Top 10 Questions for First-Time Therapy Seekers
What concerns are appropriate for therapy? What should I talk about?
If something concerns you, no matter how big or small, it’s appropriate to bring to therapy. The concerns can range from a desire to develop greater self-awareness, relationship stress, to more “serious” concerns like anxiety disorders, depression and trauma. In most instances, people seek therapy with multiple concerns or may start with a primary concern that spins off into other areas as the therapy progresses. If you have an inclination to go, why not try it out? The truth is, everyone can benefit from therapy regardless of how much distress the concerns are causing. If you’re not in crisis mode, you have a beautiful opportunity to develop and deepen skills to support you moving forward. If you’re highly distressed, therapy is shown to be effective and can be combined with psychiatry and other services to alleviate and manage mental health challenges.
2. What happens in therapy?
At the beginning of therapy, most therapists will conduct an initial interview where they gather information about whats bringing you in, any symptoms, along with family and personal history. This allows the therapist to get a well-rounded picture of what is contributing to your concerns, so they can assist in developing a direction for treatment customized for you. After the initial assessment phase, usually 2-4 sessions, you will meet weekly to discuss your concerns, receive non-judgmental support and expertise on navigating the challenges you are facing. Depending on the goal, your therapist will guide you through developing deeper insight into your particular issues and collaborate on making incremental changes that advance your goals. Your therapist will help you reflect regularly on your progress and make any necessary adjustments moving forward.
3. How do I find the right therapist?
It is important that you find a therapist with whom you “click” and who has expertise in your concerns. A good relationship between the client & therapist is the single biggest predictor of therapeutic success. I have a blog outlining this question in more detail here.
First, you should determine whether you’d like to use insurance, your budget, and what setting (in person or virtual) suits you. Narrow your search to meet those criteria first on therapist directories or google searches. Then, reach out to a therapist who’s online presence seems like a good fit. From there, most therapists offer a free phone consultation to ensure you get along before starting. If you start and end up not clicking or feeling understood, there is also no shame with continuing your search. Remember, good therapists want to assist you in finding the right fit, even if that means switching providers.
4. How long will I be in therapy?
As long as you’d like to be an no longer than that! The length of therapy can vary greatly depending on what you’re looking for and what’s bringing you in. Some people find they work through their concerns in several months and are able to manage their mental health on their own. Others stay for many months or for extended long-term therapy with no particular end date in mind. You can expect to see the largest change in the initial phase of therapy, but many people find value in continuing beyond this. It is often useful to continue therapy in order to stay accountable to the progress you’ve already made and keep on developing those skills. Some people choose to end after reaching their initial goals, while others switch to a less frequent meeting schedule to continue receiving support for long-term struggles that flair up as life happens.
5. How will I know if therapy “works” for me?
It takes time to build a therapeutic relationship, so therapy seekers are often told to try it out for a few months if they are unsure. Knowing if it’s working for you could vary greatly depending on your expectations. Typically, clients will know it’s working when they develop a sense of deeper self-awareness and feel they are being challenged in a way that’s promoting growth. It’s an awesome feeling when you realize that some of the work done in the therapy hour translates to how you experience or view life and your challenges. If things are looking more hopeful, meaningful and vibrant, you’re onto something good!
6. How does confidentiality work?
Part of what makes therapy special is it’s confidentiality. 99% of the time, you can be assured that what is said between therapist and client remains private. Confidentiality is part of the legal and ethical requirements to conduct psychotherapy and is outlined in the informed consent that you sign prior to starting therapy. Nothing will be shared with anyone unless you sign a release for information to be shared. This is sometimes helpful if your therapist would like to discuss your case with your psychiatrist or medical doctor. There are two limits to confidentiality that clients need to be aware of. The first relates to our legal designation as mandated reporters. This means that if you report that child or elder abuse is happening, family or not, we are required to make a report to protective services. The only other time a therapist would break confidentiality is if the therapist determined a serious safety risk to yourself or others. This can be necessary to prevent harm in clients who are suicidal.
7. Does it make sense to pay out-of-pocket?
Paying for therapy services out-of-pocket gives you more freedom and choice when compared to strictly staying in network. Many clients also do not have mental health benefits or the benefits come with time restrictions and co-pays that are just as expensive as out of pocket. The major benefit of paying out-of-pocket is that you can choose a therapist who is an expert in your concern. That therapist will not be beholden to the insurance company and will not be required to give you a diagnosis. This means that you can work on whatever you want, for as long as you want. Your information and details of your treatment will not be shared with your insurance which is beneficial for clients who prioritize privacy. Additionally, some insurances offer out-of-network benefits. Out-of-pocket therapists can also provide you with a receipt for you to submit to your insurance who will then reimburse you for the partial or full-cost of sessions.
8. How often should I meet with my therapist?
In order to establish a solid therapeutic relationship, most therapists will suggest meeting weekly to start. Generally, meeting weekly provides the momentum and engagement that results in the best outcomes. The frequency of meeting is determined by the therapist based on what is most appropriate for your unique situation. This is often determined collaboratively and can be adjusted as needed. Many of my clients have taken breaks for vacation or switched frequency for particular reasons and resume weekly when their situation changes.
9. What if I don’t want to talk about certain topics?
You are in control when it comes to sharing. Sometimes we aren’t ready to open up or go deeper into a particularly difficult topic. Your therapist will respect the pace you set and should not probe further than what is comfortable for you. You should never hesitate to communicate with your therapist around what topics are off-limits. If things naturally change as time goes on, feel free to bring up previously off-limits topics with your therapist. They will work with you collaboratively to make sure you stay emotionally safe while going into sensitive issues.
10. What do I do if I don’t feel good about something that happened in therapy?
At it’s core, therapy is a relationship between two people. If you are left feeling misunderstood or hurt by something your therapist says, you should bring this up to them in a way that feels comfortable. This will give you and your therapist a chance to be accountable to any harm caused, and to explore what happened. Often, these situations can lead to insights for clients and therapists about what would be more beneficial to the client’s process. Rupture and repair are part of life and can be a safe place to experience advocating for yourself in a supported way.
Still have questions? Interested in connecting? Reach out to me!
