The First Time I Went to Therapy
The first time I went to see a therapist, I was in college. I hadn't thought to do any research to find someone other than what was available at the counseling center. I didn't understand her credentials (she was an LCSW-C, which meant she was a licensed social worker... I wanted to see a counselor, not a social worker!), and to be honest, I am not even sure what I was looking to get out of the whole process. Allegedly, she was adept at managing all things related to surviving college and everything that goes along with it. But the only thing I really remember about her was that she had 2 party size bags of Doritos sitting in her office as though she was on her way out the door to a super fun get together with friends. Either that, or she brought her groceries into her office, instead of her house. I could never be sure.
Every week I sat there, resentment building, annoyed that she was clearly having a better time in her life than I was, since she was leading a life that required party sized bags of Doritos while my life had been split in two. It didn't help that her approach was not a match for my shell-shocked self. All in all, she was probably a very nice person, but her no nonsense approach and reactions to the few things I disclosed did not make me feel at ease (to say the least) and I was equally relieved and sad when she pointed out that this was not a good fit.
Seriously, she fired me! I didn't know therapists could even do that!
Side note: we can, and we do, but some of us are more gentle about it that others. But I digress…
Was this all there was? Where was the nurturing, comforting, ‘I get it’ lady I had been hoping for?
Here’s the point. If you’re reading this, chances are you’re contemplating finding a therapist. Or maybe you have found a therapist but aren't sure if they are the right one for you...remember that thing they said the other week that made you so mad? Or the time they gave you that look and you had no idea what it meant? Or maybe you are staring down a list of names from your insurance company, everyone with different alphabet letters after their names (do they even matter?). And then there is that one friend who suggested you try their life coach...
Wherever you are in the process, there is only One Thing that matters:
You need to find the right fit. Here’s how.
First and Foremost Get Clear on Why You Are Coming In
I actually had a very specific reason for sweating it out in the counseling center my freshman year of college. But I was not in a place to articulate it. Are you feeling the same way? Not a problem. Grab a pen & paper and write down what it is that’s bringing you in right now. You can use hieroglyphics, pictures, or code words if you need to, just make sure it makes sense to you. You can always burn it later. You might find it’s more difficult to write down or conceptualize, even though the thought has been drifting across your mind for weeks. Hence, the code words and stick figures ;-) This is an important step, because it will help you get clear on who & what you are looking for. After jotting your notes or drawings, complete the following sentence: I am coming in for ______ and I just want someone who will ____________. Had I done this critical step over 20 years ago, I may have found myself in much more compatible space.
Depending on what is bringing you in, you may want someone who is versed in treating a garden variety of problems. If you know you have a pretty specific concern or root problem, you’ll want to see a specialist. This is especially true if you’re trying to manage a higher level concern, like an eating disorder, complex trauma, or suicidal ideation. Therapists are all skilled in different areas of focus, such as couples, anxiety, transgender issues, family trauma, etc. You want the one who specializes in your need.
Next step? Ask around. Seriously, ask anyone you trust (cast this net as wide as you like) if they know a licensed* therapist who specializes or focuses on _____. If you have a preference of something specific in your future therapist’s nature, such as sensitivity to culture, spirituality, or gender identity, throw that in there, too. Once you get some names, the fun part begins…
Look them up online. When I was in college, email and chat rooms were becoming all the rage, so no options for this then. Technology does have its upsides. Most of us have a website or profile listing that covers everything we know you need to know about us: who we treat, how we do it, and what you can hope to gain from our work together. We throw in things like credentials* and experience, too, but the most important part of this step is getting a feel for who the therapist is. We want to be a good fit for you as much as you want us to be a good fit for you. If you know you want a therapist who will sit and listen to you unpack the history you've never shared, you don’t want to call the one who advertises brief therapy or quick action oriented treatment. If you cuss like a sailor and need a therapist who won't bat an eye, there are plenty who make it clear, up front, they will be cussing right along with you. You should be able to tell fairly quickly if you want to take the next step, which is…
Make the call. If your potential person has the ability to schedule a free consult, do it! You want a therapist who can discern whether they have the right skill set and approach for the services you are seeking. It is important for both the therapist and the client to feel they are a good fit for you.
Did you know? it takes as much as 6 weeks to build rapport and feel comfortable enough with someone to know if it’s going to work for the long haul. My 1st therapist summarily dismissed me (she may not remember it this way, but whatever) upon week 7. Give it time, and don't be afraid to call your therapist out on that weird look they gave you. They may be blown away by your insight and excellent judgement, or they may be wondering if you just heard their stomach growl. It happens. Or ask about the bags of Doritos sitting in the corner. I my humble opinion, anything they bring into their office is fair game. Also, that thing they said that made you so mad? I remember seeing a different therapist, years after the Doritos lady, and getting really ticked off by something she said. I called my friend Gina on the way home, also a therapist at the time, and told her all about how this person was clearly off base. Gina’s response? “So she hit a nerve, did she? What’s that about?” She was right, of course. Generally speaking *anything* said in the therapy session is good material for therapy. So bring it up and get it out there in the open. Chances are, your therapist either a) had no idea they said anything that got to you and will be endlessly curious as to why it upset you (like Gina) or b) have been waiting all week to bring it up with you because they *knew* something was off the moment they said it. It’s a win-win for you, either way.
To summarize: you want the right skill set and approach. Look them up, have a chat, and try it out. It is entirely possible one of you will discover you need a different level of care, or someone whose expertise is in a different area than you thought you needed. You have not wasted your time by seeing a therapist and having one of you discover that a different practitioner is warranted. Know why? Because you just built a relationship with an expert in the field who knows you and who (hopefully) whose judgement you trust. When they give you a list of referrals, you can be sure they have your best interests at heart. Doritos lady did not give any referrals, but did invite me to come back “when I was ready”. I mock this incident, but it only took 20 years for me to decide she was right. I was not ready. You might find, you are not ready, either.
That is okay. We are here for you whenever you are.
I created a simple worksheet for you to make this process easier. If you would like your copy of my free worksheet to find the right therapist, you can do so here.
*A word about the differences between coaching, therapy, and credentials / licensure
I had plenty of reason not to like my first therapist, but the letters after her last name, much to my chagrin, were not one of them. Licensed Clinical Social Workers (LCSW-C) are as much licensed to practice therapy as Licensed Clinical Professional Counselors (LCPC) or Licensed Marriage and Family Therapists (LMFT). A licensed clinician (look for the L in the letters after their name) is someone who has an advanced degree in their field, passed a national exam, and been given permission by their state to practice mental health counseling or therapy. In the state of Maryland, no one is permitted to practice mental health counseling or therapy without a valid state license.
"Life Coaching" is not a regulated industry, despite the different ‘certifications’ floating around. Some therapists are coaches, but even so, what they are doing as a coach is not (and should not) be mental health counseling or therapy. Coaching does not dive very deeply into your presenting issue, and it will be more supportive & solution focused. If you are considering a coach to help you, chances are, you are not managing anything terribly clinical or mental health related. Building your business? Helping you ace the interview? Helping you get a better handle on day to day life? All great jobs for a coach. Quality coaches will know when your concerns warrant a mental health counselor and will refer you accordingly, if that is what’s needed.
Peer-to-peer support is another form of coaching. Someone who has been-there-done-that can offer peer to peer support to coach you through your current predicament. There are also many recovery and support groups that have sponsors or peer support. Peer-to-peer support can be done before, during, or after therapy and it can be fantastic. I have seen a ton of insightful and supportive feedback within these groups and it is invaluable in its own right. Nothing fuels hopelessness and despair like loneliness. Groups and peer support during & after therapy can help.
What do you think? I would love to hear your feedback in the comments section below.
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2/4/2020 02:32:55 pm
It was really helpful when you said to ask anyone you can trust for recommendations. For the past couple of months, I have been feeling depressed all the time and I have lost a lot of passion for the things I used to love to do. I'll make sure to keep these tips in mind as I search for a therapist to help me with my depression.
2/25/2023 10:23:36 pm
I could lie and say that it is simple to locate a therapist who would help you to overcome any issue you are facing. Since I was 16 years old, I've gone through at least a dozen (and possibly more) different therapists. Each one has its highs and lows, but finding a therapist is lot simpler now than it was when I was sixteen. You may visit the web to locate hundreds of possibilities rather than having to rely on the advice of hushed names muttered in bars or the incorrect phone number of a friend's therapist scribbled on a napkin.
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Cindy Goeller is a licensed therapist who loves listening to others, eating Maryland steamed crabs, and exploring the Finger Lakes of New York. When she is not in session with her clients, she can be found writing, baking, or spending time with her family.