By Dax Johnson, LCMHC, NCC
The first few sessions of therapy are almost always a little awkward.
There's a particular kind of discomfort that comes with being in a room with someone whose job is to understand you — but who doesn't yet know you, and who you don't yet know how to trust. Most people manage that discomfort by presenting a careful, edited version of themselves. Organized. Articulate. The version that has already thought through most of what they're about to say.
That's normal. That's actually fine. No one walks into a first session and hands over all of it.
But here's what's worth knowing: that careful, edited version is not the work. It's the beginning of it. The work starts when the editing slows down — when something unscripted comes out, when the carefully managed version gets interrupted by something more real. That moment doesn't happen because the client decided to be vulnerable. It happens because something in the relationship made it feel possible.
Building that relationship is not accidental. There are specific things — on both sides of the room — that either create or undermine the conditions for real therapeutic work.
As a therapist, these moments are very precious to me. It takes a great deal of courage and bravery for a person to bridge this moment in their therapy journey, and it is a moment I intend to honor and cherish.
What Clients Can Do
Say what's actually happening, even when it feels risky.
The single most powerful thing a client can do to build a working therapeutic relationship is to say the thing that feels most difficult to say. Not because vulnerability is inherently valuable, but because every time a client risks something real and the therapist receives it without judgment, the relationship gets deeper and safer. The therapist can only work with what's actually in the room.
This includes saying when something isn’t working. If a session felt useless, if a response landed wrong, if something the therapist said made you want to leave — those reactions are not problems to hide. They’re the most useful information in the room.
Yalom was direct about this. In The Gift of Therapy, he described the moment a client turns to their therapist and says “that didn’t help” or “I was angry after our last session” as among the most valuable things that can happen in treatment — not because conflict is inherently productive, but because most people never get to do this. They swallow the complaint, drive home, replay the conversation, rehearse what they should have said, and never say it to the person who needs to hear it. Therapy, Yalom argued, is one of the only relationships in a person’s life structured to reverse that pattern entirely.
He called this “here-and-now” work — the practice of attending to what’s actually happening between two people in the room, right now, rather than staying safely in the past or in abstract narrative. When a client can say that landed wrong or I felt dismissed last week, that moment is not a disruption of the therapeutic work. It is the work. It is the pattern, alive, in the room, where it can actually be examined and responded to differently than it ever has been before.
This is something I tell every client I work with. You have every right to bring those moments to me — the friction and the frustration, not just the breakthroughs. Therapy isn’t only the sessions that feel productive. It isn’t only the moments of clarity or the relief after something finally gets named. It is equally the sessions that feel stuck, the moments where you almost said the hard thing and didn’t, the discomfort of staying in the room when part of you wants to leave. Working through those moments is therapy. The good sessions and the hard sessions are both the work.
A therapist who can hear honest feedback without becoming defensive is a therapist worth staying with. A therapist who can’t — that, too, is information you needed to have.
Give the relationship a fair runway.
Therapeutic fit becomes clear over time, not in the first session. The first few sessions involve a lot of information-gathering and calibration. You're learning how this person thinks, how they respond, whether their style matches what you need. They're learning you. Deciding the relationship isn't working after one or two sessions is a bit like deciding a conversation isn't interesting before the other person has had a chance to respond.
A reasonable window is somewhere between four and six sessions before making a serious assessment of fit. By that point you'll have had enough real interaction to tell whether the relationship has potential — not whether it's perfect, but whether it's workable and worth investing in.
And if you do reach that point — if you’ve given it a genuine window and the fit simply isn’t there — consider one more thing before you go quiet. Not another full session necessarily, but something. A brief email. A short final meeting. Even a voicemail. Something that says: this is ending, and here’s why.
This isn’t about softening the blow for your therapist. It’s about what you deserve as much as anything else. Closure is not a clinical nicety — it’s a real human need, and therapy is one of the few relationships in your life where someone is specifically trained to help you end things well. A final conversation, even a short one, gives you the chance to name what worked and what didn’t, to leave with something consolidated rather than something simply abandoned. It also gives your therapist something genuinely useful — honest feedback about where their approach missed, what landed wrong, what they might do differently. Good therapists want that information. It’s how the work gets better. If your experience with a therapist wasn’t a great fit, the most useful thing you can do with that is say so — not to wound them, but because that kind of direct, grounded feedback is exactly what professional development is made of.
You don’t owe anyone a dramatic farewell. But you do deserve an ending that honors the work you showed up to do — even the work that didn’t go quite the way either of you hoped.
Distinguish between "this isn't a good fit" and "this is getting uncomfortable."
These are two different things, and they feel similar from the inside.
A bad fit means something fundamental isn't working — the therapist's style is consistently mismatched with your needs, their values conflict with yours in ways that can't be bridged, you don't feel respected or understood. Those are real and legitimate reasons to find someone else.
But discomfort that comes from the work getting closer to something real is not the same thing. Many people leave therapy precisely when it's starting to reach something important, because the discomfort of proximity to that material triggers the same avoidance patterns that brought them to therapy in the first place. Learning to tell the difference between "this therapist isn't right for me" and "this is getting harder because we're getting somewhere" is one of the most useful things a client can develop.
What Therapists Can Do
Be a person, not a performance.
Donald Winnicott wrote about the "good enough" caregiver — the idea that perfect attunement is neither possible nor necessary, and that the inevitable small failures and repairs within a caring relationship are actually where some of the deepest growth happens. The same applies in therapy.
A therapist who presents as infinitely patient, unbothered, and perfectly attuned to everything is not creating safety — they're creating a performance that the client can't trust. What creates safety is genuine presence. A therapist who is actually moved by what is moving, actually curious about what is interesting, actually honest when they've misunderstood or need to circle back — that therapist is a real human being. Clients can work with a real human being.
I’ll offer something personal here. I have ADHD and dyslexia, and both show up in my sessions in ways that are entirely visible. There are moments when a word gets lost somewhere between my brain and my mouth. Moments when I jump too quickly toward an insight before pausing to sit with the emotion that needs to be felt first. Moments when my thinking goes on a brief tangent before I can reel it back. These aren’t things I hide, because I can’t — and because trying to would cost more than it’s worth.
For some clients, those qualities make the room feel less clinical and more human. For others, they’re a dealbreaker, and that’s genuinely okay. A therapist is not a function. They’re a person — with their own wiring, their own blind spots, their own way of being in a room. Some people fit better with some therapists than others, and that goes both directions. The goal isn’t a therapist who is textbook perfect. The goal is a therapist who is real, who is present, and who is genuinely trying. Therapy works because two human beings show up to it — not because one of them manages to seem like they aren’t.
Therapy is a deeply human experience.
Practice transparent, boundaried disclosure.
Therapist transparency does not mean the therapist's personal life, struggles, and opinions become content in the session. That would be clinically irresponsible and ultimately a disservice to the client.
What it does mean is that the therapist brings their actual self into the room in ways that serve the client. Acknowledging genuine reactions in the moment — "what you just said stopped me" — naming what they're observing — "I notice something shifted just now" — owning a misattunement rather than defending it — these are acts of transparency that deepen the relationship without crossing ethical lines. They communicate that this is a real encounter, not a managed procedure.
Name what's happening in the relationship directly.
One of the most underused therapeutic tools is also one of the most straightforward: simply saying out loud what is observable in the room between two people, right now. Not a grand interpretation — just an honest observation. "I want to check in — it feels like something shifted after what I said a few minutes ago." "I notice you seem more guarded today than last week, and I'm curious what that's about." "I'm aware I've been doing most of the talking in this session."
These moments of direct relational attention accomplish something powerful. They model that the relationship can hold honest observation. They teach the client that dynamics can be named without catastrophe. And they often open the door to exactly the kind of material that produces real change — because what's happening between client and therapist is almost always a version of what's happening in the client's broader relational life.
What Both Sides Share
The goal is collaboration, not performance.
Therapy works best when both people understand that they are working on something together, not when one person is delivering something to the other. The client's role isn't to be a good patient. The therapist's role isn't to be an expert who dispenses insight. When both people are genuinely oriented toward the same thing — the client's actual wellbeing and growth — the relationship becomes what Carl Rogers described: a shared movement toward the client's own becoming.
Ruptures are not failures.
Every real relationship has moments of misattunement, misunderstanding, or friction. In therapy, these moments are not problems to be smoothed over quickly — they're opportunities. The clinical concept of "rupture and repair" describes what happens when a therapist and client encounter friction in the relationship and work through it together. The repair itself — the experience of a conflict being held, named, and resolved without the relationship ending — is often more therapeutic than any single session of clean, uninterrupted work.
Staying through a rupture teaches something the client may never have learned: that relationships can survive honesty. That a person can express something difficult to someone who matters to them, and the relationship doesn't collapse. That insight doesn't live in the head. It lives in the body, built over time through experience.
And it builds toward something most clients have never been able to do in the context of a significant relationship — engage productively with conflict, disagreement, and difficult emotion without the whole thing falling apart.
Which is exactly what the final piece in this series is about.
This is Part 3 of a four-part series on the therapeutic relationship — what it is, why it matters, how to build it, and what becomes possible when both therapist and client are willing to go somewhere real together.
Crisis Resources
988 Suicide and Crisis Lifeline: Call or text 988 (available 24/7)
Crisis Text Line: Text HOME to 741741
Emergency services: Call 911 or go to your nearest emergency room
Dax Johnson is a Licensed Clinical Mental Health Counselor (LCMHC) in Murray, Utah, specializing in trauma, self-sabotage, anxiety, and depression. He is a National Certified Counselor (NCC) and holds an MS in Clinical Mental Health Counseling from Grand Canyon University. Dax uses evidence-based approaches including EMDR, CBT, IFS, and SFBT, as well as Christian counseling for clients who desire a faith-integrated approach.
Lionheart Counseling LLC provides mental health therapy to adults in Murray, Salt Lake City, South Jordan, Sandy, Draper, Midvale, West Jordan, Taylorsville, Herriman, Cottonwood Heights, Orem, and Provo, Utah and via telehealth statewide.
Dax Johnson, LCMHC (#13937032-6004) | Licensed under Utah Code 58-60-402 and 58-60-407
