By Dr. Danielle Keenan-Miller
If you’re thinking about starting psychotherapy, either for the first time or after a break, it’s a good idea to take a moment to check in with yourself about your readiness for treatment. By the time you start treatment, your therapist will have done a lot of preparation to be ready for your therapy--usually six years of school (if you’re seeing a psychologist) plus additional supervised training after school, and ongoing continuing education. Equally important to the kinds of preparation that your therapist does is the internal preparation that you do as you’re embarking on the collaborative enterprise of psychotherapy.
What does it mean to be ready for therapy? There’s no one answer to that question, but psychological scientists describe four distinct parts to psychotherapy readiness.²⁶ First is the desire to engage in therapy. That might seem obvious, but it’s not uncommon for people to present to therapy with some ambivalence about starting. Sometimes they’re only coming because a parent, spouse, or other important people have told them they should. If you’re feeling unsure about whether therapy is what you really want, it’s important to address that concern in the first session or two. Your therapist will be able to explain to you the risks and benefits of therapy and help you identify ways that it can benefit you specifically.
A related component of being ready for treatment is having a sense of what you want to change. Sensing that something in your life is problematic for you and then feeling a desire to do something differently in that area are essential ingredients for change.²⁷ A good idea before a first session is to make a list of goals you have for your treatment-- what would you like to change? How would you like your life to be different at the end of treatment?
Another part of readiness is a willingness to be open with your therapist about your thoughts, feelings, and actions. Oftentimes, people feel guilt or shame about the problems that are bringing them into therapy, so it’s normal to feel somewhat uncertain about sharing the details of your life. It’s important to know that therapy is a safe, non-judgmental place, which is part of what makes it powerful and quite different from the other relationships in your life. Feeling safe and trusting your therapist is an important part of the therapeutic relationship, so if you’re not feeling that way, it may be a sign that you need to talk about it with your therapist or find a different match.
Finally, a willingness to take on the work of therapy is another important component of readiness. Depending on the type of therapy you’re in, that might mean doing experiential exercises or other kinds of homework in between sessions, a willingness to experience uncomfortable thoughts or emotions during session, or following through on the changes you discuss with your therapist. At a minimum, it means being able to show up regularly and being present mentally and emotionally as much as possible. Many times in the eagerness to start therapy, people will begin treatment with someone that isn’t realistic for them to see because of distance, a scheduling conflict, or financial limitations. Before you enter into a treatment relationship, take honest stock with yourself of whether or not this is the right time, place, and person for you to be willing to put in the hard work that therapy requires.
A thorough check-in with yourself about each of these four dimensions can help you identify any concerns that might get in the way of treatment so you can discuss them with your therapist from the outset.²⁸ For more guidance on choosing the right treatment provider, see our post on Six Essential Steps to Finding the Therapist That’s Right For You.
 Ogrodniczuk, Joyce, & Piper, 2009
 Prochaska et al., 1992
 Ogrodniczuk, Joyce & Piper, 2005