What to expect in therapy — and what you're allowed to say no to
A plain-language handout you can review with clients in session. Print it. Keep it. Push back if something here gets ignored.
Nothing is stored. This page forgets you when you close it.
For therapists: this is psychoeducation, not a substitute for your informed-consent packet or state-required disclosure.
Pair it with your legal forms. Invite the client to mark what they want to talk about next time.
What therapy is for
A place to understand patterns, feelings, relationships, and choices — with support.
A collaboration. Your therapist brings training; you bring expertise on your own life.
Work that should leave you more able to choose, not more dependent on the therapist's approval.
What you can usually expect
Clarity about the frame: fees, cancellation policy, privacy limits, and how to reach your therapist.
Goals you help set: what "better" means should sound like your words, not only clinical jargon.
Consent that continues: you can revisit methods, pace, homework, and who is in the room.
Honesty about limits: if something is outside their competence, they should say so and help with referrals.
Respect for your pace: useful challenge is normal; pressure and shame are not the method.
You are allowed to…
Ask "why are we doing this?" about any intervention, diagnosis label, or homework.
Say no to an exercise, recording, touch, or between-session task.
Request a slower pace, a different approach, or a second opinion.
Bring a support person when appropriate, or ask for individual time in family/couples work.
Read what you're signing. Take forms home. Ask for plain language.
End therapy, take a break, or switch therapists without performing gratitude.
Ask how notes are written and what would appear if records were released.
You do not have to…
Accept a goal you didn't help create.
Agree that a diagnosis is the whole truth about you.
Share every detail before trust exists.
Keep a therapist who dismisses your culture, identity, or values.
Do homework that feels unsafe, shaming, or impossible this week.
Stay silent about ruptures — naming "that didn't sit right" is part of the work.
Trade your autonomy for "being a good client."
Privacy — the short version
What you say is generally confidential, with important legal exceptions (like safety and mandated reporting) that your therapist should explain in plain language.
In couples/family therapy, ask how secrets are handled before you share one.
You can ask who else might see information (insurance, courts, parents/guardians, supervisors).
If something feels off
Try saying:
"I want to keep working together, and I need to name something that didn't feel okay…"
Or:
"Can we revisit the goal? The plan is starting to feel like your plan, not mine."
Or:
"I'm not consenting to that approach. What are the alternatives?"
If you don't feel safe raising it in the room, you can contact your therapist in writing, seek another clinician, or — when needed — use your state's health-profession complaint process. In Washington, disclosure paperwork should include Department of Health complaint contact information.
Optional: mark this together
☐ I understand the basic frame (fees, privacy limits, how to reach you).
☐ I had a real say in the goals.
☐ I know I can refuse an intervention without being "noncompliant."
☐ I know how to bring up a rupture or request a change.
☐ Something I still want explained: _______________________________
Handout from tawney.family. Free to use in clinical practice. Not a substitute for required informed-consent or disclosure documents. No client data is collected by this page.