THERAPY: WHERE DO I EVEN BEGIN?
Starting therapy – even thinking about it – can be overwhelming. How do I find a therapist? Do I want to do individual therapy, or family therapy? With my busy schedule, how will I find time to attend sessions? All of these are valid questions that come up for people about to begin their therapeutic journey. This article will guide you through the process by explaining words and phrases often seen in therapists’ online profiles, describing common provider types, offering suggestions for finding a provider, and describing what to expect when your sessions begin. In addition, we will debunk common therapy stereotypes. Therapeutic Words and Phrases on Profiles Two therapy-related terms you may see or hear on provider profiles (e.g., Psychology Today), are counseling and psychotherapy. Often, these terms are used interchangeably, but there are differences between the two. Counseling’s traditional focus is on a specific issue and its intention is to address a particular problem (e.g., stress management). Counseling can also include developing coping strategies or problem solving for different situations. By contrast, psychotherapy is a longer-term approach to therapy and dives deeper into the underlying processes of a person’s thoughts, emotions, and behaviors. Psychotherapy can address multiple problems simultaneously and is often used for diagnosis and the management of various mental health diagnoses, such as depression or anxiety (Sailing, 2021). You may also see providers mention theoretical orientation, which is how a therapist approaches their work and how they perceive their clients’ challenges (Sailing, 2021). For example, some theoretical orientations focus on early childhood experiences and relationships with parents, while others focus on the thoughts, behaviors, and emotions related to your current concerns. Theoretical orientations that you may see on profiles include Cognitive Behavioral Therapy (CBT), person-centered therapy, or a psychodynamic approach. Therapists who mention using a holistic perspective may adjust their approach based on the needs of a given client. Common Provider Types When searching for a therapist, it is important to understand the differences between the types of providers. Licensed Professional Counselors, Licensed Clinical Social Workers, Psychologists, Psychiatrists, and Marriage and Family Therapists can all provide therapy, but their training and overall approach may differ. Licensed Professional Counselors (LPC) and Licensed Clinical Social Workers (LCSW) are mental health professionals with at least a master’s degree in psychology, counseling, or social work. Upon graduation, they work in a clinical setting (e.g., counseling center) to accrue additional training focused on treatment, after which they take a licensing exam. LPCs and LCSWs are qualified to provide counseling to evaluate and treat mental health concerns for children and adults. Beyond this qualification, LCSWs also have the opportunity to engage in additional advanced training and receive their doctorate degree, at which point they become DCSWs (Doctor of Clinical Social Work). Psychologists have a doctoral degree in psychology focusing on the study of the mind and behavior. After graduate school they must complete a lengthy internship for additional training in treatment and theories. Psychologists can evaluate and treat mental illnesses through various assessments, clinical interviews, psychotherapy, and counseling. Based on their training and experience, psychologists can provide individual services to children and adults, or groups. A Psychiatrist is a medical doctor who specializes in the treatment of mental illnesses through the use of medications. Typically, the goal of seeing a psychiatrist is to understand and adjust medications and discuss how the medications are addressing symptoms. Often, psychiatrists do not conduct psychotherapy with their clients; instead, psychiatric visits are combined with sessions with a counselor or psychologist. Marriage and Family Therapists (MFT) earn a master’s degree to treat a wide range of clinical problems and specialize in work with couples and families. Their form of treatment is typically brief, solution-focused, and based on specific, attainable goals a couple can work to meet. The focus of an MFT’s psychotherapy is family systems – which can mean having family attending therapy together – and often addresses mental health within those systems. Suggestions for Finding a Provider Finding a provider or a therapy style that works for you is like test-driving a car, and you shouldn’t feel obliged to go with the first car you tested out. One way to find a provider is by reviewing profiles on websites like Psychology Today or Inclusive Therapist. Providers’ profiles will typically include the presenting concerns in which they specialize (e.g., children, LGBTQ+), their training, and even the insurance they accept. Another option for finding a therapist is to consult with family and friends who have been to therapy. Personal stories and referrals can be a great way to find the right therapist for you. Consulting with your medical provider, with whom you have an established relationship, is another way to find local providers in your area. It’s worth noting that sometimes a profile sounds great, but, once you officially meet, your connection with the therapist feels different. That’s okay! Feel empowered to take the time to find the best fit for you and your needs (just like test driving multiple cars!). What to Expect in Therapy Before attending your first therapy session, make sure to consult with your provider and ask about sliding scale rates and whether they accept your insurance. This way, you won’t have to worry about the cost of obtaining services and will know that your chosen provider is within your budget. Cost is often a barrier to attending therapy, so sorting out the issue beforehand may ease any feelings of stress or worry. It’s also important to ask about the structure of your appointments. For example, clarify how long sessions will last. Counseling and psychotherapy sessions typically last an hour unless a provider indicates otherwise. You might also inquire about the overall treatment length. The duration will vary, depending on your provider and your presenting concerns, but it’s important to understand how long you will be in therapy – whether several months or several years. And confirm whether your sessions will be in-person or virtual: discuss which would be best for your treatment and your schedule. During your first session, ask questions about the things that matter most to you in therapy. You may want to know how many years your therapist has been practicing, or their approach to someone with your concerns. The first session can also be a time to address values important for you to have recognized within the therapy setting. Common Myths about Therapy Something must be wrong with me if I need to attend therapy. People attend therapy for a variety of reasons, from managing daily life stressors (e.g., work-related stress, family relationships) to navigating severe mental illness (e.g., major depressive disorder, bipolar disorder, schizophrenia). I will be judged by my therapist. For those who have never attended therapy before, one fear is that they will be judged when sharing vulnerable information. However, therapy is intended to be a safe space anyone willing to be vulnerable and authentic in their experiences. If anyone finds out I am going to therapy, I will be ruined. People will see me as weak. There is still a stigma around attending therapy, but it’s important to know that this service is confidential. Just like with any doctor’s visit, your attendance in therapy and what you share there stay within that space and are not something that will be shared unless you feel inclined to do so. Once I start therapy, I will be in therapy forever. The length of time that you attend can vary and depends on a variety of factors, including your presenting concerns and the form of therapy you choose. It’s also important to know that it may take time to see results – therapy is not an immediate process. All types of therapy are the same. Therapy can look different based on presenting concerns, the theoretical orientation of your provider, and the type of provider from whom you are seeking services. Therapy is a resource that is often underused due to unclear information on how to find a therapist, a lack of knowledge about the types of providers, and various myths that keep people from attending. Seeking therapy can be an individual, couple, or family choice, one centered on well-being and mental health. Remember that seeking therapy doesn’t mean you are weak. Instead, therapy gives you an opportunity for growth and additional support.