Starting Therapy

A lot of referrals come from people starting a web search for local therapists or going through their insurance company’s provider directory. Many people make the call to set up an initial appointment without knowing much about who they are trying to schedule with. We are in a time period now where there is a high demand for therapists, and many people figure they are lucky if they just find someone, anyone, who is taking new clients.

We believe you should not only find a therapist, but you should also find the right therapist for you. Great therapists will vary widely in their experiences, their education, their approach to therapy and in the client populations that they are best suited for – and they will be happy to share their backgrounds with you so that you can decide if they are the right therapist for you. It’s important to remember that finding the right therapist for you is an individual choice that you make – it’s always nice when someone has a great reputation or when your friends and family recommend them, but remember that your comfort level and whether or not you feel heard and understood by them is just as important, if not even more important.

So how can you make sure a therapist is right for you?

Make a list of why you want to go to therapy – some people want to go to therapy to have a diagnosis confirmed. Other people have a specific problem they want to solve. Some people may have already addressed a problem, but they want therapy to help them stay accountable and to maintain their progress. There are all kinds of reasons why people want to go to therapy, and if you have an idea of what you want to do, a therapist can let you know if that is an area they can help you with, or they might be able to give you a good recommendation if they aren’t the right fit for you.
Make a list of what you want in a therapist – some people want a therapist who is very assertive and directive, other people want a slower, gentle approach. Some people like to have homework in between sessions, some people only want to have a space to talk openly. It’s great if you know a style that works well with you – if you aren’t sure, then think back to the people you have had in your life that really helped you – guidance counselors, mentors, teachers, etc. What was special about them, what did those people get right as they helped you? You may want to look for similar qualities in a therapist.
It’s okay to have demographics and preferences when you are looking for a therapist. Some people may feel most comfortable with a same-gendered therapist, or someone who is similar in age – or, some people might want the exact opposite for their own reasons, and that is okay too. Other people may want a therapist who has a specific ethnic, religious, or cultural background – and when these are factors that represent a big part of your life, it might really help to know that your therapist has lived experiences that provide not only knowledge, but also a real understanding of your situation. Not everyone has a preference for a therapist’s demographics, but some people do, and that is okay – you have a right to have a therapist that you feel completely comfortable with, that you can fully open up to. When we respect your preferences and needs, then we are respecting you, and we are showing you that your needs matter – and this is crucial in developing a therapeutic relationship and in helping you take control over how therapy benefits your life.
Read what you can online – do the therapists near you have websites or marketing profiles? Many therapists try to advertise themselves online in such a way that you can get a good idea about what their personality might be like, what training they have had, and what approaches they use in sessions. When you do your own research about a therapist, this helps you see what you can expect from therapists and it can help you narrow down your list of who to call for an appointment – which saves you time and is more likely to help you find the right therapist sooner rather than later.
Reach out – this is easy for some people, not so easy for others! You can call and ask a few questions, make up your mind later if you want to schedule. Or, you can schedule that first appointment with the understanding that if it doesn’t work out, you can always try someone else. When you call to the schedule the first appointment, there are a few things you need to ask:
1. Is the therapist licensed in my state? For telehealth, the therapist needs to be licensed in the state that you are physically located in. Sometimes we see a certain area code and we assume that the person must be located in the state that area code is in – that is not always the case! Many people live in one state, work in another, and phone numbers don’t always tell you where someone is anymore. At Hope & Meaning, we will ask you what state you are located in before we schedule you so that we can make sure you are matched with a therapist who has your state’s permission to provide therapy.
2. What is my copay – do I have to meet a deductible, if so, what is this? Insurance can be confusing, especially for people who have insurance but don’t use it often. We are glad to check your benefits for you and let you know what you need to pay when you use your insurance. You should never start therapy with anyone without being clear on your financial obligation first.
3. How will you store my information and collect payment? Know in advance if you need to use a credit card, check or cash. If the therapist is storing your credit card information, they should have a way of keeping it safe and secure so that you are protected against identity theft. At Hope & Meaning, we use an electronic medical record that stores credit card information via a HIPAA-compliant third party. After we type in card numbers, we can only see the last 4 numbers of the card – we can still store it and charge it every session for copays, but we never see the number itself again, and this is to protect you. We are happy to provide receipts that you can match against your bank records and our receipts can also be used for reimbursement and tax purposes as needed.

The First Session – What to Expect

If you have never done therapy before, a first session can seem intimidating. It’s a complete stranger who is asking all these personal questions of you, and some of the questions might be really hard to answer. Sometimes the fear of opening up keeps people from reaching out for a therapist at all – we try to make everyone we work with feel as comfortable and relaxed as possible.

The first session isn’t usually about problem-solving and solutions as much as it is about just getting to know someone and seeing if there is a connection. This goes both ways – a therapist needs to get to know you, but you also need to get to know the therapist too! The therapist needs to know enough about you to know whether or not they can help you, and if so, how. You also need to know enough about the therapist to know whether or not you feel confident in their ability to help you.

The therapist will ask about what is going on in your life right now, and also how things used to be in your life, what it was like growing up, and what your experiences with school and work and family have been like. A therapist will also want to hear whatever it is you have to say, in whatever way you need to say it. We know that some people come to us fully understanding their situation and they can say it pretty easily – but other people might still be trying to understand what they need, and they might take longer to say it. Then there are people who might have felt like they had no one to talk to, they had to bottle up their feelings – then they have that first session, and everything seems to spill out. However you need to express yourself, it’s okay. It’s our job to listen, to receive and to support. You don’t have to worry about making sure you say everything, because therapists are trained to know how to pick out the information they need, and we have the patience to let you share your story in whatever way you need to share it.

As we are getting to know you, you are getting to know us. It is always okay to ask us directly what our experience is in certain areas that interest you. We may say we have lived experience, or we may say we took certain classes about certain areas. It’s okay to ask us if we have worked with people who represent certain minority groups, and it is okay to ask us how we work with clients who have various belief systems. All therapists should respect all clients regardless of age, religion, race, gender, political beliefs, and any other factor that a client identifies as a minority status to them. It isn’t our place to judge anyone. That said – there is a difference between not judging a client vs. understanding them and finding a relatable common ground. It isn’t offensive or presumptuous if you want to talk about how we see these factors and what it means to us to work with diverse clients. The right therapist will show you authenticity, honesty, and you will feel like you found a common ground with them – there will be a sense of belonging and compatibility, and they will feel like a person you want to have another conversation with in the future.

And that is really what therapy is – it’s a conversation. As you spend the first session outlining your life and trying to get a feel for the therapist, you might not have a sense that you had a real conversation per se. This is normal, especially with clients who come to us with complicated situations that might take a while to explain. Sometimes the first session can feel more like an interview than a conversation, and that’s normal – we feel it too sometimes. We have to get a lot of information about your life in the first session in order to make the right diagnosis and to develop a correct treatment plan, and that sometimes takes away from the ability to really relax and talk conversationally. If you finish the first session with a good feeling about the therapist, go ahead and schedule that second appointment even if you didn’t get to have the conversation you really wanted – because you will probably be pleasantly surprised at the second session, when the therapist turns the conversation to you and you can talk about anything you want. That’s when you’ll start to see the magic behind these simple conversations beginning, and you’ll have the space you need to hear yourself say what really needs to be said – you’ll leave each conversation with new ways of viewing your life.