Whether you’ve been thinking about making the brave step of calling that counseling office for years or for minutes, hopefully this will answer some questions about what you can expect and even ease some of the first-time-in-counseling or last-time-I-tried-this-I-didn’t-have-a-good-experience jitters.
So, let’s talk! Setting up a foundation for success and understanding is key to starting counseling.
Isn’t counseling for really bad situations or for “crazy”* people only?
No. Another misconception is that therapy is only for those needing hospitalization for very real and valid mental health conditions, a couple navigating a divorce, or someone in other major crisis. There are different levels of care most appropriate for specific situations (i.e. hospitalization, inpatient treatment, halfway house, recovery community, outpatient, etc.) and the idea that all counseling is the same needs to be clarified. While counseling and group therapy absolutely happen in hospital and in inpatient settings, it is not limited to these.
*please note that labeling someone “crazy” for needing help with their mental health is not helpful or kind, and is a limiting belief that keeps individuals from asking for and getting help. It is derogatory. Please avoid.
So how can counseling help me? How do I know if things are “bad enough”?
In this case, counseling in an outpatient setting (usually a counseling office or private practice) is most appropriate for individuals who are highly functional and it can be a huge support you as you walk through whatever season you may be in.
Counseling can be a valuable opportunity to not only work through issues and focus on healing, but it can also be a resource to enrich an already good relationship, to prevent current minor issues from developing into major ones, or to face increasingly difficult issues head on, to bring valuable insights into your life, to pursue personal growth, to get unstuck, or to simply improve your life.
A therapist can offer a novel and objective perspective and help you gain fresh insights, and walk alongside you to overcome the struggles that are currently keeping you from flourishing.
Alright, I think I’m ready.
Okay, you’ve narrowed it down and chosen a counseling office and/or therapist. What next? An important step in the counseling process is doing some beginning steps.
What to Expect Starting or Reentering the Counseling Process
Expect to make a phone call or schedule online
Assuming you’ve already done your research and have chosen a therapist or an office you’d like to go to, it‘s time to make the nerve-wracking sweaty-palms inducing phone call! Okay but really- it’s normal to feel anxious about this.
Go in to the phone call ready to ask for the therapist you would like to see, or briefly describe what you’d like to come in for so that the therapy office can recommend someone to you. They want to help you the best that they can even in the initial phone call, and sharing a little may be beneficial to your getting help as soon as you would like.
Be aware that if you’ve chosen a specific therapist that they may have a wait list. Many therapists are fully booked or not accepting new clients. If you are set on one clinician, asking how long the wait list is may be benefical for you so that you can gauge just about how long you can expect to be waiting. If they aren’t currently accepting new clients, asking when they may be in the future can help, too!
Emailing is a possible route of communication to schedule your first appointment, but response time may not be as swift.
Expect to fill out paperwork
Once you are scheduled, you will likely be sent or given intake paperwork.
This is very important to complete well before your first session if possible. Your counselor will not be able to see you unless you have read and filled out your paperwork and signed the informed consent.
Informed consent is the primary part of the counseling process. Confidentiality is a foundational part of the therapeutic process and this step must be completed.
If you have any questions about the informed consent with your counselor, it is important to let them know.
Your therapy sessions are confidential. However, there are a few exceptions to confidentiality and it is important to understand that as part of entering the process with your counselor.
Depending on counselor or counseling practice, there may be additional forms that are required to fill out along with other steps to be completed in advance.
Figure out payment details
Some counseling offices accept insurance, while others are private pay.
Figure out when you will be charged, how, and what to do in case you have to cancel an appointment.
Be aware of your counselor’s/their office’s cancellation or no-show policy.
Your first session with your counselor
This session is important. As your therapist, we know that you’ve probably tried many avenues to resolve the issue(s) and you are tired. We know that therapy is a scary thing to start that can bring up a lot of anxiety.
As trained experts in the field of mental health we want to get down to business with you and help as soon as we can, and part of that process means gathering information and establishing goals.
In your first appointment your therapist likely will…
Go over your paperwork or have you elaborate on your paperwork
Gather pertinent background information
Ask you questions
Actively listen to you
Want to gain traction and discuss with you how often therapy should occur
Discuss what you can expect going forward in the early sessions
Set therapeutic goals with you
I’ve had the experience myself of sitting in a first session as a client and leaving going, “Okay... so what now though?” And also, “Ugh, I wish that I didn’t have to do this first session thing because it just seems like giving a bunch of background and I really want help now.”
Bleh, I get it. As someone who has experienced the same frustrations, I want to invite you and encourage you to persist. The first session is a vital part of the therapeutic process and just because you may not feel like progress was made the first session and just a lot of “word vomit”, know that it in fact was extremely important and indeed is progress. So before you throw in the therapy towel after a first session, going in knowing what to expect I hope encourages you to keep going.
Unlike going to the doctor where they listen for five minutes and give you a treatment for your problem, it is important to know that counseling most of the time is not like that. You are not merely a set of symptoms that need “fixing”. You are a complex, unique person with an important story to tell. You are worth more than someone throwing “quick fixes” your way.
The words used above regarding counseling are intentional: it is a process.
A Reflection on Growth
We don’t yell at a plant for growing too slowly and berate it for not producing fruit in the winter. Okay, maybe some of us do that. But can we expect good things to come from a plant that isn’t nurtured or intentionally cared for?
Growing a seed into a strong plant takes intentional care, attention, vital resources, and time. There are steps to growth, and we acknowledge that the plant will grow in its time and with the right care, attention, and sunlight. Growth is a process.
In the same way, counseling is a process. Just as a plant makes itself available and ready to receive help on its growth journey, so can you continually choose in counseling to be open to and trust the process. From this posture I believe there can come healing, hope, and flourishing.
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