Is therapy a space to talk "at" a person for an hour each week?
Am I supposed to vent about my problems and that's it?
Is the therapist supposed to ask me questions the entire time and lead me to those "ah-ha!" moments I see in the movies or read about in books?
How will I know if it's helpful?
Why should I trust a stranger with my vulnerabilities and secrets?
Isn't therapy only for people with serious problems?
What is the point, really?
I used to think similarly about therapy. I didn't attend my first therapy session until I was in my early to mid 20s. I had no idea that therapy was an option for the average person. When I pictured a therapist I thought of someone in a hospital setting working with a patient who was there against their will due to a psychotic break of some sort. Knowing what I know now, I wish I'd known about the gift of therapy sooner.
The answers to the questions above are all dependent on what the individual needs. For example, in my own therapy (yes, it's great for a therapist to have a therapist too), I spend my own sessions:
Crying for no apparent reason
Doing grounding work/breathing exercises
Talking through present day obstacles or struggles I'm having
Processing trauma or past experiences that have pained me
Exploring patterns in my life that aren't serving me
Celebrating victories and successes
Feeling held and seen
Joking around and laughing with my therapist
Therapy can be what you need it to be. When the relationship between the therapist and client is solid, therapy can be a safe space to process whatever is most helpful.
I know that all sounds vague in a way, but that's also the point. Therapy is not a one size fits all. Some therapists take a more person-centered approach (Rogerian in theory) and allow the client to guide their own journey. Other therapists may be more direct and provide prompts or interventions more often to their clients. Most therapists fall somewhere in the middle of this spectrum.
It is ultimately not the therapist's responsibility to lead you in your own journey. They are ideally there to support you in whatever way you need. This is why setting a goal for therapy with your therapist in your first session is crucial. This provides structure for both you and your therapist to navigate the therapeutic journey.
Two examples of very different therapy goals:
1. Specific and solution-focused goal. Client seeks out a therapist to help with their generalized anxiety disorder diagnosis. Goal for therapy: Client currently scores average of 2 out of 10 on scale of daily anxiety (0 being most anxious and 10 being least) and would like to average 6 or higher within 6 months.
2. General and long-term goal. Client seeks out therapy to learn more about their patterns and grow into a better version of themselves. Goal for therapy: Client would like to work on improving confidence, learning and practicing boundary-work and building more positive interpersonal relationships.
Therapy doesn't always play out the way you see it in the movies or in books. There are also hundreds of therapeutic theories (blueprints or guidelines) and interventions. From Freud's psychoanalytic theory (free association, dream analysis, exploring the unconscious mind) to expressive art therapy (uses actual artwork in the therapy approach), there are an overwhelming amount of options. Many therapists combine more than one theoretical approach in their work. This is why it's helpful to have some assistance in finding a therapist that has an approach that may work best for you.
So, how do you get started in finding a therapist?
Start somewhere. Starting with a session is the best way to learn what you like and what you don't.
Ask your friends or family if they have a therapist they like working with and trust. I don't encourage close friends or family members to see the same therapist, but they can ask their therapist for some referrals to their colleagues. Talented therapists often collaborate and network with other talented therapists. Before asking your friend to request referrals to other therapists, make sure you specify if you need to use your insurance or if you are able to budget to pay an out of pocket fee (may range from $60-$150 depending where you are located).
Check out psychologytoday.com and utilize the filters to search for therapists that meet the criteria you need (insurance, gender, specialities, location, and more).
For lower fee options out of pocket, try openpathcollective.org or one of these spots around the Austin area if you are in Austin:
After finding a therapist option, what do you do next?
Ask for a consultation phone call, video session or in person session before scheduling your first full length session. A therapist that is selective with their clientele is doing so in order to make sure they are able to meet the client's needs as well. They will often offer a free consultation for this reason. This provides space to answer any questions you may have and gives them an opportunity to ask you questions as well. I suggest setting up 2 to 3 consultations with different therapists so you can compare.
Some questions to ask in your consultation session:
What would a typical session look like?
What types of clients do you work with most? (Ideally they describe someone who sounds similar to you.)
Why did you decide to become a therapist? (I would want to know why my therapist chose this profession. It may be very telling about who they are as a person and how they will show up for me.)
Do you use a specific theoretical approach for therapy? Can you tell me what that approach entails and what I can expect? (You aren't expected to know what a theory is or how it works, but it may be helpful to hear the theory so you can research it and get the opportunity to hear their take on how it's explained.)
Do you have any special certifications that you utilize with your clients? (They may be trained in certain trauma work or expressive therapies that may appeal to your needs)
What if I try a few sessions with you and I'm unsure if it's helpful? (Pay attention to how they answer this. It will show how they handle uncomfortable topics. Ideally they will be very understanding and warm about making sure you find the right fit for you and will offer to help find the right therapist for you if things don't work out.)
I don't really know what to talk about in therapy. Will you help me with that in the beginning? (If this is something you are nervous about, let them know.)
Do you offer opportunities for feedback? (An additional opportunity to see how they handle this topic. I find it's very important for therapists to check in with new clients to see how they are feeling about the sessions. This is also necessary further in to the therapeutic relationship as needs may change.)
You may also want to search their name or license number to see if they have any public disciplinary action reported on their license in the past. You can do so by clicking here.
After starting the work, what should you keep in mind?
Once you begin working with a new therapist, it's important that you are clear with your expectations so they can let you know if your expectations are realistic. This is also helpful for therapists as we cannot read our clients' minds and each client is wanting something different. After letting them know what you're hoping for, they can either shift their approach or can provide you with a referral to a therapist who will better meet your needs.
Remember the goal here is for you to find the right fit for you. It is not about protecting your therapist's feeling.
A few things to note:
1. Share feedback after sessions. Let the therapist know what you liked and want more of and what you didn't like and would like less of. Definitely let them know if something made you particularly uncomfortable or upset. They are trained to receive feedback and know it isn't personal to them. This is a safe space to share when things aren't working for you.
2. If you are unsure where to start and they are waiting for you to talk in the session, let them know you aren't sure how to begin. You may say "I have no idea what to talk about right now." They are trained to help guide you and can help you narrow down what might be helpful. Remember that therapy is useful even when you don't have a crisis going on in your life. It takes a bit to get used to the rhythm, but once it happens, things will flow naturally.
3. Journal between your sessions and note down things that come up in your life that would be helpful to bring up to your therapist at your next session. You can bring the journal to your session and read what you wrote down. Your therapist will appreciate the motivation.
4. Try sticking with a new therapist for 3 to 5 sessions before deciding if things aren't clicking. It can take time to get into a flow with a stranger. This is especially true if it's your first time to therapy.
5. I encourage new clients to attend therapy weekly in the beginning to get momentum moving. Sometimes waiting too long between sessions is the reason the flow doesn't progress.
I encourage you to reconsider if you've ever thought therapy isn't for you. My dream is for everyone to have a positive therapy experience at some point in their lives. You are never too old to go to therapy nor are you too late.
My personal journey in therapy has involved the healing and nurturing that only a confidential and objective outside party can provide for me. I feel like it's a space I can say the things I'm too afraid to say anywhere else. It's a space where I can throw out thoughts I have that I'm not yet ready to share with those close to me. My therapist is able to call me out on things I may not see or point out patterns I assume would be obvious to me but that I clearly miss. I often ask my therapist if I'm being an asshole and she will tell me! I genuinely believe we all deserve space like this to be held for us. If you aren't convinced, check out my blog on how powerful it can be to hold space for others.
I wish you well in your therapy experience.