Reaching out--Why is it so Hard?

Contributed by Tracie L Keller, LPCC-S

Initiating a new therapeutic relationship feels a lot like going on a first date. Think about it: the first therapy session is when you as a client meet with a new person (typically one you’ve never met before) and sit down to share personal details about your life. First assessments feel vulnerable and new. Stomachs may feel “funny”; sweating is not uncommon; nerves might feel seriously shaken. So if you feel anxiety about coming into counseling, then why do it?

I’ll tell you why. Because it works. Counseling has been shown to help reduce symptoms of a variety of mental and emotional health concerns; from depression to anxiety, trauma-related issues to family of origin difficulties; counseling works. It has been researched and written about, and hordes of people from all walks of life speak of the success that they have reached through counseling.

Finding the right “fit”

In order to find use in counseling, it is important that you find the right “fit.” So then, what is a good fit? A good fit is finding someone who meets your needs as an individual, and is willing and capable of helping you work on the issues that you are bringing to the therapeutic alliance. From years of experience in working with clients, here is a list of questions that I have come up with that I encourage clients to ask prior to meeting with a new therapist:

1. What is your helping style?

Helping style is the means through which a counselor approaches working with a client. It can mean the type of therapy that a counselor is trained in and utilizes to treat mental and emotional concerns. Examples of helping styles that you may hear of in speaking with counselors include Cognitive Behavioral Therapy (CBT), Interpersonal Therapy (IPT), Solution Focused Therapy, or Gestalt Therapy (though there are many, many more!). Don’t be afraid to ask your counselor (or potential counselor) about what these styles mean. These are the terms that helping providers use to describe their craft, and it is important that you find the one that effectively treats what you are coming in to work on.

2. What is your approach to treating ______________?

This question is vital in that it gives you the information that you need to effectively decide whether this potential counselor is able to treat your concerns. If you have decided that you want to seek care to address drug or alcohol concerns, it’s important that you state that in speaking to him or her. If you have been recommended to seek help for an eating disorder, particular helpers are more equipped and trained to treat said conditions. While many clients know exactly what they may be “bringing in” to therapy, some others may feel more lost on how to put this into words. If you are one of these people, don’t worry. Meeting with a new counselor is a way to find the words with another person regarding what is not working or needs to be changed. In first conversations such as those regarding scheduling, you may want to let your potential counselor know that you need some help in identifying goals. A good “fit” for a counselor would be one who responds appropriately to this “curiosity” or lack of knowing that you have. He or she will be willing to meet with you and help you pinpoint what, exactly, you are wanting to change.

3. How do goals get set? How do I know that I’m meeting them? How do I know that I’m getting “better?”

This is probably one of my favorite questions to hear a client ask. Mainly because it makes total sense! Of course a client wants to know how goals are going to be identified and made, as well as measured. Most people that I know do not want to be in therapy for the rest of their lives! Therapy is supposed to be short-term. It is supposed to have an ending (or in counseling terms, “termination”). Goals help us direct our work together, and make counseling overall different than any other kind of relationship. Measuring goals can look like assessing changes via assessment protocol (think: pen and paper tests), or it can look like measuring behavior or mood changes via self report. With today’s technology, it can even look like self reporting changes via an app on your phone (there are a lot of these out there!). The right counselor for you will be willing and able to meet you where you are, be able to recommend different methods, and be constantly assessing whether your needs are being met with him or her.

4. (PSSSST! This is my FAVORITE question!) What would your response be if after meeting (for a time), you found that I needed something different than you can provide?

This is my favorite question for a reason. It is so useful to know that should a counselor not be a fit, even if you have seen him or her for a period of time, that there are referrals that this person can provide to get you where you need to be. We have discovered that relationship between counselor and client is a very vital thing; however, so is finding a therapist who is knowledgeable and capable of treating the concerns that you bring in as a client. Resources and referrals for other counselors are needed in particular times of treatment in order to help you reach your goals. Don’t be afraid to take referrals should a counselor recommend them; don’t be afraid to ask for them should you determine that there isn’t a fit with your current (or even potential) counselor.

Additional questions that I recommend you ask in scheduling with a new provider include:

  • Do you take insurance? If not, what is the cost for services?
  • What is your availability? Typical questions re: availability include any specialty times (evenings, weekends, early morning)

While starting with a new counselor may feel difficult, my hope is that with these points considered, you can feel more equipped to make that first call.