It starts on time.
Therapy is in many ways a relationship, one between you and your therapist. And like any good relationship, it is built on trust and respect. Showing up on time to your session not only respects your therapist’s time and energy, it respects your own. This holds true even if you are meeting online.
You settle in.
Your therapy session will be carried out in a room that is clean, tidy, and quiet. Your therapist should work from such an environment even over Skype. Usually you and your therapist sit upright in comfortable chairs, facing each other, or facing your computer screens. There might be some chit-chat as you get comfortable. Therapists are human, and are not beyond talking about things like transport and the weather!
The therapist asks about how you’ve been doing.
A therapist will tend to start by asking you how things have gone since your last meeting. How did your revelations from your last session affect you? Did any of the goals you set work out? You might also discuss any homework you have done (depending on what sort of therapy you are doing). If it’s your first session, then you might instead be asked about why you have come to therapy, and a bit about your family and life history.
Questions, reflecting, silence.
Depending on the type of therapy you are trying, the conversation will either organically develop, or you will be guided to work with certain topics. The therapist will listen intently to you. They will also allow silence for you to think and feel. They will not give you advice or tell you what to do. This is a myth about therapy. Instead, a good therapist will reflect back to you what you have said so you can clarify, and they will ask good questions that help you find your own answers.
Exercises and tools.
Some types of therapy, like psychodynamic or person-centred, are open-ended. They tend to involve just sharing, reflecting, and questioning. Others, like cognitive behavioural therapy (CBT) and dialectical behaviour therapy (DBT), are structured. They involve exercises and/or homework. Tools that your therapist can use are varied and include things like mindfulness, visualisation, role play and guided relaxation. You can ask in your first therapy session if the type of therapy offered involves exercises, homework, and tools, or not.
You pay for your session.
Some therapists take payment at the beginning of the session, or, if over the internet, require payment in advance. Others take payment at the end of a session. If you have a preference over when you pay, it’s something to discuss with your therapist.
Closure and scheduling.
Therapists keep a good eye on time. They will not just suddenly say ‘well that’s it', and cut you off midway through an intense revelation. He or she will usually wind down the session over the last ten minutes or so, helping you wrap up what you are talking about or feeling. You’ll then confirm your meeting for the next week, and discuss what homework you’ll do (if there is any with your form of therapy), or what goals you’ll work on.