How do I get started in therapy?

Since opening my practice last year I have become more outspoken about mental health. In response I’ve had numerous people ask me about how to get started in therapy. I love helping people learn about how to find a good therapist and these experiences have opened my eyes to the stigma and uncertainty surrounding mental healthcare. I am going to share with you some of the important steps to take when looking for a therapist.

When should I go to counseling? Isn’t it only for certain people?

Whatever image you have of the “type” of person you envision going to therapy, erase it. Every therapist or approach to therapy might not be for everyone, but everyone is the kind of person who can gain something from therapy. That being said, ambivalence about therapy is normal. There are very loud parts of society that tell us that we need to figure our problems out on our own and this is part of the stigma and problem of seeking help. If you’ve ever felt emotional pain or been stuck in life then therapy can be helpful. Therapy is more about helping you live the life you want and deserve than it is about analyzing and fixing yourself. Also, every day doesn’t have to be bad for you to go to therapy. Counseling can help you identify patterns or problems that don’t cause problems every day but are still stuck points in your life. The only prerequisite for therapy is realizing that you want things to be different in your life. You don’t even necessarily have to know what isn’t working or what you’d want to be different - a good therapist will help you figure this out. After you schedule that first session, you and your therapist will collaborate on how often and for how long you will meet.

How do I choose a counselor? Where do I even start?

I’ve heard a lot of people say they chose their therapist because someone recommended them. If you know someone who is in therapy, ask them about their experience and for recommendations, but you should do your own research too. How many times have you had a bad hair cut or felt displeased by your experience with a mechanic because of a recommendation from someone else? You may need something different than your best friend or sister. By putting in a little bit of work you can make an informed decision about who you trust to be part of your healing journey. I recommend starting your search online. Helping professionals put a lot of work into their websites and online profiles to help people learn about them and their services. Most mental health professionals have profiles through sites like PsychologyToday, GoodTherapy, or TherapyDen. You can use the filters on these sites to help narrow your search.

Depending on where you live it may feel like there are too many providers available. This can be a little overwhelming, so I’m going to try to break things down as concisely as possible. Before even beginning your search, I’d encourage you to consider what it is that you’re wanting to work on in therapy. For instance, you may want help with anxiety, relationship problems, premarital counseling, addiction, or grief. Look for providers who work with the presenting problem that you have. Also look for providers who work with your age group. Read through their profiles and spend time on their websites; this will help you get a feel for the type of person they are. Finding a therapist that is a good fit for you is super important for therapy to be effective. You want to be able to connect to and feel empowered by your counselor. After you’ve narrowed your list of options down, give them a call or send them an email. Most mental health practitioners I know offer some kind of free consultation. This is an opportunity for you to ask questions you have or receive clarification from the therapist on their services.

Depending on your circumstance, there may be other options available to you as well. For instance, if you’re a college student you should have access to counseling through your school. Also, certain employers have Employee Assistance Programs (EAP) that provide therapy services to their employees. On a side note, EAPs are typically limited to a certain number of sessions so double check with your human resources department. There is less autonomy in these situations because individuals may be assigned a counselor or choose from a list of providers. The most important thing is that you feel comfortable with the person you are working with and that they have the skills to work with you on whatever it is that you’re bringing into the therapy room. My first experience with therapy was through an employer’s EAP program. It was a positive experience but I’m also happy that I can now freely choose who I want to work with.

Take a look at how you live your life. Your lifestyle and needs may also play a role in how you choose a therapist. Specifically, if you’re experiencing marital or familial problems I’d recommend seeking out someone who specializes in and offers couples or family therapy. If you’re seeking an evaluation for a specific concern such as ADHD, I’d recommend you look for someone who offers those specific evaluations. It is also not uncommon for someone to meet with both a therapist and psychiatrist if medication support is recommended. You may also be interested or need the convenience of online therapy; this can be helpful if you travel a lot, work non-traditional hours for work, live in a rural area with very few providers, or are simply drawn to the idea of healing from home. Think about what it is that you need from therapy and make a decision that is sustainable.

Lastly, I want you to know that it’s okay to discontinue therapy with someone if you feel that they are not a good fit for you. Before choosing to no longer see a counselor I would encourage you to bring up the concerns you have about fit. Sometimes all that is necessary is a little adjustment in the approach to therapy, but it’s okay to part ways if necessary.

What about paying for therapy? Why should I consider opting out of using my insurance?

There are different ways to pay for therapy. Typically people either pay for therapy privately or use their insurance. Insurance can be a cost-conscience way to receive therapy. You can set your insurance provider as a filter on the sites listed above or contact your insurance company for a list of providers. Not all providers accept insurance, though, so choosing this route may limit who you can work with. It’s also worth noting that even private pay counselors can offer monthly statements that you submit to your insurance company for reimbursement (definitely check with your insurance provider’s out of network policy). Helping professionals have very valid reasons and arguments for the choice they make about billing insurance for psychotherapy services. For full transparency, I am a private pay counselor and not billing insurance allows me to focus all of my energy and resources into helping my clients. I don’t have to split my time between my client and their insurance company. For you, this will be a very personal decision that depends on a lot of factors. My goal here is to help you understand all of your options. If you’re interested in utilizing your insurance and need to meet online, I’d recommend that you contact your insurance provider and learn more about what options you have.

What if I don’t have insurance and am on a tight budget?

Therapy is still for you. Having low funds is not a good reason to avoid getting the support and help you need and deserve. I’d recommend taking a look back at the list of providers you found earlier and look for those who offer a sliding fee scale. A sliding fee typically means that the provider will offer a reduced rate if you qualify based on your finances. I also recommend looking for a provider through Open Path Collective. Open Path connects individuals with providers who agree to offer a reduced rate for services.

My hope is that this post is informative yet generalized enough to help you make the decision and move forward with therapy. By no means is this post exhaustive or meant to cover everything there is to know about therapy resources, but I hope it has you thinking. For your convenience, I’ve added links with all of the sites I mentioned above. And if you have any questions, please reach out and let me know: trisha.lpc.thespace@gmail.com

Good luck!

The Crepe Myrtles are Blooming.

I sometimes feel overwhelmed by life's burdens.  Just the other day I was driving alone in my car and I realized, in that moment, how small I had made my world.  I had spent 20 minutes driving yet all I could think about were the things causing me stress.  I hadn't thought about the other people on the road with me, considered whether I was driving carefully, or even troubled myself to consider solutions to my worries.  The reality is, I was worrying about the same things that eat up most of our worried minds: the future, plans, finances, saying the wrong thing, so on and so forth.  I was allowing my past and my future to consume my present and could feel the discomfort spread: first my chest, then my stomach, and then my head. Then something special happened - I glanced to the left and saw a blooming crepe myrtle.  

I don't have a green thumb or know much about trees, but I remember living in an apartment complex about a decade ago that had sidewalks lined with crepe myrtle trees and they were beautiful, though not year round. From then on, I looked forward to seeing the first blooms because it happened so quickly and they filled the world with color - white, magenta, red.  I also associate it with the beginning of Spring, which for me is an easier season to love than Winter.  

But this isn't really about the beauty and wonder of crepe myrtle trees or Spring, but rather, having something to look forward to, especially during tough times.  Luckily, the things that you and I worry about most of the time are not things that are life threatening.  They bring us fear due to uncertainty and lack of control, and we can feel this fear in every ounce of our body, mind, and relationships.  The stress can't kill us, but it can feel paralyzing.   

I'm a bit anxious by nature, so I've collected a number of different coping mechanisms to help when I'm feeling overwhelmed or panicky.  But there are circumstances where I know my mind might be a bit more worried until the passing of an event, such as waiting on the results of something.  And in these conditions, I rely on another set of skills to keep me grounded and at peace.  I ensure that there are things in my day and life that I enjoy, such as taking five minutes to meditate with the crepe myrtle trees.  When I have a busy day scheduled, I treat myself to a breakfast and fancy coffee or plan a dinner I can look forward to throughout the day.  When I know a couple of weeks will be more stressful for me, I carve out extra time for my friends and plan ways to pamper myself during the week (hello epsom salt bath on a Wednesday).  I've learned to be gentle with myself.  

We need not feel all the worry all the time.  So find (or rediscover!) the things you enjoy and make time for them, especially when life asks a lot of you. Your body will thank you, your mind will thank you, and your people will thank you.