Cartoons often depict a patient lying on a couch and looking at ink blot pictures in a therapist's office. It's such a common notion, that patients regularly entered my office asking, "Where's the couch?" (I only had chairs).  

The Hollywood portrayal of therapy isn't any more accurate than the Dilbert depiction. In the movies, therapists often become friends with their patients--or even fall in love with them. In reality, therapists are trained to establish healthy boundaries that shouldn't be crossed.

If cartoons and movies have been you're sole source of information about therapy, you're not alone. Consequently, you may have a lot of questions about what therapists actually do, how treatment could help, and whether you should actually talk to someone.

Here are the top seven questions I've heard from people who are considering going to therapy:

1. Is my therapist going to judge me?

Whether you've got an embarrassing addiction, or you're having an affair, your therapist isn't going to deem you a bad person. Don't worry. No matter how bad you think your story is, the therapist has probably heard it all before.

Their job is to help you come to your own conclusions about what's best for you. They won't condemn you for your mistakes or shame you for your past.

2. Do I have to talk about my childhood?

No. You don't have to talk about anything you don't want to. Your therapist may encourage you to address tough issues, but ultimately, you're in charge of the topics you discuss.

If you're not comfortable with certain subjects or you don't want to answer some of the questions a therapist asks, you aren't under any obligation to talk.

3. Is online therapy an option?

Yes. Online therapy is definitely an option. You can access a licensed mental health professional from your desktop or mobile device. It's a convenient and more affordable alternative to face-to-face therapy.

Most online therapy sites, like Talkspace or Betterhelp, allow you to use a nickname so you can remain anonymous. Most also allow you to message, live chat, or attend video or phone sessions with a therapist.

4. How many sessions do I need?

This depends on the issues you're addressing and the type of treatment you're receiving. Some treatment, like cognitive behavioral therapy, is often short-term. You might find eight therapy sessions are enough to help you find relief.

In other cases, therapy is more long-term. Someone who has a complex history of grief or trauma may attend therapy for several years. But you can talk to your therapist about your expectations up front.

5. What actually happens during therapy?

Most therapists don't prescribe medication. Instead, they focus on talk therapy.

Your therapist may ask you some questions about your past. You might also share information about your day to day life, your emotions, or the way you think.

Your therapist may also work on teaching you specific skills, like anger management strategies or anxiety reduction skills. Your treatment depends on your goals.

6. Will anyone know I see a therapist?

Your treatment is confidential, and your therapist will need to follow strict ethical codes and laws. Your therapist may only violate your confidentiality if there is a safety issue--as in the cases of child abuse or a serious threat to someone's life.

If you have specific concerns, like you don't want your partner to know you're in treatment, or you're worried about running into someone you know in the waiting room, talk to your therapist about it.

7. How do I know if I need to see a therapist?

There are many reasons you might want to see a therapist. Anything from difficulty concentrating, trouble sleeping, high stress levels, relationship difficulties, high anxiety, depression, and trauma are just some of the reasons people commonly seek help.

Published on: Oct 10, 2019
The opinions expressed here by Inc.com columnists are their own, not those of Inc.com.