Therapy for young adults facing life’s difficult moments

Your first appointment is a chance for you to meet us, talk about what’s brought you here and think about whether therapy could help.

You might know exactly what you’re struggling with, or you might just know that something doesn’t feel right. Either is fine.

We’ll explain how therapy works and answer any questions you have. You can tell us as much or as little as you want to.

No. Some people know exactly why they want therapy. Others know they’re struggling but can’t really explain why.

You might want help with particular feelings, relationships or experiences, or simply want to understand yourself and what’s happening in your life a little better. Working that out can be part of the therapy.

That’s fine. You don’t need to arrive with a list of things to talk about or the right words to explain how you feel.

And therapy doesn’t always have to be just talking. You might draw, do something creative, play a game or use another activity while you talk and think things through.

Not necessarily. Talking can be a big part of therapy, but you don’t have to sit opposite someone and talk continuously for 50 minutes.

You might draw, do something creative, play Uno or focus on something else that makes it easier to think and talk about things.

No. Your therapist may sometimes ask about something that seems important, but you won’t be forced to talk about an experience before you feel ready.

Therapy can sometimes involve difficult feelings, but the work should happen at a pace you can manage. You can always tell your therapist when something feels too much or you’re not ready to explore it.

No. Things that happened in the past can sometimes help explain how you think, feel or respond today, so they may become part of therapy.

But therapy is also very much about what’s happening now – friendships, family, relationships, school or college, worries, experiences and everyday life. How much you talk about the past will depend on you and what comes up in therapy.

Your therapist isn’t there to judge you. You can tell us about thoughts, feelings, experiences and things you’ve done that you may find difficult to tell anyone else about.

You also don’t need to worry about shocking or offending your therapist. That doesn’t mean they’ll agree with everything you say or do: it’s their job to help you understand what’s happening and why.

Yes. Confidentiality is an important part of therapy, and we’ll explain exactly what it means before therapy begins.

In short, though, your therapist won’t normally repeat what you say to your parents, carers, school or other people in your life.

However, there are limits to confidentiality. If we become seriously concerned that you or somebody else may be at risk of harm, or there’s another serious reason we need to share information to keep someone safe, we may need to involve somebody else. Wherever possible, we’ll talk to you about what needs to happen and why.

No. We don’t give parents or carers a report of what you talk about in therapy.

We may sometimes give them general information about how therapy is going or whether it’s still helping. That doesn’t mean telling them what you’ve said.

And if there’s something important you want to tell somebody but don’t know how, your therapist can help you work out what you want to say.

Yes. They can contact us if they’re worried or think there’s something we should know. That doesn’t mean your therapist will automatically agree with what they say, discuss it with you in a session or tell them anything about your therapy in return.

If they do want to tell us anything, we ask parents or carers to speak with our clinical team first, rather than using your session time to update your therapist.

It depends on your age and circumstances. If you’re younger, a parent or carer may need to be involved in things like consent and booking appointments.

But that doesn’t mean they’re with you in sessions. Therapy at TMH is usually one-to-one, so sessions are for you and your therapist. What you discuss is confidential within the limits we’ll explain before therapy starts.

Your therapy doesn’t suddenly have to stop. If it’s still helping and you want to continue, you can carry on working with your therapist into adulthood. The main change is that decisions about your therapy, including who we’re allowed to communicate with, become yours to make.

No. You don’t need a diagnosed mental health condition before you come to therapy.

You might want help with feelings, relationships, behaviour, experiences or something about yourself you’re trying to understand.

If you already have a diagnosis, or you’re being assessed, we’ll take that into account – but it’s only one part of who you are, not the whole story.

TMH provides therapy, not formal diagnostic assessments. But we work with many of the struggles and experiences that can come with these conditions, whether you have a diagnosis or not.

And if we think a specialist assessment could be useful, we’ll talk that through with you and help you understand what other support might be appropriate.

Yes. Therapy isn’t about trying to remove or change your neurodivergence. But it can help with things you struggle with alongside it, such as anxiety, relationships, identity, self-esteem or difficult emotions.

We can also adapt the way we work to suit how you communicate, as well as any sensory or other individual needs.

You don’t need to be good at talking about emotions to have therapy. We see lots of people who are experiencing something difficult but can’t identify or explain what they’re feeling.

Your therapist can help you with that rather than expecting you to arrive with the right words.

You may see things differently from your parents, school or whoever’s worried about you. That doesn’t automatically mean they’re right and you’re wrong.

We want to hear what things are like from your point of view. Your first appointment will give you a chance to do just that, and decide what you think about therapy.

Yes. Therapy works best when you’re willing to give it a try. We don’t want to force or pressure you into it.

If you’re not sure, it’s still worth coming to the first appointment before you decide. Meeting us doesn’t mean you’ve agreed to ongoing therapy.

If you decide it isn’t right for you, we’ll respect that.

Tell us. The relationship with your therapist matters, and not every pairing is going to be right.

Sometimes the relationship can feel more difficult because therapy has touched on a difficult topic, so it can be worth talking honestly with your therapist about what isn’t working.

Equally, sometimes the fit simply isn’t right. And if that’s the case, we can talk about whether another therapist might suit you better.

There are lots of different approaches to therapy, and what works for one person won’t necessarily work for somebody else.

Your first appointment helps us understand what you’re struggling with, what you want help with and which therapist or way of working might suit you. After that, we can think about which approach or combination of approaches might help, from CBT and psychodynamic therapy to creative approaches and Eye Movement Desensitisation and Reprocessing (EMDR), which can help with traumatic memories.

There isn’t a set answer. Some people come with something fairly specific they want help with. Others need more time to understand experiences, feelings or patterns that have developed over years.

We won’t rush you. But therapy shouldn’t continue forever just because you started it either.

You and your therapist will keep talking about whether the work is helping and when the time might be right to end.

Change isn’t always dramatic or immediate. You might notice that you understand yourself better, react differently to something that usually causes problems, recognise a pattern, or find it easier to talk about something.

Sometimes the difference becomes clear while you’re having therapy. Sometimes you only notice it later. You and your therapist will keep talking about what’s changing and whether the work is helping.

That can happen. Talking and thinking about things you’ve struggled to understand can sometimes bring up difficult feelings.

But that doesn’t mean you should simply put up with feeling worse. Tell your therapist what’s happening. To help, they need to know what the experience is like for you.

No. You don’t need to wait until things become unbearable before asking for support.

Therapy can help when something difficult is happening now, before something becomes a crisis, or simply because there are things about yourself, your relationships or your experiences that you want to understand better.

Yes. Talking about self-harm or suicidal thoughts doesn’t automatically mean you’ll be sent to hospital or that your therapy has to stop.

Your therapist will listen and talk with you about what you’re experiencing and how safe you are.

If we believe there’s an immediate or serious risk to you or somebody else, we may need to involve other people or services to keep everyone safe. But wherever possible, we’ll involve you in understanding what happens next.

Yes. Therapy isn’t about deciding whether you’re a good or bad person. You can talk about things that feel embarrassing, confusing or incredibly difficult to say out loud.

Your therapist is here to help you understand what happened, what you were feeling and what it means to you now.

Yes. You can use therapy to think about sex, sexuality, gender, relationships, identity or questions you don’t feel able to explore somewhere else.

You don’t need to know exactly how you identify before you talk about it, either. Your therapist isn’t there to push you towards a particular identity or conclusion. Sessions are an opportunity for you to work out what these things mean to you.

Yes. Friendships, dating, break-ups, rejection, loneliness, fitting in, family relationships, trust and feeling close to people can all be part of therapy. Your therapist can help you understand what’s going on and what might help.

Yes. Things that happen online can affect you just as much as face-to-face situations.

You can talk about social media, group chats, gaming, online friendships, bullying, exclusion, comparison, sexual content or anything else that’s happened online – we won’t suggest the only answer is to switch your phone off.

Yes. Struggling with education can be about much more than the work itself. You might be dealing with anxiety, attendance, pressure, friendships, bullying, concentration, neurodivergence, motivation, expectations or the fear of failure.

Therapy isn’t simply there to make you attend more or get better grades. It’s about understanding what the experience is like for you and what might help.

Yes. TMH therapists don’t prescribe medication, but lots of people have therapy while taking medication.

We won’t tell you to start, stop or change it. But it’s helpful for us to know what you take and if anything changes, as medication can sometimes affect how you feel.

Often, yes. It wouldn’t be appropriate to receive the same or very similar therapy from two therapists at the same time.

But when different services provide different kinds of support, therapy doesn’t automatically need to stop. With the right permission, we can also get in touch with the other professionals supporting you, so that the different types of support fit together.

Usually, no. If it would help to speak to another professional, we’d normally discuss this with you first and get the right permission.

However, there are exceptions if we have a serious concern about your safety or somebody else’s. But speaking to somebody else doesn’t mean giving them access to everything you talk about in therapy.

If something important happens that you think your therapist should know about, you can contact us or use whatever method of contact you’ve agreed with your therapist.

They may not be able to reply straight away, but you can talk about it in your next session.

However, TMH isn’t a 24-hour crisis service. If you or somebody else isn’t safe and needs help straight away, get urgent help rather than waiting for your therapist to respond.

Yes, if you have an agreed way of contacting them.

Your weekly appointment is still the main time for therapy, and our therapists work part-time, so you shouldn’t expect an immediate response.

If you need practical help from TMH between sessions, our reception or clinical team may also be able to help.

Therapy at TMH usually happens once a week, at the same time each week.

This regularity helps you and your therapist build a strong relationship and keep the work moving from week to week.

We appreciate you’ll have holidays and other events, but regular interruptions can make it harder to keep the therapy moving forward. It’s worth thinking about whether a weekly appointment will work for you before accepting a regular place.

Because that time has been reserved for you, your usual weekly fee still needs to be paid if you miss or cancel a session.

Sometimes we can arrange for the session to be online, but this depends on the circumstances and your therapist’s availability and can’t be guaranteed.

No, not simply because they’re paying for it. Paying for your therapy doesn’t automatically give somebody the right to know what you talk about. The usual rules around confidentiality still apply.

Sometimes. Some people prefer being in the room with their therapist. Others find online sessions easier or more accessible. So if online therapy is suitable for you and the kind of work you’re doing, sessions can take place by video call. We can talk with you about which option’s likely to work best.

You can decide you don’t want to continue – we won’t force or pressure you to remain in therapy. But if possible, we always encourage having a final session.

This gives you and your therapist a chance to think about the work you’ve done, what may have changed and what you’ve got out of the sessions.

We’ll respect your decision, but we’d encourage you to consider having one final session. Stopping suddenly can leave things feeling unfinished, and a last session gives you a chance to talk about why you want to stop.

If it doesn’t feel right to have this last session immediately, it may sometimes be possible to arrange a final session a little later.

Potentially, yes. Ending therapy doesn’t mean you’ve failed or that you can’t ask for support again.

People change, circumstances change and new things happen. If you want help again in the future, you can contact us and we can talk through what you need then.

You don’t need to prove that your problem is serious enough. Something can matter to you without being a crisis, a diagnosis or something other people can see.

Your first appointment gives us a chance to understand what’s happening and whether therapy might help. And if we don’t think it’s the right support, we’ll tell you.

Therapy isn’t a competition over who has had the hardest time. Someone else having a hard time doesn’t make what you’re going through any less important.

If something’s affecting you, or you want help understanding yourself, your relationships or your experiences, you’re allowed to ask for support.

No. Therapy isn’t about turning you into somebody else or somebody else’s idea of who you should be.

It’s about understanding yourself better – your feelings, relationships, experiences and the ways you respond to things. What you do with that understanding is up to you.

It’s understandable that your relationship with your therapist may become important to you – having someone you trust and a set time where you can focus on yourself can make a real difference.

But the aim isn’t to make you dependent on therapy. Over time, what you learn about yourself should become something you can use outside the therapy room.

That’s fine. There’s no correct way to behave in therapy. You might cry, laugh, get angry, feel awkward, sit quietly, change the subject or sometimes not feel much at all.

You don’t have to perform therapy or react in the way you think your therapist expects.

Tell them. Therapy isn’t about your therapist always being right. They might notice something, suggest an idea or wonder about what something means. You’re free to disagree.

Talking about why you see something differently can be just as useful as agreeing.

Therapy should be something you choose thoughtfully, not something you simply get signed up for. But you don’t need to decide before you meet us.

Your first appointment gives you a chance to see how we work, ask any questions and get a sense of whether you’d be comfortable talking to one of our therapists.

We’ll be thinking about it too, because we’ll only suggest ongoing sessions if we genuinely believe they’ll help.

Something doesn’t have to be happening now for it still to matter or affect you. In therapy, you can talk about difficult, frightening or harmful experiences from your past, including things you may never have spoken about before. You don’t have to tell everything at once, either.

Talking to us about something from the past doesn’t automatically mean we have to share it with other people. But if what you tell us makes us concerned that you or somebody else may not be safe now, your therapist may need to think about whether anything else needs to happen. Wherever possible, they’ll talk this through with you and explain what happens next.

Yes. You don’t need to change the way you normally speak or worry about finding the ‘right’ words in therapy.

You can swear, get angry, disagree, have strong opinions or talk about thoughts and feelings you worry other people might judge you for. Your therapist is there to understand you, not tell you what you should think or believe.

You can say what you think, but we do ask that you don’t threaten or hurt your therapist or anyone else at TMH.