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How to structure a therapy session

Learn more about creating a routine that works for you and your clients.

December 9, 2024

5 min read

Therapy can be hard and vulnerable work. Creating a predictable routine in how you structure therapy sessions can help create a sense of safety for clients, helping strengthen your therapeutic relationship and your ability to support whatever they’re struggling with. 

But what’s the best way to structure a therapy session? Below, learn more about how therapists can structure their sessions, and how to create a routine that works for you and your clients.

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How can you structure a therapy session?

How to structure a therapy session can vary among therapists and their clients. In general, an intake session will look different than a standard session or a discharge and crisis session. A prescribing provider may conduct a session differently than a licensed professional counselor, social worker, or a marriage and family therapist. 

Certain treatment protocols, such as EMDR, can also shape the structure of a therapy session. And at times, a client’s needs may dictate how a session goes. But in general, a few key components can help you guide your work with clients, ensuring you make the best possible use of your time in session.

Beginning of session

At the beginning of the session, after greeting your client, do a quick read of how they’re doing. You may need to help them transition to the therapy space. “If someone is late or clearly looking at their phone or other tabs on their computer, I like to give them a minute or two to settle in,” says Julia Jarrold, a licensed therapist and Headway’s clinical lead of patient and provider experience. 

A few questions can help you and your client connect at the beginning of the session and determine the direction of your time together: 

  • Can I be helpful in helping you ground yourself before we get started? 
  • Would it be helpful to revisit anything from the last session? 
  • What would you like to accomplish in today’s session? 
  • Is there anything else that feels especially important to work on today?

During the session

As your client opens up about how they’re feeling and what they want to accomplish in session, you'll start determining how best to guide the session, incorporating expertise from a particular modality or inferring what interventions may be most helpful. This work can also vary among therapists, but in talk therapy, it often looks like listening to your client and offering interventions as appropriate. 

Try to be conscious of meeting the client where they are. “Assess throughout the session if you need to slow the client down or dig into specific areas, or make notes of what you want to ask later on,” says Jarrold.

Generally, it’s a good idea to pause before intervening. Active listening, or reflecting back anything your client shares, is a great strategy. Pay attention to how your client presents emotionally and physically during this time. If they seem upset or dysregulated, Jarrold recommends using a grounding technique before you move forward.

Nearing the end of the session

Therapists are responsible for keeping time, and part of that means being conscious of what’s being shared, when to intervene, and what can be bookmarked for the following session. Toward the end of your session, try to restate what you’ve heard from your client and remind them of their progress and goals. 

Keep an eye on the clock and wait for a good time to make your client aware of the time limitation. You may want to ask how they’d like to use the last few minutes of your session, or plan in advance how you both like to end your time together during therapy.

“I have some clients who only want to talk about logistics around scheduling at the end, and others who like to end sessions with breathwork,” says Jarrold. “This can be something you co-design, but as a therapist you hold the responsibility for remembering and implementing these things.”

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This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.

© 2026 Therapymatch, Inc. dba Headway. All rights reserved. No part of this publication may be reproduced without permission.

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