Curious About Therapy? Start Here.

Article #10

February 18, 2025

Access the podcast format of this article on my Spotify channel here.

"Don't ever feel like the best days are behind you. Reinvention is a form of hope."

Phil Wohl

We’ve spent about 10 months now in this space talking about tools, skills, knowledge, research, and insights aimed at helping you improve your mental wellness.  These are all things that I discuss in sessions with clients.  But what about therapy in general?  Today’s topic is for those who are not familiar with the process of therapy and are curious about what to expect or how to take your first steps in the process.

Who is therapy for?

This is one of my favorite questions, and one of the easiest answers: therapy is for just about everyone.  There has been a long standing stigma surrounding the mental health field and those who have pursued its resources.  There are a lot of misunderstandings that therapy is a last resort, something to pursue only “when things are really bad" or if someone has a severe and lifelong mental illness.

This is false, and in fact I strongly recommend people pursue therapy - especially if they’ve never done it before - when things in life feel relatively stable.  This is because therapy can equip us with strong tools to use when life’s challenges come our way. 

Therapy is a great way to learn more about ourselves, and if we wait until we hit a breaking point to start it, we have to wait longer before we can do the deeper self work and exploration because the initial period in therapy will be focused on stabilization.

Some indicators that you’re a good candidate for therapy are:

• You’ve struggled to be direct and honest about what you want in relationships or with yourself

• You don’t have a support system outside of your biological family

• Your family of origin uses passive aggressive language to communicate a point

• You were exposed to verbal, physical, or sexual abuse at any time in your life

• Your body often feels “on edge” and you struggle to be able to relax

• You feel guilty about doing things for yourself

• You often feel scattered

• It’s hard to get yourself to do the things that bring you joy

• You experience resentment in your relationships but don’t know what to do about it

• You feel like your relationships are in a repetitive loop that you don’t know how to get out of

• You struggle to make deep and meaningful connections with others

• You identify as a “people pleaser”

• You often engage in behaviors that aren’t aligned with your values but don’t know how to stop

• You don’t have clarity on your values, goals, or sense of identity

• You find that your emotional state is strongly influenced by the emotions of those around you

• You don’t feel okay unless your relationship is okay

• You feel like you’ve lost yourself in parenthood or your relationship

• You regularly feel burnt out

• You have anxiety around engaging in conflict

• You struggle with being authentic

• You feel like your emotions are out of control

• You feel like you’re out of touch with your emotions

• You feel like you have a history of failed relationships

• You feel like you don’t know how to spot “red flags” in others

• You’ve experienced loss

• You’ve never been to therapy

I’m considering therapy.  What would it look like to get started?

If you’re considering going to therapy, it’s important to first acknowledge the courage it takes to make such a big step.  Going to therapy - especially when the process is new to you - can feel intimidating.  I always praise my clients when they come in for their initial intake for their bravery.  It’s really inspiring when a person decides they want to learn and grow in the unique way that happens in therapy.

Finding a Therapist

Logistically, if you are considering pursuing therapy, your first step is to find a few therapists who you feel might be a good fit.  You can do this by calling your insurance company and asking for a list of in-network providers in your area, or you can search on Psychology Today, which allows you to customize your search based on location, insurance, gender preference, religious background, and other specifications.

Consultation

I always tell people that finding the right therapist for you is like dating - it’s rare that you’ll meet the right fit on your first try.  For this reason, I recommend making a list of 3-5 providers in your area and reaching out to them to schedule a consultation first.  Nearly all therapists offer free consultations, and they typically range from 15-30 minutes.  You can typically decide between a phone call, telehealth call, or in-person consultation.

These consultations are a great way to meet therapists and determine if they are a good fit for you.  It’s also a great time to determine if they have the background to work with your specific presentation of needs and symptoms. 

Here are some questions to ask during a consultation:

• What is your professional experience working with _____?

• What is your approach as a therapist?

• What does your schedule look like?

• How do you handle termination with a client?

• What personal experience do you draw on in your work?

• Do you specialize in any specific diagnoses or challenges?

• If you don’t feel like we would be a good fit, do you have any referral recommendations for someone you know who might be a good fit for me?

For those who prefer a therapist who can incorporate a faith perspective, the consultation is a great time to ask the therapist about that too.

I strongly recommend asking the therapist about their scheduling availability, because too many times I have gone through an intake with a client and then looked to set future appointments only to realize that we won’t be able to work together because of scheduling differences.

Consultation is also a great time to be really clear about what you are hoping to gain in therapy.  The clearer you are, the easier it will be to find the right fit. 

During a consultation with clients, some questions I typically ask as the therapist are:

• Why are you pursuing therapy, and why now?  Was there a specific event that prompted this?

• What mental health symptoms are you dealing with right now that you would like to see improve?

• Have you been in therapy before?  If so, what made that a positive or negative experience?  What did your therapist do that was effective for you?  What was your mental health diagnosis?

• What are you looking for in a therapist?

• What are the goals you have for our time together?  What would you like to see improve in your life?  How would your relationships with others and yourself change?

• What level of work and time are you willing to commit to?

• How will you know that our time in therapy is ready to come to a close?  What will your life look like?  How will your relationships with others and yourself look different?

If you can come into a consultation appointment with some of these questions answered ahead of time, it will make the process more seamless for you and the therapist.

After each consultation, take some time to reflect on what it was like.  Did you feel comfortable in their office?  Did it feel easy to connect?  How did your body respond to being around that person?

Intake

If you meet with a therapist and decide that you’d like to move forward with them, your next step would be scheduling an intake assessment.   If you are paying out of pocket, I like to give people a heads up that this session will typically be more expensive than all the others (usually about $50 more, give or take) because the therapist is conducting a complete biopsychosocial evaluation and providing a diagnosis.

*A quick piece on mental health diagnoses: if you are receiving therapy services through insurance, you must have a mental health diagnosis for the therapist to bill insurance.  It’s common for people to come in and report that they don’t have any major mental health issues, but rather are just wanting support to adjust to life changes or to learn and grow.  There are diagnostic codes therapists can use in this case, so don’t let this dissuade you from pursuing therapy.  Diagnoses are more for the therapist than anyone else, and this is because it helps them determine the best course of action and tailor sessions based on your needs.  It’s no different from a doctor needing to know if you have the flu or a broken arm, because those have very different treatment approaches.

Before the intake assessment, the clinician will typically send you a link to an online portal for you to create an account.  Once you’ve done that, there will be a number of questionaries for you to fill out.  Some of these measure anxiety and depressive symptoms, some communicate the clinician’s cancellation and confidentiality policies, and one will be the Client History Form.  This form asks you questions about your medical history, mental health history, family relationship history, religious background, current relationships, living situation, and more.  It’s really important for you to fill this out ahead of time, because the clinician will be drawing on this document when you meet for the intake session.

During the intake session, the clinician will review the Client History Form with you and ask some questions to learn more about your background.  The intake session typically lasts 60 minutes, and in some cases, the therapist might have to wrap up the intake process in the next scheduled session with you.  Every therapist does this a little bit differently.

At some point in the intake, the therapist will ask you about your goals for your time in therapy.  This is an important question, because your answer guides your treatment.  After you finish the intake session, the therapist creates a treatment plan for you that is based specifically on your treatment goals.  I tell all of my clients that this is a living document, meaning that they can request to change it at any time.

Just to give you an idea of what a treatment plan has, here are some common treatment goals:

• Clinician will educate the client on coping and emotion regulation tools, and the client will practice these to “have more control over my emotions.”

• Client and clinician will discuss healthy parenting practices for the client to utilize in his relationships with his children “to connect better with my kids.”  Client and clinician will explore where the client struggles with unhealthy parenting practices related to his own experiences of childhood dysfunction.

• Clinician will educate the client on the tenets of emotional maturity to assist the client in “showing up better in my relationships.”  Client and clinician will explore barriers the client encounters when working on engaging in her relationships with emotional maturity and problem-solve through these.

Understanding the treatment plan and knowing your role in its creation is important, because this document drives your treatment.   Personally, I plan ahead for all of my sessions, and all of my plans are based on the client’s personal treatment plan.

Sessions

After your intake session, you will begin coming in for regular recurring sessions.  Most clients start out with weekly sessions.  Personally, in my own practice at Blue Jay Therapy, it’s my policy that clients come in on a weekly basis for the first 3 months, because I have found that weekly sessions provide the consistency necessary to support clients in the initial phases of therapy.  This can be a time of significant growth and change, and having the scaffolded support of weekly sessions supports this growth.

In the first few sessions, your therapist is working to build rapport and strengthen the therapeutic alliance.  You will most likely spend the first chunk of time in therapy learning foundational coping and communication skills, but every therapist is different.

At every point in the therapeutic process, it’s important to remember that it’s your job to be clear with your therapist about what you want and what you’re comfortable with.  Being clear and taking accountability are some ways that you can really ensure you are getting everything out of therapy that you need.

What is the client’s role in therapy?

• Create treatment goals for your time in therapy; this is usually done during your intake session, and you will revisit the goals every couple of months with your therapist to ensure they are still relevant.  Having a vision for how you want things to improve is important.  If you struggle with this, your therapist can help.

• Set an intention with your therapist for each week in between sessions where you will practice what has been discussed in sessions; some examples are practicing a coping skill, practicing healthier communication skills, or reframing your internal self talk.

• Throughout your week, make healthy changes that are discussed in sessions; this is critically important if you want to see improvements in your mental health and relationships.

• Take accountability for your opportunities for growth and observe barriers that prevent you from making changes.  You and your therapist work as a team to problem solve how you can overcome the barriers that are preventing you from putting these things into practice.

• Share feedback with the therapist on what is and is not helpful in sessions; this is vitally important for your clinician to know, as your sessions are about you.  It’s important that you are getting out of them exactly what you need.  Healthy therapists welcome and appreciate opportunities for their own growth!

What is the therapist’s role in therapy?

• Provide education to you as the client to understand how you can change your ways of thinking, how you treat yourself and others, and practice problem-solving in a way that helps you achieve your treatment goals.

• Receive feedback from you as the client and pivot as needed, based on your needs.

• Maintain current education and knowledge in the field as it relates to the client’s needs and treatment goals or refer the client out if they feel that working with the client is out of their scope of practice.

• Regularly share resources with you as the client to help you gain more insight on your situation and ways you can make healthy changes.

• Listen without judgment.

• Challenge the client’s cognitive distortions or unhealthy thought/behavioral patterns and problem-solve with the client how to work through these.

• Maintain confidentiality unless the client shares they have plans to harm themselves or someone else; in this case, the clinician will inform the necessary parties so that everyone can be safe.

• Support the client by holding space for the client’s emotions and experiences.

How long does therapy normally last?

Therapy in general can last anywhere from a couple of months to a few years.  It depends on what your treatment goals are and how severe your symptoms are.  There is no right or wrong timeline to finishing therapy.

This is a choice you make based on your progress toward your treatment goals.  Sometimes, when people reach their treatment goals, they decide to end their time in therapy.  For others, they create new treatment goals and continue their time in therapy.  Some clinicians are clear with their clients that they are meeting for a brief period of time solely for the purpose of working toward solutions for the client’s current challenges (this is called Brief Solution Focused therapy). 

Other clinicians are more in it “for the long haul” - acting as problem-solver, emotional support, sounding board, and utilizing more long-term therapies, such as IFS (Internal Family Systems) therapy for trauma healing and resolution.

Why go to therapy?

Therapy is one of the only places where you can interact with someone who knows you deeply and is also able to maintain objectivity when helping you understand situations in your life, because they don’t have personal involvement like friends or family members do.  You can also trust your therapist to tell you the truth rather than telling you what you want to hear. 

In addition to this, for a therapist to be licensed as a mental health professional, they are required to earn a graduate degree, pass an intensive state licensing exam, and continue to regularly gain new tools and skills through supervision and continuing education requirements.

The cost of not going to therapy can be steep: fractured and distant relationships, struggles with self worth, repeating the same relational and emotional patterns without new outcomes or resolutions, and a disconnection from the most authentic parts of yourself.

What you stand to gain, on the other hand, is invaluable. Therapy is an excellent space to learn about yourself, understand how to give yourself what you need to thrive, resolve chronic emotional challenges, discover the courage to pursue what you’ve always wanted, treat yourself with more kindness, and learn to love those around you more deeply.  And really, you don’t need any excuse to do what it takes for your own flourishing.  That’s reason enough.