THERAPY

10 Important Things To Know When Considering Therapy

Often, the thought of trying to find a therapist or gearing up to go to therapy can feel overwhelming — something you probably don’t need or want to feel when you’re likely already going through a tough time.

Questions like, “How do I choose the right therapist?”, “How can I find someone with openings I can actually attend?”, or “What should I even talk about in a therapy session?”, are probably running through your head.

Look, I get it.

I remember thinking these thoughts when I went looking for my therapist a long time ago.

And since then, I’ve learned a lot both as a therapy client and also as a therapist about how to search more effectively, how to make it affordable, how to get the most of your therapy sessions, and much more. I’ve rolled my insights into today’s post  – the 10 important things to know when considering therapy.

Whether you’re a longtime therapy client already seeing a therapist, whether you’re looking to start up therapy again and especially if you’re thinking about starting therapy for the first time, I hope this list of insights and tips feels helpful for you and encourages you to pursue therapy.

I may be biased, but I honestly think it’s one of the best investments you can make in yourself if you’re looking to see some sustainable, measurable change in your life.

So read on, and please tell me in the comments below about one thing you might add to this list based on your experiences in therapy! I can’t wait to hear from you.

1. The times, they are a changin’…

Once upon a time, going to therapy may have held some stigma (think Betty Draper in Mad Men… ugh.). But today, I’m personally and professionally delighted to be living in a time where, thanks to a multitude of celebs, athletes, royals, Millennial-driven media sources, and regular folks like you and me speaking out loudly and proudly about how important mental health is, going to therapy is becoming increasingly destigmatized and increasingly considered as normative as seeking out professional care for any other aspect of your life. In 2017, therapy’s more popular and more accepted than it ever has been. It’s a great time to be considering starting therapy!

2. Seeking out therapy doesn’t make you “weak.” It makes you smart.

Making the decision to seek out therapy isn’t a sign of weakness; it’s a wise act of self-care to reach out for support from professionals when there’s a challenge you need help with. You’d reach out to a doctor for help setting your broken bone or to a lawyer if you needed help filing divorce paperwork, wouldn’t you? When it comes to your mental and emotional health it’s no different. Reaching out for professional support is an incredible act of self-care to address the challenges you’re facing.

3. Therapy is one of the best investments you can make in yourself.

Don’t get me wrong: therapy is a financial commitment. It’s a financial investment. And it’s an investment in yourself and your ability to become more aware of self-sabotaging patterns and more capable of practicing new, more effective thoughts and behaviors.

This – this ability to think and behave more effectively – can profoundly and positively impact your future relationships, your work, your health, and even your finances. If you’re like most people I work with, you’ve likely already invested a lot of time and energy and money into your education, your career, your home, etc.. I truly believe that therapy is a continued investment in your overall wellbeing and success in life. And if you need help brainstorming how you can afford therapy from an out-of-network therapist like myself, check out this helpful handout I created about that.

4. Searching for a therapist can feel overwhelming, so here are some tips.

Look, I know from personal experience just how challenging it can be to find a therapist – I’ve gone through this myself. Where to start, how to know if you’re choosing the right one, how to get a therapist to actually call you back, how to find a time slot in their practice that you can actually make… it can all feel quite overwhelming and maybe even a little demoralizing which is kind of the last thing you want to feel when you already feel anxious or overwhelmed with what’s going on in your life. So I want to offer up some tips and tricks to make the process easier for you.

Understand the implications of using an in-network therapist versus an out-of-network therapist. 

Using your insurance to find and pay for a therapist can be a fine option, but just be clear about the possible risks of doing so and learn about why a lot of people choose to look for an out-of-network therapist instead.

If you decide to go out-of-network, search for nearby therapists through Yelp, GoodTherapy, or Psychology Today. 

Or ask for referrals from trusted friends, family, or colleagues. Scan the therapist listings and see who you like, who has offices convenient either to your home or workplace, and who just generally seems kind and warm in their pictures. Start by making a shortlist of 5-7 to call or message.

When you call or message them, ask for an initial consult call.

This is to help you assess if they feel like a good fit for you.

Most therapists will be happy to take the time to speak with you on the phone to help you answer any questions you have. A consult call is a wonderful way for you to connect before you book that first session and really get a sense of the therapist.

When you get them on the phone, definitely ask any questions you have.

“Do you have experience working with XYZ?”, etc. But mostly, pay attention to the feelings you have on the phone with them. I say this all the time but, in most cases, it really doesn’t matter what specialties a therapist has or where they trained, what matters is if you actually feel comfortable with this person. If you feel comfortable with them, if you trust them, if you like them, this will make for good therapy because you’ll likely feel safe enough to open up about vulnerable material. If you don’t feel comfortable with the therapist, it’s not likely going to be good therapy. So trust your gut on this one.

If a therapist only has session slots available that aren’t ideal for you, don’t fret or rule them out yet! 

Yes, evening therapy slots are competitive and sometimes hard to book but still, tons of people come to therapy during the day or late afternoon through a variety of means. Some folks go into work an hour earlier or later, or make up the time some other way if their boss/team is okay with that. Or, if your workplace allows you to work from home one day a week, that’s a good day and way to squeeze in a therapy session.

Personally, I’m always happy to give a work excuse to my clients if that would be helpful and I also provide online video and phone sessions for those times when you may not be able to make it into the office in person, but you can close your office door and grab some privacy for a session. So all of this to say, if the therapist you want to see only has daytime slots available, you can still totally make this happen. And finally, I have a waitlist that folks sign up for to be the first to learn about new openings in my practice (including those coveted evening hours that may feel more ideal).

5. There is no right or wrong way to do therapy.

I’m privileged to work with a lot of first-timers to therapy so I get told a lot, “I’m not sure what to talk about today.” or “I’m not sure how to do therapy correctly – where should I start?” and I’m here to tell you: there is no right or wrong way to do therapy.

I encourage my clients to pay attention to what’s at the forefront of their awareness when they sit down on the couch for the session. Notice any feelings in your body, any thoughts in your mind, if a dream from the night before is still bothering you, if there’s a problem you’re having in our relationship as therapist and client, simply bring up whatever feels most at the forefront of your awareness and we’ll start there. I always trust that if we notice where your energy is and follow that thread, it will lead us to the work that needs to be done on any given day.

Remember: there is no right or wrong way to do therapy and everything and anything is grist for the mill when it comes to therapy.

6. How therapy actually “works.”

This is a question that, if you asked 100 different therapists, you’d likely get 100 different answers to. So I will say is that, in my opinion, therapy – also called psychotherapy or counseling – “works” because it gives you a different kind of relational experience than you may have had before in your life.

I truly believe that it is through our early relationships that certain patterns get established and certain wounds created and it is only then through relationship that these patterns and woundings can shift and be healed. When we work together as therapist and client, it’s actually the relationship between us that becomes the therapy in addition to the all of the ways we explore, address and clarify the content you bring into the room.

Therapy “works” because it gives you a different kind of relational experience, a healing kind of relational experience that can actually change the neurons and neural grooves in your brain, leading to long-term change in your life. Therapy also “works” in that it provides you with a space, probably unlike any other in your life, that’s confidential, safe, and secure and allows you to get in touch with vulnerable subjects and have a trained, professional guide to help you better understand these subjects and make changes in your life if you want to.

7. Process hangover is a thing.

Another thing I tell my clients, particularly my first-time clients, is that “process hangover” is a thing that they may experience after a first session together, and possibly after we get in touch with deep, emotional material in any given session.

Process hangover can mean feeling a little disoriented, feeling raw and tender, feeling some shame come up because you’ve exposed parts of yourself that you’ve worked hard to keep tucked away, etc.. In other words, you may feel the emotional impact of opening up in therapy in the days after the therapy session has ended. And that’s okay! That’s totally normal and natural and, actually, it’s a really good thing. It means that what we’re talking about matters.

So just take good care of yourself and be curious about what you need to support yourself if you experience “process hangover” after therapy.

8. Things may feel worse before they feel better.

I know, I know, this may not be what you want to hear, but it’s important to know: when starting therapy, things may feel worse before they feel better. I often describe beginning the work of therapy (particularly if you’re looking to explore and change some deeply held beliefs, thoughts, and patterns) as what might happen if you decide to tackle a thorough cleanout of an overly crammed closet you haven’t touched in years.

When you begin the process of cleaning out the closet, you have to pull everything out and strew it about you on the floor, it may start to look like a big pile of chaos, and you may feel overwhelmed halfway through the project when you look around and see the mess around you. You may want to quit and you may regret having even started. But to get things really, properly cleaned and organized, you have to keep going.

As you do, you can sort out what goes to the trash, what gets donated, what gets returned to the closet and better organized. In time, you’ll have finished the project but please do know that there may be a point (or many points) when it feels worse before it feels better. The same thing happens with therapy.

9. Therapy takes time!

Similar to what I wrote above, it’s important to know that healing takes time depending on the content you’re looking to explore and heal. It’s important to remember that it took you however-many-number-of-years to develop the patterns/habits/ways of being that you have, it will take time to unlearn and then learn and practice something different.

Be patient with yourself with this process. Long-term change doesn’t happen overnight (contrary to what some pop culture coaches and speakers may try to sell you). It’s important to know that building or rebuilding a strong, healthy, integrated psychological foundation may take some time, and that’s okay. I invite you to trust the process.

10. How to make the most of your therapy.

Some of the tips I share with my clients to help them make the most out of their therapy with me include:

Get clear about your goals. 

In my initial intake forms and in my first session with a new client, I always ask the question, “If I could wave a proverbial magic wand and help you get three things from therapy, what would they be?” Sometimes you may only know one or two goals; sometimes you may have five, at times you may not feel clear at all about your goals for therapy. All of this is fine and, certainly if you don’t know what your goals are; one of your first goals in therapy could be actually getting clearer on your goals! Stay in dialogue with yourself and your therapist about what you would like therapy to support you with in your life. Having clarity about this on an ongoing basis can help make your sessions and therapy work more fruitful.

Journal.

Journaling in between therapy sessions is such a terrific way to deepen your work. Journaling about thoughts and feelings that came up after each session, jotting down notes of things that happened during the week that you want to bring up in your next session with your therapist, all of this is great material for your therapy. I personally use an old-school Moleskine for my journal but you can journal in a note in your smartphone, in a Google doc on your laptop, whatever works for you.

Pay attention to your dreams. 

I’m a big believer in the power of dreams to help us better understand what work we may need/want to do in therapy, so I always ask my clients to pay attention to their dreams, particularly after what feels like powerful or deeply emotional sessions to see what comes up for them. For some tips about how to interpret your dreams, with or without the help of a therapist, check out this blog post I wrote.

I truly hope it felt helpful for you to read about these “10 Things to Know When Considering Therapy.” I may be biased, but I honestly think that therapy is one of the best and most important investments you can make in yourself.

Here’s to healing relational trauma and creating thriving lives on solid foundations.

Warmly,

Annie

Frequently Asked Questions

This is part of our comprehensive guide on this topic. For the full picture, read: How Therapy Actually Works: A Complete Guide.

You deserve a life that feels as good as it looks. Let’s work on that together.

References

• Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014). The impact of mental illness stigma on seeking and participating in mental health care. Psychological Science in the Public Interest.
• American Psychological Association (2017). Stress in America: The State of Our Nation. APA.
• Vogel, D. L., Wade, N. G., & Hackler, A. H. (2007). Perceived public stigma and the willingness to seek counseling: The mediating roles of self-stigma and attitudes toward counseling. Journal of Counseling Psychology.
• Cuijpers, P., Karyotaki, E., Reijnders, M., & Purgato, M. (2020). Meta-analyses and mega-analyses of the effectiveness of cognitive-behavioral therapy for adult depression. World Psychiatry.
• Schore, A. N. (2012). The Science of the Art of Psychotherapy. Norton & Company.
• American Psychological Association (2013). Guidelines for Psychological Practice with Boys and Men. American Psychologist.
• Hill, C. E., & Knox, S. (2009). Processing the therapeutic relationship: A qualitative study of clients’ experiences of process and outcome. Psychotherapy Research.
• Stiles, W. B., Barkham, M., Twigg, E., Mellor-Clark, J., & Cooper, M. (2003). Impact of early sudden gains in cognitive-behavioral therapy for depression. Journal of Consulting and Clinical Psychology.
• Beutler, L. E., Harwood, T. M., Alimohamed, S., & Malik, M. (2002). Functional impairment and coping style as predictors of psychotherapy outcome. Journal of Clinical Psychology.

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