Thinking About Therapy? Here's What to Expect
Sitting across from a complete stranger and talking about your thoughts and feelings every week can feel... well... weird. If you haven’t had this experience before, it can be intimidating to start the process and find someone that you feel comfortable with. Here’s a look into searching for a therapist, the process of getting started, and insight into your very first session.
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What Do Therapist Credentials Mean?
There are so many acronyms after a therapist’s name, so it can be confusing to know who is a good fit and who is best suited for your needs. The first thing to check is whether they are licensed (or legally practicing under supervision) in the state where you will be physically located during sessions.
Next, you may have a preference on what kind of license they have. A lot of different degree programs and licensing boards allow for people to work in the mental health field. The common ones are:
Licensed Professional Counselor (LPC)
Licensed Clinical Social Worker (LCSW)
Licensed Marriage and Family Therapist (LMFT)
Psychologist (PhD or PsyD)
Psychiatrist (MD or DO)*
Licensed Mental Health Counselor (LMHC)
All of these require at least a Master’s degree in the field of counseling or social work. None of these licenses is inherently "better" than another. They simply represent different educational paths and areas of emphasis.
You may also see provisionally licensed therapists, like me! This can be:
Resident in Counseling (working towards LPC licensure)
Associates (LPC-A)
Associate Marriage and Family Therapist (AMFT)
Licensed Clinical Social Worker Associate (LCSWA)
These are therapists that have completed their Master’s degree from an accredited university (including hundreds of supervised practicum and internship hours), and are completing supervised post-graduate clinical hours toward independent licensure.
*Many focus primarily on medication management rather than ongoing psychotherapy.
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Where Do I Search For A Therapist?
To find a therapist that can help with your specific concerns and/or goals, it’s important to read all about them. Many therapists maintain profiles on directories like Psychology Today, but you can also find providers through your insurance directory, referrals from your primary care provider, or a therapist's own website.
Be sure that the therapist is taking new clients, and see how they prefer to be contacted (this might be phone, email, or through a form on their website).
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What Happens During a Therapy Consultation?
A lot of therapists offer free or low-cost consultation calls. This is where you can introduce yourself and what you are looking to achieve in therapy. During this call, you can also ask your therapist any questions you have. Some questions I recommend asking are:
What is your experience working with [insert concern here]?
Have you worked with clients that share my [identity/culture/religion] before?
What is your therapy style? Are you direct, structured, laid back, etc.?
Do you take my insurance? Do you offer sliding scale options for low-income clients?
Do you offer in-person or virtual sessions?
This is the time to get a feel for their personality, experience, and therapeutic approach. Schedule a few calls with different providers to get a good idea of your options.
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What Happens During The First Therapy Session?
All of these considerations have brought you here. You found someone that seems great, and you’re ready to get started. Heads up: you’ll have to fill out some paperwork. Most of it is pretty simple, and will just gather payment and insurance information. Other forms are worth reading carefully before signing. One is going to be an informed consent document. This will explain everything that may take place, and how your information is protected under HIPAA. Confidentiality is KEY in therapy in order for you to feel safe, so be sure you understand exactly how your therapist protects your privacy.
There will also likely be an intake form. You may complete this before your first appointment, or your therapist may review it with you during the intake session. This will go over your mental health history, support system, career, health, and more. This allows your therapist to better understand you and your life and tailor care to you.
The rest of the session will depend on your specific therapist. In my intake sessions, I like to discuss any further details from the intake form in order to be sure we’re on the same wavelength. Then, we will go over what goals you have for treatment. Some questions I like to ask clients are:
How will you know that our work together is progressing?
When you are done with therapy, what will look different in your life?
What are you hoping to learn or improve on during our time together?
Is there anything that would make me or this space more approachable or comfortable for you?
Do you work better with directness and structure, or would you like a more open and free-flowing approach?
This allows me to “set the stage” and understand you clearly so that I can tailor a treatment plan and approach to your specific needs. Everyone that comes into my office is entirely unique, so there is never a one-size-fits-all approach.
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What If My Therapist Isn't the Right Fit?
This happens more often than people think, and it usually isn't anyone's fault. If you're simply not clicking with your therapist after a few sessions, it’s absolutely okay to let them know! One of the greatest impacts in therapy is the relationship and trust between a client and therapist. If that comfort isn’t there, not much else is going to be helpful. You can send a message or email to your therapist letting them know it isn’t the right fit, or you can mention it in a session. Either way, therapists understand they won’t be the ideal therapist for everyone, and will gladly provide referrals to other providers if you need them!
*Now, if you want to stop seeing a therapist because something happened in or out of session that made you uncomfortable or felt wrong, you can bring that up with your therapist as well. If you are unsure about ethical or legal issues, there is also a way to file a complaint with the therapist's licensing board if you believe there has been an ethical or legal violation. This is a major step, but necessary to keep clients and this profession safe. Your therapist’s license number and board information is most likely listed on their website or in their paperwork.
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Okay, I just threw a LOT of information at you. This process can be really intimidating to first-timers, and as someone who's been on both sides of the therapy room, I understand that feeling. Hopefully this article gives you insight into the process so you can feel prepared and informed as you start your therapy journey. If you have questions, feel free to reach out using my contact form and I’d be glad to help you!
Starting therapy is a huge step. Whatever you're feeling is okay, but I hope you're also able to feel proud of yourself. It’s hard to be vulnerable with a stranger and ask for help. But putting yourself through the discomfort to find growth, peace, and happiness is always a worthy endeavor.