with me or another therapist, I want you to feel more informed and comfortable making that decision.

Explore the Guide

Section 1

What Exactly Is Therapy?

Therapy is a professional relationship where you work with someone trained to help people navigate emotional, psychological, behavioral, and interpersonal difficulties.

What therapy looks like can vary quite a bit. Some therapists primarily provide a space for you to talk, feel understood, and explore your experiences. Others may offer advice, help you identify patterns, teach specific skills, or use structured techniques to change thoughts and behaviors.

There isn't one approach that works best for everyone. What matters is finding an approach that fits your needs, preferences, and the concerns you're hoping to address.

For me, therapy involves empathy, understanding what someone wants to change, identifying specific goals, learning useful skills, and practicing those skills in everyday life. But that's my approach. Other therapists may work differently, and that's okay.

Curious About Different Types of Therapy?

Cognitive Behavioral Therapy (CBT)

Explores connections between thoughts, emotions, and behaviors. It often involves identifying unhelpful patterns and practicing strategies to change them.

Dialectical Behavior Therapy (DBT)

Emphasizes skills such as emotional regulation, distress tolerance, mindfulness, and navigating relationships.

Acceptance and Commitment Therapy (ACT)

Helps people develop psychological flexibility, make room for difficult internal experiences, and take action guided by their values.

Psychodynamic Therapy

Explores how past experiences, emotional patterns, and relationships may influence present difficulties.

Person-Centered Therapy

Emphasizes empathy, acceptance, authenticity, and the therapeutic relationship.

TEAM-CBT

A structured approach emphasizing Testing, Empathy, Agenda Setting, and Methods. It incorporates regular feedback and techniques designed to address specific problems.

These are only a few examples. Many therapists incorporate techniques from multiple approaches. The therapist's training, experience, relationship with the client, and how treatment is applied can all influence outcomes.

Section 2

Are All Therapists the Same?

Absolutely not.

Even therapists who use the same treatment approach can have very different personalities, communication styles, experiences, and ways of working. One therapist might be relatively quiet and reflective. Another might be more conversational, direct, or structured. Some provide substantial guidance during sessions, while others focus on helping you explore your own thoughts and arrive at conclusions.

You may feel comfortable with one therapist almost immediately, while another might not feel like the right fit. That doesn't necessarily mean either therapist is bad at their job. It means that the relationship and approach matter.

The Importance of the Therapeutic Relationship

Research consistently identifies the quality of the therapeutic relationship as an important factor associated with treatment outcomes. Feeling respected, understood, and comfortable enough to be honest can make a meaningful difference. However, having a good relationship doesn't automatically mean therapy is helping you make progress. Ideally, you want both: someone you trust and a process that helps you work toward your goals.

Section 3

Finding the Right Therapist

Finding a therapist can feel overwhelming. You may have dozens of names to choose from, and it's not always obvious how one provider differs from another. Here are a few things worth considering:

Experience and training

Does the therapist have experience helping people with concerns similar to yours?

Approach

How does the therapist generally work? Does that approach sound like something you'd be comfortable participating in?

Personality

Do you feel comfortable talking with them? Can you imagine being honest, even when something is difficult to discuss?

Practical considerations

Are appointments affordable? Do they accept your insurance? Does their availability work with your schedule?

You don't need to know all these answers immediately. A consultation can help you figure them out.

You Are Allowed to Change Therapists

Sometimes you begin working with someone and realize that the relationship or approach isn't what you need. That's okay. You can talk with your therapist about your concerns, ask whether something could change, or decide to work with someone else. A therapist can be compassionate and competent without being the right fit for every person.

Section 4

Questions to Ask During a Consultation

A consultation gives you an opportunity to learn about the therapist, explain what you're looking for, and determine whether working together makes sense. You don't need to arrive with a detailed explanation. Sometimes simply saying, "I've been struggling, and I'm not sure where to start," is enough.

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Therapy Consultation Questions

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Section 5

What Happens During the First Appointment?

Different practices organize their intake processes differently. Generally, there are three stages worth understanding.

Step 1

The Consultation

Discuss what you're looking for, ask questions, and determine whether the therapist may be a good fit. A consultation is generally not a full therapy session.

Step 2

Initial Assessment

Your first formal appointment may gather information about symptoms, history, current circumstances, goals, and previous treatment.

Step 3

Regular Sessions

After assessment, therapy focuses on goals through discussion, exploration, learning techniques, practicing skills, and reviewing progress.

Important Reminder

You don't need to know exactly what you want to work on before attending your first appointment. Part of the therapist's role is helping you understand your concerns and identify meaningful goals.

Section 6

What Does Therapy Actually Feel Like?

You might feel nervous, uncomfortable, relieved, emotionally exhausted, or unsure. You might cry, laugh, or leave with more questions than answers. These experiences can occur and don't automatically mean anything is wrong.

Feeling nervous

It can take time to become comfortable talking openly with someone new.

Not knowing what to say

You don't need to prepare a speech or have everything organized.

Crying

Crying can be a natural emotional response. You don't need to apologize for it or force it to happen.

Feeling tired afterward

Discussing difficult experiences can be emotionally demanding.

Struggling with homework

Learning new skills takes practice. If an activity feels overwhelming, discuss that difficulty.

Feeling uncertain about progress

Improvement isn't always straight-line progress. Changes may happen gradually.

A Note From Teddy

Talking about problems can be helpful, but sometimes meaningful change also requires taking action. Therapy can help you understand yourself differently, while practicing what you're learning outside appointments often helps those changes become part of everyday life.

Section 7

Confidentiality and Privacy

Is What I Say in Therapy Private?

Confidentiality is an important part of therapy. In most circumstances, therapists are legally and professionally required to protect your private information.

However, confidentiality is not absolute. Disclosure may be required or permitted in circumstances involving certain safety concerns, suspected abuse or neglect, and applicable legal requirements. Your therapist should explain confidentiality and its limitations before beginning treatment.

Will my therapist hospitalize me if I'm honest?

Talking about suicidal thoughts, depression, self-harm, or other difficult experiences does not automatically mean you will be hospitalized. Therapists regularly work with people experiencing distressing thoughts and emotions.

When safety concerns arise, a therapist may ask questions about intention, plans, access to means, available support, and other relevant factors. Hospitalization or emergency intervention may become necessary in some circumstances depending on the level of risk and applicable laws. Whenever possible and appropriate, therapists work collaboratively with clients to address safety concerns and identify suitable support.

This is general educational information, not a guarantee about an individual situation. Ask your therapist how they approach confidentiality and emergency situations.

Section 8

How Do I Know if Therapy Is Working?

Therapy takes time, and progress isn't always immediate or consistent. You should generally understand what you're working toward and how your therapist is helping you get there.

Feeling less overwhelmed

Responding differently to difficult thoughts

Improving communication

Participating in activities you've avoided

Experiencing fewer or less intense symptoms

Understanding yourself more clearly

What If I'm Not Improving?

Discuss it with your therapist. You may need to adjust the approach, clarify goals, address barriers, or consider additional services. A good therapeutic relationship matters, but treatment should also be responsive to your needs.

Section 9

How Therapy Works at Karos Counseling

My approach is structured, collaborative, and focused on helping people make meaningful progress. I'm Level 3 certified in TEAM-CBT, incorporating techniques that help people identify specific problems, understand what may be maintaining them, and practice new ways of responding.

  1. 1

    Consultation

    Discuss fit, goals, and next steps.

  2. 2

    Initial Assessment

    Understand history, concerns, and priorities.

  3. 3

    Ongoing Therapy

    Practice skills and work toward goals.

  4. 4

    Progress Evaluation

    Review feedback and direction.

  5. 5

    Completion or Continued Support

    Adjust as needs evolve.

1. Measuring Progress and Feedback

I use brief questionnaires before and after sessions and ask for feedback. This helps us identify changes and make adjustments instead of assuming meeting regularly is enough.

2. Practicing Between Sessions

I expect participation in activities relevant to your circumstances and goals. If something isn't working, we discuss and adjust it. Practice helps turn session skills into everyday tools.

3. Working Toward Specific Goals

I prefer clear priorities and a collaborative plan. Other concerns can still matter; we identify where to focus and adjust priorities when necessary.

My Long-Term Goal

I don't want clients to feel that they need to remain in therapy indefinitely. My goal is to help you develop skills, gain confidence, and make meaningful progress so you can manage difficulties more independently. Some people benefit from brief treatment; others need longer-term support.

A Note About Children and Families

Therapy for children can look different from adult therapy. Depending on age and needs, treatment may involve parents or caregivers, developmentally appropriate activities, and opportunities to practice skills outside appointments.

Section 10

Additional Resources

Understanding Insurance

Learn how deductibles, copays, claims, coverage changes, and Indiana Medicaid may affect therapy costs.

Read the Young Adults' Guide

Ready to Get Started?

You Don't Have to Figure Everything Out Before Reaching Out

You don't need to know exactly what's wrong, which approach you need, or how to explain everything. Those are things you can begin exploring with a therapist. If you'd like to learn more about working with me, I offer a free 15-minute consultation. And if another therapist would be a better fit, that's okay, too.

Request a Free ConsultationContact Me

You can also call or text at (219) 386-3296.