May is Mental Health Awareness Month, and there’s no better way to start it off than taking the first step in seeking help or assisting those who would like to start counseling. Doing so raises awareness and helps break down negative, long-held beliefs — many of them untrue — about what it means to attend therapy, whether as an individual, couple, or family.  

For those new to the process, and understandably ambivalent, let’s discuss how you can play a key role in changing societal attitudes toward mental health — even before you even sit in a therapist’s office — and what contributes both positively and negatively to our mental state, and how to go about finding counselor suited to your needs.   

Create Awareness 

Fortunately or unfortunately — depending on how you look at it — we are always connected, digitally at least. Our smartphones ensure we are only a couple clicks away from responding to a bombardment of text messages, staying up-to-date on current events, responding to work emails, or coordinating your kids’ carpool schedule.   

And work pressures remain one of the top stressors in our lives. A Gallup poll showed that U.S. workers report feeling the highest levels of stress, with 57% of respondents stating they feel stressed on a daily basis, even though almost half feel there is a stigma around talking about mental health in the workplace.   

While we surely have more convenient lives in many respects, in other ways, life stressors have become more omnipresent, with the separation between work and home life increasingly muddied. 

We may think this is just how life is — going through the motions, checking things off the to-do list — but if the last decade of heavy smartphone use has taught us anything, it’s that the hyper-connected world we live in is not necessarily better for our mental health. In fact, some studies have found a positive correlation between increased digitization and symptoms of anxiety and depression.  

That flies in the face of the myth that you should have experienced a particularly tragic event to need therapy. To the contrary, many who find they are experiencing symptoms of depression or anxiety are dealing with a more insidious form of such conditions, ones which are the product of a variety of external factors we often deem positive — working long hours, access to innovative technology and overabundance of material goods. While all these have positive aspects to them, they sometimes prevent us from being present and checking in with ourselves emotionally.  

Behavior and Attitude 

Lots of progress has been made in de-stigmatizing mental illness and therapy, but more work remains. Current attitudes often vary greatly depending on gender, age, cultural background, religion, socioeconomic status, and upbringing. For instance, data from the American Psychological Association shows the greatest increases in unmet need for mental health services were among Latino and Asian populations, as well as those identifying with two or more races. And women also tend to seek mental health services at higher rates than men.  

Never before have U.S. companies been so generous with offering employees mental health days — rather than just sick days — as well as added benefits, such as subscriptions to meditation apps and mindfulness coaching.  

The more therapy and mental health conditions are discussed openly and honestly, the less alone people will feel seeking therapy. And we intuitively understand that the less lonely individuals feel about the struggles they’re enduring, the less likely they are to suppress it. 

But because different demographics and groups of people view therapy differently, it’s particularly valuable for those harboring particularly stubborn stigmas to take the courageous step of seeking help and discussing it with trusted family members and friends, as well as creating more diverse representation in the field of mental health.   

Starting Therapy 

Starting therapy, whether it’s with a new therapist or your first-ever experience, can feel overwhelming. After all, the reasons you’re seeking counseling are likely accompanied by feelings of vulnerability, discomfort, or even shame. But the process doesn’t have to be stressful.  

Know why you are seeking therapy 

There may be a defining event that was the genesis of certain symptoms or feelings of despair, anxiety, anger or depression. But it’s also likely you can’t pinpoint specific moments. It’s important to understand what you hope to get out of therapy, as well as what you’re currently experiencing, regardless of how familiar you are with the underlying causes.  For example, a husband and wife may not quite understand why they are fighting on a regular basis, but pinpointing what they hope to get out of therapy — a healthier relationship less riddled with accusatory remarks and assumptions — is a good first step. For both couples and individuals, it’s important to seek change, especially internally, and understand what you hope to get out of therapy.  

Identify important traits and experience 

There are some logistical considerations to take into account, including insurance coverage or whether you prefer face-to-face or teletherapy. Each option has its pros and cons, and it will come down to your own personal comfort level. But depending on your financial situation and benefits, be sure to research what your bill will look like for both types of sessions.  

From there, it’s helpful to consider a therapist’s traits and experience you’d find particularly compatible. For some, working with a mental health professional who has worked with clients struggling with substance abuse disorder is critical. Or perhaps seeing someone who shares a similar cultural background or religion is important. Gender can also play a role, as research has shown that nearly 70% of female clients prefer a counselor of the same sex.  

Use online directory tools like GoodTherapy 

Even after taking all of these factors into account, people often abandon the search once it feels difficult and time-consuming. After all, someone seeking a therapist is often already feeling overwhelmed, and meeting regularly with professionals who don’t seem like a good fit is draining and demotivating.  

To lessen those chances, and before meeting one-on-one with any available therapist who happens to accept your insurance, use online directory tools like GoodTherapy to filter your search for criteria that are important to you.  

You can also refer to the GoodTherapy guide for a more robust breakdown of what to expect out of therapy and how to start the process.  

Be an Advocate 

You don’t have to be a mental health professional or have a large social media following to be an advocate for therapy and mental health. Anyone can make a commitment to check in more with loved ones.  

Four ways to check-in: 

• Ask to meet up or schedule a time to call 
• Express gratitude for your relationship/friendship  
• Send a message that lets them know they’re on your mind 
• Follow up about something they’ve previously discussed with you  

Remember, small interactions like this play an outsize role in de-stigmatizing mental health conditions, including depression or anxiety. And showing support for counseling and professional help also goes a long way. After all, nine out of ten people have said that stigma and discrimination have impacted their lives when it comes to mental health.  

Make sure your loved ones know where to find therapists that can respond to their needs and know that getting help is the first step toward a more fulfilling life. 

What Is Involved in an Initial Mental Health Consultation?

If you’re looking for a therapist, you may have noticed phrases like “initial consultation” or “initial mental health consultation.” Are you about to attend your first mental health consultation, or curious about what an initial consultation entails? We figured. Read on to learn all about it. 

Your first conversation with a new mental health provider is exciting. You are taking significant steps to manage your mental health and conquer your goals. A mental health consultation is a perfect time to assess whether or not someone is a right-fit therapist for you. Consider this initial consultation an opportunity to “try them out” – see if you “click” with them, share your goals, and pay attention to how they talk about what you share.

Is this someone you want as an ally on your personal journey? Do they share insights that resonate with your values? Does their approach to therapy work with what you want to get out of the experience? The initial consultation will help you think through these questions. 

What to Expect from an Initial Consultation

Your first conversation with a new mental health provider is exciting. You are taking significant steps to manage your mental health and conquer your goals. A mental health consultation is a perfect time to assess whether or not someone is a right-fit therapist for you. Consider this initial consultation an opportunity to “try them out” – see if you “click” with them, share your goals, and pay attention to how they talk about what you share.

Initial consultations often take place over the phone or video chat and typically run anywhere from 10-30 minutes, depending on the provider. During this time, you’ll get to know the therapist and their practice. They’ll most likely have some questions for you about what you’re looking for, what your concerns are, and what your schedule looks like. They’re trying to assess whether or not they are well-suited to helping you with your concerns. But this is also an opportunity for you to find out what you want to know.

Is this someone you want as an ally on your personal journey? Do they share insights that resonate with your values? Does their approach to therapy work with what you want to get out of the experience? The initial consultation will help you think through these questions. Choosing the right therapist is an important aspect of getting what you need, and it’s worth the effort to prepare a bit before your initial consultation. 

How to Prepare for an Initial Mental Health Consultation

Write Down Your Concerns

The first thing you can do to prepare for your mental health consultation is to write down your concerns. Your list might include symptoms you’re experiencing, difficulties you’re facing, or issues you’d like to explore. Having this list in front of you during an initial consultation will help you ensure you mention everything that you want to bring up with the therapist. Trying to come up with or recall all that information on the spot can be difficult. 

Prepare to Ask Questions

Asking questions is a great tool to help you decide if a therapist is a good fit during your initial mental health consultation. While the therapist will certainly have questions to ask you, too, having some prepared to ask them will help you learn the information that is important to you. 

7 Questions to Ask Your Therapist

#1 What is your specialty?

Most therapists have multiple specialties (or types of therapy and client concerns they specialize in). This does not necessarily mean their specialties cover your specific needs. For example, if someone battling addiction is seeking the help of a mental health professional, the provider needs to have experience in that area in order to be effective.

#2 How long have you been practicing? Tell me about your experience. 

Listening to a therapist talk about their experience will help you understand what they’ve seen and what they can help with. It’s important to note that many therapists have a variety of experiences that are relevant to their practice, both professionally and personally. 

#3 How much will I pay? 

While more and more therapists are accepting insurance, many don’t – and almost all will accept private-pay clients. One perk of private-pay options is that your therapist doesn’t have to submit a mental health diagnosis to an insurance company. Make sure to ask them about their fees, sliding-scale opportunities, and any pre-paid, discounted, multi-session packages they may offer so you can make the arrangements you need to cover the cost of therapy. 

#4 How often will we meet?

The therapist might have an idea in mind for the frequency of your therapy sessions. This may differ depending on your needs, and will likely be subject to change based on your progress. 

#5 What will my treatment plan look like?

Is there a concrete treatment plan that they want you to follow? This is important for helping you stay engaged and setting expectations for your work together. If you’re interested in a specific type of therapy this provider offers, like EMDR or Brainspotting, now is a great time to bring it up. 

#6 Do you assign homework? 

Many therapists will give their clients “homework,” or things to work on in-between visits. Therapy homework may include techniques to try, exercises to practice, and coping strategies to use.

#7 I want to work with you. What happens next? 

If you’ve made up your mind and decided to go with this therapist after your initial mental health consultation, you should ask what the next steps are going to include. These next steps may include “homework,” coordinating with your insurance, scheduling your first therapy session, and more.

The Value of an Initial Consultation

If you decide to work with a therapist after an initial consultation, that’s great, but even if you decide they’re not the best fit for you, your time was not spent in vain. It’s very helpful to find this out before you settle on a therapist, and if you have concerns that are outside this particular therapist’s scope of practice, they may have recommendations for you of therapists who do work with folks that have your sort of concerns. 

Many therapists offer this initial mental health consultation for free. To find someone in your area who offers this, click here to search by zip code or city and then filter your results by Pricing>Free Initial Consultation. 

If you’ve never gone to therapy, you might not have much idea what happens in a therapy session. This is fairly common, since much of what people know about therapy comes from (often inaccurate) media portrayals.

In the past decade, awareness around mental health issues has increased significantly. Greater awareness has helped reduce mental health stigma by supporting therapy as a beneficial, normal method of getting help. Accordingly, the shroud of secrecy around therapy has started to fall away. Your friends, family members, even your coworkers may be perfectly willing to open up about their experience in therapy and how talking to a mental health professional has helped them.

But if you’re still unsure about therapy, or don’t know anyone who’s gone to therapy, you might hesitate before booking your first session. Maybe you feel nervous about what a therapist will do, or you don’t think your distress actually merits therapy.

You don’t need to experience any significant mental health issues or emotional distress for therapy to work.

Before exploring how therapy works to help people who are struggling, let’s bust that myth right now. You don’t need to experience any significant mental health issues or emotional distress for therapy to work. If you’re struggling, confused, feel like you want to sort out a problem or your life and don’t know where to start—therapy can help.

Therapy Is Personalized

The process of therapy can differ somewhat based on what you’re experiencing.

For one, the length of therapy can vary based on the issue you want help with. If you’re struggling with depression after a breakup or job loss, for example, therapy often helps you work through the problem within a few months. You might not be completely “cured,” but you’ll generally be able to resolve lingering distress on your own. That’s a key goal of therapy.

Serious or longer-lasting concerns, like trauma from abuse or chronic depression, may require more therapy sessions and a more intensive approach.

In most cases, you’ll spend just an hour each week in therapy. But your therapist might also recommend specialized types of therapy to meet your needs. Dialectical behavior therapy, for example, generally involves an hour of therapy, an hour of skills training, and an additional hour of group therapy each week.

Therapy doesn’t operate as a blanket remedy or one-size-fits-all approach. Therapy for intrusive thoughts (a component of OCD) will likely look much different than therapy for a phobia of dogs.

But even two people with generalized anxiety might see treatment proceed in different ways, based on the type of treatment the therapist specializes in and their individual needs.

If you’ve tried various coping strategies and still struggle with severe anxiety, for example, you might want to try medication, a perfectly valid (and helpful) treatment option. Your therapist should support your decision and work with you to find the right drug.

If you know you don’t want to take medication at all, unless absolutely necessary, you might look for a therapist who specializes in alternative treatments, like yoga or nature therapy.

Therapy Helps People Reach Goals

You might consider going to therapy (or want to avoid therapy entirely) with the idea that your therapist will give you advice, tell you what to do, or ask how every little thing makes you feel.

But therapy doesn’t work like that. Rather, therapy offers a safe, nonjudgmental space for you to talk about problems and anything that’s overwhelming you or even just making life a little tough. Your therapist listens to what you have to say and then works with you to develop a plan to confront challenges and achieve an improved quality of life.

You can also go to therapy if you aren’t experiencing significant distress. Therapy can be beneficial in the pursuit of any goal, no matter what that goal is.

Maybe you want to date but feel you lack the skills to approach someone or make a relationship work. Perhaps you want to work on being closer with your teenage children. Or maybe you just want to break a lifelong nail-biting habit.

Whatever your goal, your therapist will help you explore potential changes you can make to arrive at the outcome you desire. But you come to therapy with your goals (or spend time identifying them in session). You also have an opportunity to share solutions that don’t work, which can help you and your therapist work together to find something that will have benefit.

Say you’ve been feeling low because you no longer have time to create art. Your therapist asks what a typical day looks like for you. After you explain your schedule, they point out you’re spending all your time doing things for others, something you never stopped to consider.

In short, therapy can help you work to identify and break concerning patterns or habits on your own. Therapists don’t give you all the answers. They help you find the right tools to help yourself.

In therapy, you drive the car. Your therapist can help you navigate when you get lost or help dig you out if you get stuck in the mud.

Therapy Puts You in Control

In therapy, you drive the car. Your therapist can help you navigate when you get lost or help dig you out if you get stuck in the mud. But your therapist doesn’t decide where you go or how you get there. You do that work yourself.

That’s why finding a therapist you can work well with is so important. You can often help personalize your own therapy experience by choosing your own therapist, so look for someone you feel comfortable with.

Therapists aren’t machines. Their unique personalities, mannerisms, and styles of interaction will likely show through in the therapy process. Their personality can help attract you to the work you’re doing together, or put you off it.

Finding a therapist who will encourage you to keep pushing through difficulties, even when it’s unpleasant, is also essential. Therapy often feels uncomfortable, even unpleasant. That’s a normal part of the process. But when you and your therapist have a strong working relationship, you trust them to support you through the discomfort and arrive at a place where you feel ready to make change.

If you don’t believe your therapist will continue offering compassion and support, regardless of the thoughts you share or challenges you face, you’ll have a harder time opening up and sharing your vulnerabilities. As a result, therapy may have less effect.

You pay for therapy. It’s your space to create change. Your therapist offers guidance during the process, but you work toward what you need.

Conclusion

If you go into therapy looking for a quick, easy solution, or with the hope your therapist will solve all your problems, you won’t get much out of the process.

Therapy can be hard work, and going into therapy with this in mind can help prepare you for the occasional tough session. But when you work with the right therapist, therapy can be productive and healing, and most of your sessions will probably feel rewarding, even when they’re a little difficult.

Ready to find a compassionate therapist? GoodTherapy is the best place to start. Start your search here.

References:

1. Frey, E. (2017, April 27). How therapy actually works and 5 myths about therapy debunked. Retrieved from https://medium.com/kip-blog/5-myths-about-therapy-debunked-17e7fdd8b8a5
2. Going to a therapist. (2018). TeensHealth. Retrieved from https://kidshealth.org/en/teens/therapist.html
3. Understanding psychotherapy and how it works. (n.d.). American Psychological Association. https://www.apa.org/helpcenter/understanding-psychotherapy
4. What is psychotherapy? (2019). American Psychiatric Association. Retrieved from https://www.psychiatry.org/patients-families/psychotherapy

Dear new client: Welcome to the wonderful world of therapy! I know it can be hard to come in for your first appointment—really hard. You are here to meet me, a stranger who will hear about parts of your life that no one else hears about, and entrust I will do everything I can to help you. To make things easier, here are 10 crucial things I want you to know.

1. Honesty is the best policy.

If you’re not honest in the therapy space, you’re missing out! This is a rare opportunity to be 100% honest without the prospect of being judged. You’re paying for therapy, so lying is counterproductive. Are you using drugs? Tell me. It helps me better understand and work with you on everything from coping skills to medication use and interactions, to social skills, to behaviors that may or may not be attributed to substance use, to relationships, to even finances. Cutting? Tell me.

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2. Therapy is an investment in both the present and the future.

The skills you learn here, and the support and insight you receive, will not only help you with the situation you’re in, but will become part of the “toolbox” on your lifelong journey. You’ll gain knowledge that improves your ability to cope with stress and mood swings, helps your understanding of why and how you do things, and facilitates communication between you and others in your life including loved ones, friends, and business connections.

3. Keeping appointments and being on time is critical.

Part of therapy is consistency. If you’re late, we not only have less time together, we also have to think about the reasons you’re not arriving on time. Making therapy a priority is important. And yes, you may be charged a fee if you don’t show up or you cancel late. The time you’ve reserved is yours and yours alone. When you don’t show up, two things happen: other people needing help who would love to have your time slot are not able to, and I don’t get paid for my time. I rely on this in planning my family and work finances.

4. If you have any concerns, tell me.

I can’t fix or address what is wrong unless I know about it. I won’t get angry or offended or lose my cool. Therapy is all about the therapeutic relationship between the therapist and the person in therapy. If you’re offended about something I said or how you feel treated or mistreated, give me a chance to help you understand or change things. Some things that may seem trivial, such as the fear of being overheard by others in the waiting area, can be addressed and/or explored. If you’re worried because I seem angry, let’s talk about that. My thinking face can look like a grumpy face at times. Knowing your concerns and allowing me to address them is a way to work on empowerment.

5. Nothing is off limits.

Don’t be embarrassed to bring up things, even uncomfortable ones such as sexual experiences or feelings, anger or rage, dreams or fantasies. Believe me, I’ve heard and dealt with nearly everything. I’m not easily embarrassed or fazed. You can also say something such as, “There is something I really want to bring up, but I’m embarrassed.” I’ll help you work through your feelings, and even if you don’t talk about it right away, we can work toward creating a space where you feel okay sharing it.

6. Don’t worry about me.

I have support systems in place if I need help. I seek supervision from peers or others who have more expertise in a given area than I do. Therapists don’t operate in a vacuum, nor should they. I can handle your anger, sadness, and grief. I also know my limits. This is why some therapists refer people to other therapists for some issues. If, for example, I am uncomfortable working with someone who is struggling with a terminal illness because it’s outside my expertise, I will help you find someone who can better assist you.

In the case of therapy, if I were to have an outside relationship with you, I couldn’t be a productive or helpful (or ethical) therapist. Unlike a friendship where both people support each other, my only focus when we meet is you.

7. There’s a good reason I can’t have a friendship with you.

It’s the same reason I can’t be my friend’s therapist. It’s called a dual relationship, which basically means being two things at once to someone. In the case of therapy, if I were to have an outside relationship with you, I couldn’t be a productive or helpful (or ethical) therapist. Unlike a friendship where both people support each other, my only focus when we meet is you. My years of training, supervision, and experience are all focused on helping you.

8. I’m not perfect by any means.

I run late sometimes. I may miss an email or forget to return a phone call. This doesn’t happen often, but if it does, please let me know. In the case of running late, I will make up the time either at the current session or at a later time. If it bothers you, let’s talk about it. Again, nothing is off limits.

9. What you say to me stays with me, with two exceptions.

The exceptions are if I feel you are going to kill yourself or hurt someone else, or if I suspect there is child or elder abuse or neglect. This doesn’t mean if you say you wish you were dead I’ll call the police. But if you mention a plan or I feel like you are on the edge of suicide, I have to take action to ensure the safety of you and others.

10. When you’re ready to leave therapy, that’s great!

It’s something you might be thinking of or I may bring up. Please don’t just stop coming in. Let’s talk about it. If you abruptly leave without letting me know, I am likely to be both confused and concerned for your well-being. The preferred method of ending therapy is to have at least one session where we talk about what we’ve achieved and where to go from here. Closure is important for both of us. You are always welcome back—be it in a month, a year, or five years.

Again, welcome to therapy. I’m glad you’re here. Let’s start this journey together.