May is Mental Health Awareness month! In my heart, I feel we are getting a little closer to recognizing mental health as regular health, but there is still so much work that needs to be done.
I have this conversation, somewhat frequently, on what to expect or what you need to know when looking for a therapist. I often like to congratulate the person, even just asking questions is a great first step. Recognizing that you may need therapy and finding information can be extremely intimidating and overwhelming. I would not consider myself an expert, but I hope I can help a little.
1. Reflect on your well-being and manage your expectations.
Do you feel ready to talk or motivated to change? That is a great start! It is important to check-in with yourself, especially if seeking therapy is voluntary, to recognize if you are ready to share and are intrinsically motivated. Do not force yourself into going to therapy if you are not ready. Do not expect your therapist to have all the answers or wave a magic wand. Therapy is the type of treatment where you only get out of it as much as you are willing to put in. Be prepared to be listened to, but, also challenged. A good therapist will meet you where you are, but they will also gently push you to try and be the best you can be.
2. Therapy is for everyone!
I think everyone can benefit from a few good therapy sessions in their lifetime. Unfortunately, not everyone feels that way. You may receive judgment from your family or friends, which may cause you to reconsider your decision. You may minimize your own feelings and talk yourself out of it because you feel like your problems are not big enough to seek therapy. The stigma surrounding seeking therapy is still great, but seeing a therapist is like seeing a primary care doctor; it is preventative medicine. Your mind is just as important as your heart or your lungs.
3. Find out about your insurance coverage.
A lot of insurance plans cover counseling or other mental health services. You may find a provider via a google search but it can be discouraging when you made the appointment and it turns out they do not take your insurance. I would also recommend calling your insurance company versus looking online, as provider directories may not be updated regularly. Some insurance companies tend to require a diagnosis in order to reimburse you or disburse payments to the provider. You have to make the choice if that bothers you or not.
If you want to forgo using your insurance or do not have any insurance, many providers offer self-pay options using a sliding fee scale. A sliding fee scale is typically based on your income and allows services to be rendered at a reduced cost.
Either way, nothing helps ruin your therapy experience like receiving a bill you cannot afford.
4. Psychiatrist v.s. Psychologist v.s. Psychotherapist
This can be confusing, so I hope I can help distinguish the three titles/occupations.
A Psychiatrist is a medical doctor (MD), they went to medical school, completed a residency and/or fellowship program, and are board-certified physicians. Psychiatrists specialize in the diagnosis and treatment of mental health disorders. A psychiatrist can provide psychotherapy, but unlike a psychologist, they can also prescribe medication, order laboratory work, and perform other medical treatments.
A Psychologist is an individual that has completed an advanced degree (Ph.D. or Psy.D) in the field of psychology i.e. clinical psychology. Psychologists partake in rigorous research and practical clinical application to diagnose and treat mental health disorders. Treatment includes psychotherapy and other non-medication techniques. Psychologists are considered doctors but are not medical doctors, as designated above, they are doctors of philosophy or doctors of psychology. Psychologist and Psychiatrist often work together; a psychologist will refer their clients to a psychiatrist for more advanced care.
“Psychotherapist” is an all-encompassing term for an individual that performs psychotherapy. Psychotherapists can be Psychiatrists, Psychologists, Licensed Social Workers, Licensed Counselors, Psychoanalysts, Licensed Mental Health Counselors, Marriage and Family Therapists, and other disciplines.
5. You probably will not lie on a couch.
When you think of a therapy session, does an image of a brown, leather chaise lounge pop into your head? You lie on it, while an older person with glasses sits in a corner, silently judging you or asks you to start from your childhood. If yes, you can thank Sigmund Freud and television for that.
Therapy does not have to take place on a couch or in a sterile, white room. Therapy can be in your own home, in a neutral cozy environment, or even outside. When I used to conduct therapy sessions, I would often start with a breathing exercise or a brief yoga flow to help my client feel at ease. I would sometimes sit on the floor, sit on the couch beside them (if they are comfortable), or take advantage of the nice weather and find a nice quiet place outside. If the environment is important to you, this is something you can certainly ask before you make your first appointment.
6. Your first visit will probably consist of a lot of questions.
Just so you are aware, a typical therapy session is a 50 minute hour. Your therapist will use that extra 10 minutes to write notes about your session, take a breather, or use the bathroom before their next client. The first session, however, can sometimes be a little longer, maybe an hour and a half. They may perform a psycho-social assessment which gathers your history including physical health, social health, family history, how you have been feeling lately, and what you are hoping to get out of therapy. This can be a little unnerving as it is a lot of questions and information you may not feel ready to reveal just yet .But, it is helpful, as it allows your therapist to receive a high-level overview of your well-being. Be honest with your therapist if you need a break or if you are beginning to feel overwhelmed.
7. You are not obligated to stay with your therapist.
You can usually tell if your therapist is a good fit within in the first 2-5 minutes. Follow your gut, if the chemistry is off, you are not obligated to stick with them. If you do not feel you are being heard or if it just does not feel right, do not ignore that feeling. If you stay because you feel bad switching therapists, it could really do more harm than good. Sometimes you have to try a couple to find the right one. Remember, this is your journey and you need to feel right about the person who is going to help you along.
8. Your therapist probably sees a therapist.
This goes back to therapy is for everyone. You may feel intimidated by your therapist, but remember they are human just like you. It is not polite to ask, but your therapist probably sees their own therapist. It is a tough job, on top of any external circumstances that may be going on in their personal life. They learn to compartmentalize, but they need some TLC too.
9. Do not forget to give yourself credit.
Making that step to find a therapist and schedule an appointment is a big feat! Do not for a second think you just completed a small task. You are taking a big first step towards better health and wellness. You deserve a pat on the back!
10. If you are in crisis and need immediate assistance, call 911 or your local crisis hotline.
This can be a really scary moment or several moments, especially when you feel alone and unsure of what to do. There are a lot of good people available to help. You are not overreacting! There are more people that want to listen to you than you realize. Here are some resources:
I hope you this was helpful. If nothing else, please remember that you are not weak, your feelings and concerns are valid, and whenever you feel ready to reach out for help is the right time.