New to Therapy? Here’s How to Navigate the Process!

For many people who haven’t had experiences with therapy before, it can seem mysterious and intimidating. As a psychotherapist in the Washington DC area for the past 10 years, I’ve had many friends and family members ask me for guidance about whether they should seek help, who to go to, what type of treatment to ask for, and what therapy will be like. Here are my guidelines:

When to seek help

Whether it is a mental or physical health problem, here are some things to ask yourself about your symptoms in order to decide when it’s time to call in a professional:

– What are the symptoms? And specifically, what is their Frequency, Duration, Intensity, and Interference in Functioning? Symptoms don’t necessarily indicate a problem – for instance, we all feel anxious or angry or sad sometimes. But when those normal negative emotions become overwhelming, last for weeks or months, or prevent us from reaching our potential or getting through our routines, then it can signify a larger problem which would be helped by therapy.

– What have you tried so far to resolve it, and has it helped? We all have different ways of coping – some helpful, some not so helpful, and some harmful. If you’ve been trying positive coping strategies like exercise, meditation, journaling, etc. and nothing is helping, it might be time to seek therapy. If you have been using harmful coping behaviors like self-medicating/excessive drinking, avoiding important tasks, or regularly unloading your frustrations on your loved ones, these are also good indications it is time to seek help.

How to Choose a Therapist

Don’t just go to anyone- therapy is big investment of your time, energy, and money. Finding the right therapist isn’t always easy, but it is worth it! Here are my tips for how to find and pick the right person for you:

– Engage your resources to get a good recommendation. Your primary care doctor is often a good place to start, as they will have referrals for you and be able to suggest what type of therapy to look for. If you’re looking for your child, talk to their pediatrician and their school counselor. You could also ask friends and family for therapist recommendations if you feel comfortable doing so.

– If you research on your own, use the Therapist Finder tool on Psychology Today, https://therapists.psychologytoday.com/rms/. You can filter your search by zip code, insurance, age of client, mode of therapy, and more. Then you can see full bios, prices, and contact information. It’s a very useful resource!

– Focus on the match. While it is important to find someone competent and skilled in working with the particular issue you’re seeking help for, it is equally important to work with someone you like and can trust. You’re going to be building a relationship with this person, so think about who you feel most comfortable with.

– Have a phone call first. Therapists should offer you a free initial phone call (I often spend 15-20 minutes with a potential new client on the phone). Use this time to tell them what you’re looking for and see if you both think it is a good match.

– Don’t worry about the type of degree. It doesn’t really matter whether someone is a social worker, psychologist, counselor, marriage and family therapist, or psychiatrist. Anyone who provides therapy has gone through years of education and training. What really matters is whether you like the therapist, and if their experience and approach match what you’re looking for.

Think about the Type of Therapy You Want

Therapy isn’t one-size-fits-all; there are a variety of models. Many therapists use a blend of different approaches, but some are more specialized in certain types of therapy. You are more empowered as a consumer in any situation when you know that you have options and can explore them up-front. Here are some tips:

– On your initial phone call, ask how the therapist generally addresses the type of problem you have. Ask if your symptoms are the type of thing they usually help clients with, and then ask how. See if you like how they describe their approach to solving a problem, if it makes sense to you, and if it is how you want to start working on things.

– Do a little research on the types of therapy offered by the therapist you’re thinking of going to. If you see on a bio that someone is specialized in CBT, or EMDR, or EFT – these labels might mean nothing to you, but if you do some reading then you might have a preference for the type of treatment you’d like to receive.

What to Expect During the Course of Therapy

If you’ve never been to therapy before, you might only have TV and movie depictions to go off of, and those are often unrealistic! Here’s what you should expect:

– Expect to talk about some things that make you uncomfortable in order to find ways to feel better. Talking about a problem is uncomfortable. But the idea is that you build trust with a person enough that you can candidly discuss the distress you’ve been experiencing and try out different solutions, so that you can feel relief and see progress.

– Expect to have a treatment plan. You should be able to know after a few sessions what what your goals/desired outcomes are, and how you’re going to get there with the help of your therapist. Generally you can expect your plan to involve meeting once a week for at least a couple of months.

– Expect to feel better over time. This sounds obvious, but it’s easy to get complacent with pain when you’ve been experiencing it for a while. Don’t lose sight of the goal to feel better! If things aren’t getting better in therapy, don’t lose hope; talk to your therapist about it and ask what other things you might try or what timeline is reasonable to expect to feel better. Also, remember that progress isn’t always a straight line; sometimes it’s a few steps forward and a couple steps back. Hang in there, talk through it, and keep focused on the bigger picture of your goals.

I am constantly moved by the courage and resilience that people have to make positive changes in their lives. Remember that you are your own best resource, advocate, and caretaker, and that seeking professional support is part of good mental and physical self-care. Going to therapy is a big decision, but hopefully these guidelines can make it a less confusing one.