“Therapy isn’t for me.”

As a clinical psychologist, I hear versions of this fairly often. Sometimes it comes from someone who tried therapy once and had a terrible experience. Other times, from someone who has never been and thinks talking to a complete stranger about their deepest feelings would be their worst nightmare.

I can understand why. An unhelpful experience can leave a lasting impression, and therapy can look fairly strange from the outside. But one experience, or one idea of what therapy is, does not necessarily tell you what another might be like.

Therapy is an unusual relationship. We take two strangers and expect one of them eventually to talk about things they may barely discuss with the people closest to them.

Decades of research have shown that the relationship you develop with your therapist is one of the most important factors associated with how therapy goes. That does not mean you need to feel immediately at ease, or that good therapy should always feel comfortable. Sometimes therapy is uncomfortable precisely because you are talking about things you normally avoid. But there is a difference between therapy feeling difficult and feeling that the person sitting opposite you just doesn't get you.

Trust takes time. You learn whether someone listens, how they respond when you say something difficult, and, importantly, what happens when they get something wrong. Therapists make mistakes. Being able to say when something hasn't felt right, and to talk it through together, can be an important part of building trust.

You don't have to walk out of your first session feeling you've found the perfect therapist. But you should have some sense of whether this is someone you could eventually trust with the things that matter to you.

Then there's the question of what happens once you're in the room. Not all therapy involves talking about your childhood, although in fairness, if you come to see me, I'll probably ask about it.

Therapy can feel very different depending on the approach. Some therapy is more structured and practical, focusing on a particular problem and ways of managing it. Other therapy is more exploratory, with space to develop a deeper understanding of yourself, your relationships and the patterns in your life. Many approaches draw on elements of both.

You do not need to know exactly what kind of help you need before you ask for it. Part of the process is being open to discovering what might help. And sometimes that means recognising that individual psychological therapy isn't what you need at all. You may need something more practical. You may benefit from a session with your partner or family. Or you may find that something in the circumstances around you needs to change.

Sometimes our distress is a response to the relationships, pressures or circumstances we're living with. Talking cannot solve every problem, and not every problem needs to be solved within the person experiencing it.

But talking with someone can help us make sense of what is happening and see it from another perspective. From there, we can think together about what might make a difference, both within and outside the therapy room.

World Mental Health Day in October prompted plenty of conversations about mental health and the importance of seeking support. But support does not have to look the same for everyone.

There is no prize for being in therapy, and therapy does not have to be the answer. But deciding therapy isn't for you should not mean deciding you're on your own. There are many ways of being helped. The important thing is simply to stay open to the people and possibilities that might make things feel different.

• Lizzy McManus is a Bermudian clinical psychologist at Solstice, a leading multidisciplinary mental health and wellbeing organisation in Bermuda, providing compassionate, confidential and evidence-based care across the life span