I think I’m ready for counseling, Now what?

Curious about the therapy process?

Keep reading.

If you are reading this then maybe you or someone you know may be interested in starting counseling. Going to therapy can be a wonderful thing for self-growth and development and it can also be nerve-wracking and confusing. Here are some thoughts from a therapist for those interested in reaching out for some extra help.

How to start looking for a therapist?

How do I find a therapist near me?

Looking around for therapists is often the first step in starting therapy. If you want to use your insurance some good first steps would be to call your insurance company and see what they cover. Ask about if they cover copays, do you have to meet your deductible first, do they cover in person or online therapy, do they limit the number of sessions you can have or the length of sessions, and if they require a diagnosis on file. You can also ask them if they have anyone in their network that they can recommend.

If you’re using insurance, another good spot to look for therapist are online directories such as Psychology Today, Mental Health Match, Therapy Route, and more. You can go to those sites and search for therapists for free most of the time! The biggest perks of those directories are that you can filter down the options! Instead of sifting through hundreds of profiles, you can filter options down based on insurance/price, gender, specialties, and more. The biggest downside of these platforms is they are not always up to date so while their page may say they are accepting new clients, about 50 percent of the time when you reach out and ask them if they are accepting new clients, they say they are full or not respond to you. Because of this, it is a good idea to try to find 3-5 options to reach out to in hopes that one of them you like has an opening.

If you don’t want to use your insurance, or if you do not have insurance, you have a lot more options! Many therapists offer private pay sessions which means you pay them yourself without using insurance. You can read more about why some therapists do this HERE. Prices vary depending on the training, location, and specialties of the therapist. You can find these therapists often through their websites and through other providers you may know. For example, if you’re a new mom and wanting help managing the changes of motherhood and balancing going back to work, you can ask your OBGYN if they have any recommendations for therapists. Specialized therapists often work as a team with providers so you can get someone you trust who understands your unique situation.

If price is a factor, some therapists offer a sliding scale which is based on household income. If you need other options, many non profits offer free or reduced counseling for folks in their community. Also, many training programs offer free or reduced services if you are willing to meet with interns or students. Feel free to reach out to them and they can also connect you with places based on your financial needs.

Tip- don’t wait until rock bottom to reach out for help.

Many therapists, especially those who take insurance or work with special populations, are often on a wait-list which can be really frustrating if you are looking for help now. Time slots like evening and weekend spots also fill up fast and may require a longer wait-list as well.

What happens after you find a therapist you’re interested in?

Now you get to reach out to them. Some places you reach out directly to the therapist by calling or emailing them. When doing so, it is helpful to leave a short yet informative message about why you’re calling. You can say your information, the services you’re interested in, and good times to call back or email. I hear it a lot from my therapist friends who say they get a lot of people calling yet not leaving voicemails. Most places will not call you back if you don’t leave a voicemail due to safety and confidentiality concerns. If you are emailing, feel free to give a quick sentence update on what your goals are and that can help the therapist determine if they could be a good fit.

Many therapists, especially in private practice, are having interested clients schedule a time for a free video or phone consultation. This limits phone tag and increases the chances you will get a hold of someone ASAP. Some places don’t return voicemails for days or weeks. Whereas if you schedule something, you know you are going to get to talk to that person at that time! Check out what a sample consultation request looks like HERE.

BTW- Some places, like agencies, assign you to a therapist after you complete an “intake” form or questionnaire. We can talk more about this later when discussing therapist fit, but just know if you are not ready to answer those questions when talking to the agency, you can always call back when you have that time and are in a private, secure place.

Maybe you actually get a hold of the therapist on the first try or you are prepping for your scheduled consult call!

Here are some questions to ask them to see if they’d be a good fit.

1.      what kind of therapy do they do and what are they trained in?

2.      do they have experience working with clients like you and people with your goals?

3.      what to expect in the first session?

4.      how do they give and receive feedback?

5.      are they more short term or long term oriented?

6.      do they focus more on the present, future, or past?

7.      do they take your insurance and how do they handle costs/fees?

If you are talking to a therapist on the phone, you don’t have to schedule right then. They may tell you they are booking up or can’t hold a spot, which is true, but if you are not ready to schedule and need to reflect on their answers, feel free to say you will call them back. This is why it’s important not to wait until rock bottom because if you do decide you want to schedule with them and they fill up, you may have to go on a wait-list or get another referral.

Your first session is booked, now what?!

This may look different depending on the type of counseling you’re looking for and the type of therapist. Typically though, an intake session, or first session, is generally a time to go over paperwork, ask questions to the therapist, begin building trust with the therapist, and the therapist will start asking questions to assess goals and what is going on.

REMINDER- you never have to disclose anything you aren’t ready to. A therapist may ask about past traumas, relationships, or things you haven’t talked about and you can always tell your therapist you aren’t ready to disclose that yet but that the therapist can ask in a few sessions or you can bring it up when you’re ready.

Another reminder- it is YOUR hour which means you have full control in that room. A therapist has tools and ways to get you to where you want to go, but you get full control on what paths you want to go down and what topics you’d like to explore. It is okay if you don’t fully like or trust your therapist in the first session. Especially for new folks, therapy can take some getting used to so I always recommend 3-4 sessions to see if it gets easier. HOWEVER- if your therapist offended you, made you feel unsafe, or you left feeling gross afterwards, it is okay to end the therapy relationship sooner. Therapy can be really confusing for new folks so please reflect on your needs and when possible, tell those needs to your therapist.

What if I don’t like my therapist or want to switch therapists?

So let’s say your a few sessions in, or even maybe a few months or years into therapy and you realize you don’t like your therapist. Remember there is a difference of not liking them and feeling like they aren’t helping you reach your goals and a therapist who is unethical or unsafe. If you ever feel like your therapist is unethical or abusive or unsafe, you can always leave that therapy relationship and in many states you may report them to their bosses or their license board. If they are ethical and good therapists, just not a good therapist for you, there are several options for you to take.

1.      If you feel safe in the relationship, bring up your concerns. Maybe it is something they are able to change and can get back to the path of your healing and growth. For example, if a client of mine likes more homework or art focused treatment, I can easily add some work for them to do outside of therapy time and bring in activities for them to do to use their creative side. Sometimes what you need may not be changed in therapy, and that is okay! It leads me to your second options which is..

2.      Find a new therapist. Again, if you are comfortable with your current therapist, you can ask them for suggestions on people with training or experience with your specific needs. If a client really wants to explore their attachment with their parents in hopes it will help them with their relationship, I will not be the best therapist for them but thankfully I know several good folks who could be a good fit. Or maybe it is the personality difference and that is also okay. I am typically a highly involved, humor oriented, excited therapist. If a client wants someone more reserved or serious, it does not mean I am a bad therapist, it just means we are not a great fit and again, thankfully I know therapists with other personality types I can refer to.

3.      If you don’t feel comfortable talking to your therapist, you can end the relationship and find someone new on your own. It is best if you can inform your current therapist that they are no longer needed, again you have full control over how much and what you tell them. But if you do not feel safe with them, you can always ghost them.

Now, this guide is not exhaustive but I hope it clarifies some questions or concerns you may have about starting therapy. I will do more of these about different processes of therapy, but I really think the hardest step is just starting so good for you for reaching this step!

Feel free to reach out with any questions about my therapy process!

• Alicia Johnson, LMFT, the burnout therapist.

  • serving women across Michigan, Florida, South Carolina, and Oklahoma