Starting Therapy: You Don’t Need to Have It All Figured Out

It's OK to not know where to start in finding a therapist. It can be common just to know that something feels off and you want some additional support.

Sometimes, you just know something feels off. Maybe your anxiety has started stealing joy from your daily life. Maybe conflict has crept into your relationships, and you find yourself feeling like you’re on opposite sides instead of the same team. Or maybe you’ve started wondering whether some of the challenges you’ve faced over the years could be related to neurodivergence and you have no idea where to start.

Here’s the good news: you don’t have to have all the answers before starting therapy. In fact, figuring things out together is part of the process.

1. Begin by Noticing What’s Showing Up

Take a few moments to reflect on what’s been feeling difficult or out of alignment. This might include:

• Current struggles like anxiety, depression, trauma resurfacing, low frustration tolerance, or ongoing relationship conflict

• Future goals such as finding more peace, ease, and structure in your life; building deeper connections; or actually feeling lit up by your day-to-day again

• Growing mismatches between the life you envision and the one you’re living right now

Even jotting down a few bullet points can help bring clarity to what you’d like to work on in therapy.

2. Explore What Type of Therapy Might Fit

If you’re new to therapy, talk-based approaches like Cognitive Behavioral Therapy (CBT) or Emotionally Focused Therapy (EFT) can help you organize your thoughts and understand patterns.

If you’ve already done talk therapy and are insightful about your triggers, but haven’t seen real change, it may be time to integrate somatic or polyvagal-informed work. These modalities focus on helping your body feel safe and regulated, which can decrease anxiety and depression while improving connection and motivation.

For those with a history of trauma, integrative approaches that combine IFS (Internal Family Systems), CPT (Cognitive Processing Therapy), and somatic or polyvagal principles can be transformative. They allow for healing at a sustainable pace that supports real, embodied change.

If you suspect ADHD or executive functioning challenges, therapy that focuses on skill-building, structure, and strengths-based strategies can be life-changing. The goal isn’t to “fix” you, it’s to work with your brain, highlighting its superpowers while buffering the challenges.

3. Find a Few Therapists to Interview

Once you have a sense of what might be helpful, start searching. Directories like Psychology Today, Zencare, and Therapy Den let you filter by gender, insurance, specialties, and therapy type (like EMDR, CBT, or IFS).

Don’t hesitate to “interview” therapists, fit is essential. The therapeutic relationship is one of the strongest predictors of success in therapy. Most therapists (myself included) offer free consultations so you can ask questions and see if the connection feels right before investing time, money, and emotional energy.

Questions you might ask include:

• What does your intake process typically look like?

• How do you tailor therapy for each client?

• How directive are you during sessions?

• How do you incorporate feedback or adjust our focus over time?

  
  

You deserve to feel safe, understood, and aligned with your therapist’s approach.

4. What to Expect from the First Session

In my practice, I think of the first two sessions as an opportunity to gather information and map out your unique story.

Before your first visit, I’ll send over my practice policies and intake questionnaires, which include broad measures to help me assess a range of concerns. I review these ahead of time so our first session (a 90-minute assessment) can go deeper without wasting time on generic questions. Every clinician has a different process, so don't be afraid to ask what that looks like in the therapist you're interviewing.

That first session can feel like a lot; you’re often sharing your life story and the parts that feel most tender. I recommend scheduling it during a time when you can decompress afterward. Give yourself permission to rest and recharge.

5. Mapping the Path Forward

After your first session, I take time to put everything together into what’s called a conceptualization, essentially a roadmap of your key concerns, how they developed, and which treatment approaches may be most effective.

In our second session, I start our session by sharing this feedback. We look at themes and choice points together, identify where to start, and collaborate on next steps. From there, therapy becomes a living process, something we keep shaping and adjusting as your needs evolve.

6. The Ongoing Process

Good therapy isn’t static. Over time, your goals and needs may shift and that’s a good thing.

Throughout the process, we’ll keep checking in:

• Do you want more structure or more open exploration?

• More homework or less?

• Are we focusing too much (or too little) on skills, patterns, or the deeper “why”?

• Should we increase how frequently we're meeting for a short period where you need more support or is it time to step down to monthly sessions as you're feeling more steady?

  
  

Therapy is most powerful when it’s collaborative and grounded in ongoing dialogue.

Final Thoughts

Starting therapy is an act of courage. It’s saying, I deserve to feel better than this. You don’t need to have everything figured out, you just need a willingness to begin.