What to Expect When You’re… Seeking Therapy for the First Time. By Sarah Baird, LCMHC, LCAS-A, NCC
Seeking therapy for the first time is a vulnerable decision, especially when dealing with difficult decisions or issues that have become too hard to manage. However, it is one of the best and most healthy decisions you are making for yourself in this moment.
To get started, consider using social media, websites, blogs, and word of mouth to find therapists in your area. PsychologyToday.com offers a glimpse into different therapists, their work, study, population, insurance, and appearance. Asking clarifying questions about your values, goals, and preferences can help you choose the right therapist.
During your first session, ask about the therapist's theoretical model, modalities, client types, and experience. Consider the therapist's education and experience background, approach, cost, frequency, and resources for follow-up.
The first therapy session may vary depending on the therapist's type of therapy and the type of counseling you are seeking. If you are seeking family therapy, marriage counseling, career counseling, or grief counseling, they will look similar but have different elements. If needed, the therapist can recommend and refer you to additional therapy for specific help.
Locations-wise, sessions will be around 50-60 minutes and occur as often or frequently as you and your therapist feel will best suit you and your goals. Adjusting session frequency based on communication is crucial for successful therapy sessions.
In therapy sessions, it is important to approach the process with an open mind and avoid dismissing the client's concerns about confidentiality. Therapists are trained to help with long-lasting wounds and memories, and it is crucial to work from the "now problem" and backward to determine the root cause. Confidentiality is essential, and therapists should not immediately jump to the emergency room if the client is not ready to talk about their feelings.
Associate-level licensed therapists may share details about their sessions with their supervisor, but this does not mean all the nitty gritty details are spilled. Topics that are sensitive in terms of confidentiality include suicidality, homicidally, and at-risk communities. If the client has a plan, intent, or means to hurt themselves or others, they may need to be taken to the hospital. If the client is just thinking about it, they should develop a Safety Plan to implement if the feelings worsen.
Sessions should be approached like a conversation with a friend, with the therapist treating the client as the master of their own life. The initial "get to know you" session starts with asking about the client's progress since the last session and any issues that may have cropped up between sessions. The therapist shares their game plan and gets insight into the client's focus for the session.
Diagnosis is a crucial aspect of therapy, but it does not define an individual or their mental health. A diagnosis is a set of criteria based on the DSM-5, but it does not define who they are. A diagnosis is a part of the process, and it is between the client, the therapist, and their medication provider. The process involves evaluations, such as the PHQ-9 or GAD-7, which can take many sessions to understand the client. The therapist includes the client in their thought process, providing psychoeducation on the diagnosis, the best approach to navigate it in therapy, and resources to help process the diagnosis. This ongoing topic will be discussed in sessions, and it is important to be curious about mental health, open-minded, and not expect a quick fix. It is important to take pride in taking care of oneself and not let a diagnosis define you.
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