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A Beginner's Guide to Therapy: Navigating the Path to Healing

So, you’ve finally done it. You’ve decided to go on a journey of self-discovery and healing through therapy. Congratulations! It’s awesome and I’m proud of you.


Now what? If you're new to therapy, it's completely natural to have questions and uncertainties about where to start and what to expect. This post aims to provide you with a roadmap to help you embark on this important path to personal growth and well-being.


What are the Different Professions in Therapy?

Knowing who does what and why can be super confusing, even to clinicians. Therapy is a broad field with various professionals, each bringing unique skills and approaches to the table. Plus, every state might have different requirements as well. It's helpful to know the differences between them:


Wait—-what’s the difference between “therapy” and “counseling”?


These days, the 2 terms are interchangeable, but for some, there are nuanced differences in the scope of issues, the duration of sessions, and the approaches used. Counseling tends to focus on wellness and prevention (“addiction counseling”) and therapy can focus more on significant mental health disorders assessment and treatment. But really, it's the same thing.

What’s with the alphabet after their name?


Ethically, people who work in healthcare display their minimal level of qualifications, such as their state licensing and certifications, because you have a right to know their qualifications and training.


1. Psychiatrists: Psychiatrists are medical doctors who can prescribe medication to treat mental health disorders. They may also offer psychotherapy but often collaborate with therapists for a comprehensive treatment approach. If you need meds for ADHD or a mental health disorder, you will see a psychiatrist. Be aware, that not all psychiatrists are trained in therapy, and only focus on medication management.

2. Licensed Professional Counselors (LPCs): LPCs have master's degrees in counseling and are trained to provide individual and group therapy. They can specialize in various areas, such as marriage and family therapy, addiction counseling, or trauma therapy.


3. Psychologists: Psychologists hold doctoral degrees in psychology and are trained to diagnose and treat a wide range of mental health issues. They often provide talk therapy (psychotherapy) and can conduct psychological assessments.


4. Clinical Social Workers (LCSWs): LCSWs are licensed to provide therapy, case management, and support services. They often work in settings like schools, hospitals, and community agencies, focusing on social and environmental factors affecting mental health.


5. Marriage and Family Therapists (MFTs): MFTs specialize in helping individuals, couples, and families address relationship and communication issues. They are trained to work with clients to improve their interpersonal dynamics.


6. Psychiatric Mental Health Nurse Practitioners (PMHNPs): PMHNPs help diagnose, provide therapy, and prescribe medications for patients who have mental health disorders or substance abuse problems.


What about all those therapists and mental health experts on TikTok?

First, don’t get your therapy through social media. I’m not saying they are bad! Therapists on TikTok can share good information and help advocate for those who do not have a voice. It's entertainment. But, remember, you are a unique individual and deserve individualized care.


During Covid, therapists moved their practice online and some turned to social media for fun or to help. It became a big thing! Social media platforms validated and normalized the awful collective mental health of the Covid years. For many, hearing others struggle with mental health and just the struggle of getting through each day was beneficial. In fact, “TherapyTok” might have helped reduce the stigma over mental health. Following therapists on social media is fine as long as they are teaching you something helpful and hopeful, advocating for change, and getting you to consider seeing a therapist yourself.


But, there are big, serious, ethical problems with getting your mental health advice via TikTok, Instagram, etc:

  • Serious diagnosis are becoming oversimplified and apply to everyone (for example, having "T-Rex arms" does not automatically mean you have ASD).

  • The use of “pop psychology”, or over-saturated clinical jargon (for example, the overuse and misunderstandings of “boundaries”, “trauma”, and “narcissism”).

  • Therapists diagnosing or using harmful labels online.

  • Credentials aren’t shown: this is a biggie! If someone is posing as a therapist, giving advice, and using clinical jargon, then they should have the credentials to back that up. Always check Psychology Today to verify.

Alright, you’re ready! How to Find a Provider

Finding the right therapist is a crucial step in your therapeutic journey. Here are some tips to help you in your search:


Ask for Recommendations: Seek recommendations from friends, family, or healthcare providers. Personal referrals can lead you to a therapist with a track record of success.


Online Directories: Use online therapist directories, such as Psychology Today, TherapyDen, Mental Health Match, or Open Path, to search for therapists in your area and read their profiles to see if they specialize in what you need.


Use your insurance website to search for clinicians in your area.


Insurance or Cash Pay: Pros and Cons


Therapy is not cheap, and insurance companies are not paying therapists a living wage. Did you know that if you use insurance, your therapist must diagnose you? That’s great if you have depression, it’s not great if you’re dealing with a life transition. There’s nothing in the DSM 5 for that (although some therapists will make it work, wink wink, attachment disorder, wink wink). On top of that, the insurance company dictates how many sessions you can have and can impose limitations.


This is why so many clinicians do not take insurance and offer a “super bill”, a letter you submit to your insurance for partial reimbursement, instead. So, deciding whether to use insurance or pay out of pocket is an important consideration. Here are the pros and cons of each:


Insurance:

Pros: It can significantly reduce your out-of-pocket expenses, making therapy more affordable.

Cons: Limited choice of therapists, potential privacy concerns, and some restrictions on the number of sessions covered.


Cash Pay:

Pros: Greater flexibility in choosing a therapist, enhanced privacy, and no insurance-related limitations on treatment length.

Cons: Higher cost, as you are responsible for the full fee, which can be a barrier for some.


Mental health providers want to help you, so ask about a sliding scale (possibly getting a lower fee for a certain amount of time) or check out Open Path for providers in your area.


Tailoring Therapy to Your Unique Needs

What are all these “modalities” or “therapeutic approaches”? Therapists come from diverse backgrounds and are trained in numerous therapeutic modalities, each with its own set of techniques and principles. There are literally hundreds of these approaches to therapy, starting with Freud’s psychoanalysis, to humanistic, existential, CBT (the most well-known because insurance companies love it), solution-focused, IFS, mindfulness, social justice therapy, and so many more! What sets therapists apart is their ability to adapt and select the most suitable interventions based on your individual needs. Your therapist will carefully assess your situation and collaborate with you to determine the best approach for your journey to healing and personal growth. So, if your BFF sees a CBT therapist and gets lots of homework, that might not be your journey.


What to Expect from the First Four Sessions

If you’ve never been to counseling, you might think it looks like it does on TV. Honestly, I can’t think of one show I’ve seen that accurately depicts the therapeutic setting. But think of this: regardless of their approach to therapy, all therapists are trained to provide a calm, non-judgmental, caring, compassionate space for you to freely talk about your thoughts and feelings. You cannot offend your therapist or hurt their feelings, because we are there for you and to help you on your journey. It’s not about us. Your counselor will not “fix” you or your child, we cannot control or change another person, and we believe in the power of self-determination (a fancy word for your ability to make your own choices and manage your own life). It should be a trusting and authentic atmosphere.


To get there, the initial sessions are a vital foundation for your therapeutic journey. Here's what to anticipate and how to make the most of them:


1. Building Rapport: The first session is often an introduction. You’ll probably go over the intake forms, even if you did them at home. Your therapist must know a lot about you–do you have siblings, are you dating, do you go to school or have a job, and how’s that going for you? What’s your home life like? You'll get to know your therapist, too, and they will learn about your goals and concerns. This is how we build a trusting relationship essential for effective therapy.


2. Assessment: In the next few sessions, your therapist may conduct an assessment to gain a deeper understanding of your situation. This may involve discussing your history, symptoms, and the issues you want to address. This step is optional depending on your issues.


3. Goal Setting: Together with your therapist, you'll set specific, achievable goals for your therapy. These goals will guide the direction of your sessions and help you track your progress. Each session should have a connection back to your goal, so you can see how you are healing and growing, or not.


4. Active Participation: Be an active and motivated client. This is your journey, your counselor is walking beside you. So, if something feels weird, bring it up. If you don’t like something, it’s okay to speak up. Share your thoughts and feelings openly. Therapy is a collaborative process, and your input is crucial.


Making the Most of Your Therapeutic Time

To maximize the benefits of therapy, consider these tips:


Consistency: Attend your sessions regularly. Consistency is key to achieving lasting change. If you have to miss a session, let your therapist asap and see if you can move it to an online session at a better time.


Honesty: Be honest and open with your therapist. They are there to help, and they can only do so effectively if they have all the necessary information. Plus, your therapist has to believe you, so there’s really no point in lying ( unless you like wasting your time and money…).


Homework: Some therapists may assign homework or suggest exercises to do between sessions. Completing these tasks can accelerate your progress. It’s not like schoolwork, it’s more like reading a book, journaling your thoughts over the week, or trying a new way to talk to someone.


Self-Reflection: Take time between sessions to reflect on what you've discussed and apply the insights gained to your daily life. This is way harder than it sounds. You need to think deeply about how you respond to people and stress, and those thoughts come at weird times, like when you're in the shower or in the car. Safety first–don’t go deep while driving!


Remember, therapy is a journey, and it's okay to have ups and downs along the way. Your therapist is there to support you through it all. Embrace this opportunity for growth, and with time and effort, you can achieve the positive change and well-being you seek.


Hang in there!

Leslie



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