If you are reading this, you already have your first session booked. I want to start with something that may sound like a courtesy, but isn't: it was a good decision, regardless of how you feel about it right now.
Many people start having doubts right after booking their first appointment. Isn't this too much? Maybe I can manage without it? Does it even work? That is completely normal. So I will start with the last doubt, because there is a concrete answer to it.
Therapy really works
This is not the opinion of a clinic that sells therapy. The effectiveness of psychotherapy is one of the most thoroughly researched topics in psychology. It has been studied for decades, in hundreds of studies with tens of thousands of people.
The average person after psychotherapy is doing better (less anxiety, better self-esteem, coping better with daily life, work or study) than about 80% of people with similar difficulties who did not have therapy.[1]
Interestingly, research shows again and again that whether therapy helps depends to a large extent on fit: the relationship with the therapist and whether you both understand what you are working on.[2]
That is why at LAS you don't choose blindly. We help match the therapist and approach to what you come with and to how you work best. I will come back to fit, because a few practical things follow from it.
What therapy actually is
Therapy is a method of treatment with proven effectiveness, like other methods in medicine. But it is not only for people with a diagnosis. It is not a chat about life or a paid friendship. It has its own theory, its own tools and decades of research on effectiveness.
In practice it is structured work on something specific, led by someone who knows how to guide that work. Here is what most often changes.
Emotions stop running your life
You learn to recognise what is happening inside you before it floods you. It is not about suppressing emotions, but about being able to respond to them rather than just being ruled by them.
Relationships start to look different
Most of us repeat the same patterns in relationships without seeing them. Therapy is one of the few places where you can see them and try something different.
Habits that are hard to change alone begin to shift
The ones that come back despite your resolutions: procrastinating, shutting down, reaching for something when things are bad. Therapy deals with what lies underneath them, not with willpower alone.
You start to understand yourself
Why you react the way you do. Where your choices come from. What is truly yours, and what you carry from home or from past relationships.
Therapy helps with very different difficulties. Depression and anxiety. After a loss or a hard experience. In crisis, burnout, feeling stuck. With problems around closeness and boundaries. Sometimes you come with one specific issue, and sometimes with a feeling that something is generally off, and that is fine too.
You don't need a "serious enough" reason. There is no threshold you have to reach to deserve therapy.
What is the goal of therapy?
Therapy is not about "fixing" a person, nor about the therapist telling you how to live. Its goal is a better understanding of yourself, your emotions, needs and recurring ways of reacting.
Over time it is also about having more choice where reactions used to appear almost automatically. About being able to cope with difficulties differently, build relationships more in line with yourself and make decisions with greater awareness.
At the start, you and your therapist agree on what specifically should change. That goal may later become more precise or change as you understand yourself and your situation better.
In the long run, therapy should lead to growing independence, so that over time the therapist's support is no longer needed, and what you work out in therapy stays with you outside the room.
In the therapy room, everything is allowed
The therapy room is one of the few places where you don't have to watch yourself.
You can cry. You can get angry. You can say something no one has heard yet, and something you are ashamed of.
You can talk chaotically, return to the same thing for the tenth time or stay silent for half the session.
None of it will be judged and nothing will leave the room. The therapist is bound by professional confidentiality.
The only thing that applies to both of you is ordinary respect: for each other and for yourself. Beyond that, there are no forbidden topics and no emotions that would be out of place.
What therapy is not
This is the part that most often causes disappointment if nobody explains it beforehand.
It is not advice-giving
Your therapist probably won't tell you whether to leave that job or stay in that relationship. Not because they don't want to help or are hiding something. The point is that the decision should come from you, from what you really want and need, not from the therapist's opinion. Ready-made advice rarely changes anything, while a decision you reach on your own usually holds. Your therapist will help you see it more clearly, but you will make it.
It is not judgement
Your therapist does not draw conclusions about whether you are a good person.
They don't judge your lifestyle, your decisions, your sexuality, how much you drink, who you love or what you regret. In the therapy room there are no good and bad things. There is only what happened and what to do with it next. You can say things you tell no one, and you won't be met with a face, a lecture or a warning.
It doesn't work after one meeting
The first meetings, usually one to three, are an initial assessment. The therapist gets to know you and your story, and you check whether you feel comfortable talking to this person. Together you agree on what you want to work on. The actual therapy begins after this stage, when the therapist has the whole picture.
How to prepare
The shortest answer: you don't need to prepare. There is nothing to learn or rehearse. But if you want to do something, two things help the most.
Think about what you want to change. You don't have to be able to name it precisely right away. "I want to stop waking up anxious" or "I want to understand why the same pattern keeps repeating in my relationships" is completely enough. Your specialist will help you refine that goal.
And if you can't yet say what exactly is wrong, only that you have been feeling worse for a while, that is also a good enough reason to come to therapy. Understanding what is happening to you and what you need can be the first goal of your work together.
Keep fifteen minutes free after the session. Don't book a meeting right after. After the first session you may feel tired or strangely stirred up, and it is better to have a moment for yourself.
Don't know what to say?
If the session is in person
Come calmly, without rushing. When you run into a session in a hurry, the first minutes go on catching your breath and settling down. Parking shouldn't be a problem, as there is an underground car park.
If you arrive early, you can sit with us and wait in peace. We have a place for that, and no one will rush you or make small talk. For many people those few minutes of quiet before entering the room help more than anything else.
If the session is online
- Find a place where no one will disturb you and where you don't have to lower your voice. Being able to speak normally matters more than it seems.
- Log in a few minutes early and check that your camera and microphone work. That way the first minutes of the session won't go on technical issues.
- Give yourself a moment to breathe before connecting. Going straight from a work meeting into a therapy session is doable, but it is easy to bring in tension that is still in you.
- If something doesn't work, just give us a call.
Technical problems or running late?
What the first meeting looks like
It usually lasts fifty minutes, and seventy in couples and family therapy. It is above all a conversation.
The therapist will ask what brings you and how long it has been going on. They will probably also ask about things that may seem unrelated: sleep, work, family, previous experiences with psychological help. This is not nosiness, it is building a picture.
At the end of this initial stage you should name together what you are working on and agree how often you will meet. It is an important moment, and if it doesn't happen on its own, feel free to ask for it.
The first one to three meetings are an initial assessment. The therapist needs this time to create a so-called conceptualisation, a broader picture of your situation and how your difficulties connect. At the end of this stage you know what you will work on and what that work will look like.
This is also a meeting where you can ask about anything. What exactly this therapy looks like. How long work on something like your issue usually takes. Whether they have experience with exactly this. A good therapist will answer without hesitation.
How to get the most out of therapy
Come regularly
It sounds trivial, but regularity really matters. In a study of over 21,000 people, those who attended sessions weekly reached clear improvement faster than those who came every two weeks.[7]
The beginning matters especially: in a more recent study, weekly sessions during the first three weeks sped up improvement.[8]
A bit like the gym or brushing your teeth: a single time changes little, the effect comes from doing it regularly. Breaks disrupt continuity and you then have to rebuild what was already built. If you can, set a fixed time with your therapist instead of booking anew each time.
Talk about what is happening to you. Including what happens in the therapy room
This is probably the most important thing in this whole text, so I will say it directly.
During therapy you may feel something towards your therapist. Irritation. Shame. A sense that they are judging you. That they say too little or too much. Sometimes the opposite, for example that you want to please them.
This is normal and it is not a sign that you made the wrong choice.
Very often it is exactly what is worth working on, because what happens between the two of you usually reflects in some way what happens in your relationships outside the room.
So instead of drawing conclusions, bring it up in the session. It sounds awkward, and it is. Research shows that when tension between client and therapist is named and discussed together, therapy brings better results.[3]
In other words: what looks like a problem can be the most valuable part of the whole work. Provided it is spoken out loud.
Most common doubts
Finally
If one sentence from this text is to stay with you, let it be this: when something in therapy bothers you, say it in the session.
You don't need ready words or to phrase it nicely. It is enough to say what you feel. Often it is exactly from such a conversation that the work starts moving forward.
I'm keeping my fingers crossed and I'm glad you are here.
Sandra
Sandra Laskowska, psychologist, psychotherapist, SWPS University graduate. Founder of LAS Centrum Psychoterapii. Creator of @psychesandra, with over 38k followers.
@psyche_sandraSources
- Smith, M. L., Glass, G. V., & Miller, T. I. (1980). The Benefits of Psychotherapy. Baltimore: Johns Hopkins University Press. Metaanaliza 475 badań, średnia wielkość efektu 0,85, osoba po terapii jest w lepszym stanie niż około 80% osób z grup nieleczonych. ↩ Back to text
- Wampold, B. E. (2015). How important are the common factors in psychotherapy? An update. World Psychiatry, 14(3), 270-277. ↩ Back to text
- Eubanks, C. F., Muran, J. C., & Safran, J. D. (2018). Alliance rupture repair: A meta-analysis. Psychotherapy, 55(4), 508-519. Metaanaliza 11 badań, 1314 pacjentów; związek między naprawieniem napięcia w relacji a lepszym efektem terapii: r = 0,29 (d = 0,62). ↩ Back to text
- Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011). Alliance in individual psychotherapy. Psychotherapy, 48(1), 9-16.
- Barkham, M., Connell, J., Stiles, W. B., Miles, J. N. V., Margison, F., Evans, C., & Mellor-Clark, J. (2006). Dose-effect relations and responsive regulation of treatment duration: The good enough level. Journal of Consulting and Clinical Psychology, 74(1), 160-167. Oraz: Gemeinsamer Bundesausschuss (2026). Psychotherapie-Richtlinie (niemieckie wytyczne dotyczące psychoterapii). ↩ Back to text
- Lambert, M. J., Hansen, N. B., & Finch, A. E. (2001). Patient-focused research: Using patient outcome data to enhance treatment effects. Journal of Consulting and Clinical Psychology, 69(2), 159-172. Analiza danych ponad 10 000 pacjentów, poprawa mierzona kwestionariuszem OQ-45. ↩ Back to text
- Erekson, D. M., Lambert, M. J., & Eggett, D. L. (2015). The relationship between session frequency and psychotherapy outcome in a naturalistic setting. Journal of Consulting and Clinical Psychology, 83(6), 1097-1107. Dane 21 488 osób z poradni uniwersyteckiej; przy sesjach co tydzień wyraźna poprawa przychodziła szybciej niż przy sesjach co dwa tygodnie. ↩ Back to text
- Erekson, D. M., Bailey, R. J., Cattani, K., Klundt, J. S., Lynn, A. M., Jensen, D., Merrill, B. M., Schmuck, D., & Worthen, V. (2022). Psychotherapy session frequency: A naturalistic examination in a university counseling center. Journal of Counseling Psychology, 69(4), 531-540. ↩ Back to text