Let's Take the Anxiety out of Seeking Therapy!
Joe* came to see me for an initial session with a short newspaper article that I had written in his hand. "After I read this article, I knew I wanted to see you." I looked at the article, knowing that it was old. "When did you cut this out?" I asked. "Two years ago," said Joe. "I just got up the nerve to call you now."
Joe's story is not unique. Many people are anxious about seeking help. In fact, it's quite normal to feel anxious, confused and a bit overwhelmed when seeking therapy for the first time because it is an "unknown," you may not know what therapy is like.
Many people that call me have anxiety about asking simple questions about the basic structure of therapy, such as how long a psychotherapy session lasts (it depends, although the average is about 45-50 minutes). Others do not know the difference between a Psychologist and a Psychiatrist (Psychiatrists are medical doctors who can prescribe medication). So, if the process of therapy seems a bit of a mystery to you, you're not alone! Today I'm going to address a few of the common questions that people have once they have decided to seek therapy with the hopes that it will alleviate some anxiety for some of you!
How do I go about finding a Therapist?
These days, most of my clients find me on the internet. The internet has revolutionized that way people find therapists, because no longer are you picking a small name out of a large phonebook, but you can find real valuable information. There are several popular websites to look for therapists:
Psychology Today (PT): This site has a large directory of many types of therapists all over the country. Most therapists post their picture and write a profile that describes how they work, so you can get an immediate first impression of what a therapist might be like. Some of these therapists have an email contact (while others do not) so that you could email some of your initial questions.
The Anxiety Disorders Association of America (ADAA): If you're looking for someone who specializes in treating anxiety, this might be a quicker way to find that person. There's generally less information on this site about individual therapists, but everyone listed on the site is a member of ADAA and therefore has an interest in treating the anxiety disorders (although they are not screened for their actual amount of training/expertise in this area).
Christian Psychology Resources (CPR): For those who are specifically looking for a therapist with a Christian faith, CPR is a unique site that is growing by the month. Again it is nationwide, but is not nearly as large as Psychology Today.
Another way to find a therapist is through a personal referral. This means you have to ask someone you know if they know of any good therapists. The downside is that is that it is difficult for some people to ask this kind of question. The benefit, however, is that many people feel confident (and therefore less anxious) about a referral that comes from someone they trust.
How much does therapy cost?
Most people are concerned about the cost, and the answer to this question varies greatly depending on the type of therapist you see, your geographic location, and the price set by the individual therapist/agency. Community counseling centers may offer very low fees or sliding scales (where you pay based on your income), but they may also have a high turnover of therapists (meaning they may be staffed by students who move on to another training site after 6 months to a year).
Some people want to use their insurance to help pay for therapy. This is a valid option, but you need to remember that you will be giving up some of your privacy by using a third party payer. At the very minimum, your insurance company will want a mental health diagnosis. In the "worst" case scenario, they can audit the file that your therapist is keeping about your treatment progress.
You are also giving up some of your own power by using your insurance. If an insurance company is paying for your therapy they can put limits on it, sometimes by dictating who you can see, how many sessions you can have, and sometimes what type of therapy that they will cover. For example, many insurance companies do not cover Neurofeedback, which can be very beneficial for helping people with anxiety.
Some therapists are "fee-for-service," which means they do not have contracts with any insurance companies and do not bill them for services rendered. However, you can obtain a receipt from your therapist that has all the information on it you would need to submit to your insurance company if you so desire.
The issue of fees/cost is one that you need to discuss with your therapist right away because you need to be able to afford the fee. Although it is sometimes difficult to predict how long someone will be in therapy, one of the great perks about Cognitive Behavioral Therapy (CBT) is that it can be structured for different time periods. You can discuss with your therapist what might reasonably be accomplished in 5, 10, 15, 20 sessions and come up with a "game plan."
How do I know if the therapist I choose is right for me?
If you are seeking therapy for an anxiety disorder, you want to pick a therapist that has some expertise with helping people with anxiety issues. So, you might ask, "What approach do you take to treating people with anxiety disorders?" The answer should make sense to you based on what you know so far about anxiety and how you struggle.
One of the most important factors in picking a therapist is whether you believe you can form a working relationship with the therapist you are considering. You do not have to feel completely comfortable at first (many people don't!), but you do need to see some potential for being able to form a relationship. Not every therapist is right for every person, and good therapists are willing to admit that not every potential client is a good match for them.
What is the first session like?
Again, this may vary slightly among therapists, but typically when you arrive for your appointment you'll be asked to read and fill out paperwork. Some of this paperwork will address issues of confidentiality and informed consent about therapy. After you read about these issues, most therapists will discuss them with you to ensure that you understand this important information.
Your first session may just be a consultation where you talk a little about why you are seeking therapy and you and the therapist are deciding if and how to work together. Alternatively, your first session might be a more comprehensive intake, where your therapist asks you a lot of questions about your current difficulties and your history. Either way, it is certainly appropriate for you to ask any questions you have about the therapy: the therapist's expertise, training, and therapeutic approach, as well as office policies.
To conclude, remember it is normal to feel anxious when going to see a therapist for the first time! Do not let that stop you from seeking help. Just because you are anxious does not mean that you will stay anxious. In fact, most people calm down significantly within 10 minutes or so of their initial session!
*All client names/information are changed to protect confidentiality