What to Expect the First Time You See a Counselor
by Bridget Nash
Going to counseling for the first time can be scary, but it doesn’t have to be! I wrote this blog and filmed a quick video to help guide you through the process of beginning your healing journey.
Let’s Start at the Very Beginning, it’s a Very Good Place to Start (my Julie Andrews tribute for the day)
How do I find a counselor?
Like most things in life, Google is a fantastic first stop! Go to your search bar and type in something like “counselors near me” and see what pops up. Look through people’s websites, their profiles, links they recommend—you can tell a lot about a counselor from how they present themselves online. What’s your first impression? Does it fit the “vibe” you’re looking for? How do you feel when you scroll through their site? Calm, peaceful, energized, motivated, cramped, cozy, spontaneous, exposed? Do they offer an environment you think would be conducive to your healing? Find someone who speaks your emotional lingo!
Too many options? Try psychologytoday.com.This site is an awesome resource if you want help narrowing your search. You can filter counselors’ profiles by city, insurance, issues and disorders, spirituality and religious affiliation, age group they specialize in, and a lot more!
Another great option is to ask friends, family, colleagues, and the like for a direct referral to a counselor. One of the biggest barriers people feel walking into a counseling experience is feeling uncomfortable talking to a stranger about their deepest, darkest problems. Knowing that someone you have a personal relationship with trusts a particular therapist can begin to ease some of the initial discomfort of talking to them for the first time. After all, we’re a mere six degrees from Kevin Bacon, one of those is likely to be an amazing counselor!
How do I get in contact with a counselor I want to work with?
Most counselors will provide perspective clients with contact info. If you call and we can’t answer right away, please leave a message so we can get back to you. Beware: counselors are not mind readers (we are magical, but not that magical)! We can’t help if you don’t ask. I know it can be uncomfortable to talk to someone on the phone (many of us are brilliant communicators when there’s a screen involved, so this is an excellent opportunity to put on our adult pants and exercise our verbal communication skills), especially about our mental health queries and quandaries. But remember, this is your moment to interview and “feel out” the therapist before meeting them in person.
If a phone call is absolutely out of the question, an email is another great option. Some helpful information to include would be your name and what sort of support you’re looking for. Counselors love to help people, and if they’re worth their salt, they would rather you get the best care for you, even if that means we have to direct you to someone else. If you feel so inclined, we would also be delighted to know what city you live in (how long of a commute would you have? Is there someone closer to your area that could help you just as well as we could that might be more convenient for you?), how old you are (do we work with your age group?), what you do (can we offer appointment times that accommodate your schedule?).
The first (intake) session
Your first session with a counselor is usually referred to as an “intake.” This is when the counselor takes-in (get it…in take…takes in…) a bunch of information about you and starts to build rapport—a fancy counseling word for “relationship.” Most recurring sessions are about 50-55 minutes, but depending on how your therapist structures the appointment, the intake session may run a little longer because there is more information to exchange than in typical meetings. If you are concerned about how big of a block of time to plan for, feel free to ask the counselor in advance how much time you should budget or schedule yourself a little cushion before and after the appointment.
You may be wondering “why is it 50-55 minutes and not a full hour?” Therapists often schedule their clients back to back and need a few minutes in between sessions to jot down some notes, rearrange their office if they had to move furniture around or clean up supplies, grab a snack, run to the bathroom, or refresh their memory of who’s coming in next. We want to respect each individual who comes in to see us and a big part of that is making sure the room is welcoming and our attention is focused on them (instead of our growling stomachs or the heap of construction paper and glue sticks on the floor).
Do I have to pay for counseling?
In the majority of cases, yes! Unless you are going to an agency that offers free counseling, or you have an incredible health care plan that covers 100% of your mental health services, you have to pay for your therapy sessions. Discussing payment with the office or therapist you’ve chosen can be awkward (for you and them), but it’s going to be a lot less awkward to get it over with early rather than have an uncomfortable interchange at the end of the session. As Kati Morton—LMFT and one of my favorite mental health YouTubers—illustrated, it’s kind of like going to Starbucks and expecting to not have to pay for your drink. Remember, this is how counselors make their living so they can continue to provide for their families, put gas in their car to get to work, and keep the electricity on so you don’t have to meet with them in the dark.
If you have an insurance plan that includes mental health care, as the office or counselor if they accept that insurance (psychologytoday.com can help you find a counselor who takes your insurance). However, if you are not using an insurance plan, you have a copay, or a deductible, there is likely going to be an out of pocket cost. Every counselor is different, so pricing may vary. If finances are an issue, you could inquire about a sliding scale and discuss with them a rate that you feel comfortable with (keeping in mind counselors are trained, well-qualified mental health professionals making a living by helping people and may not be willing or able to significantly drop their rates). Trust me, as a young adult, I fully understand the importance of budgeting and prioritizing, but seeing a counselor to manage your mental health will pay you back in the long run (depression is one of the leading causes of workplace absenteeism and poor work performance, mhanational.org/depression-workplace,forbes.com/sites/investopedia/2013/07/10/the-causes-and-costs-of-absenteeism-in-the-workplace/#496fe3a33eb6).
New client paperwork
You knew this one was coming. Before your first appointment, your counselor is probably going to provide you with a tidy stack of paperwork. This is not because we enjoy torturing clients with busy work! Questionnaires help the counselor make informed diagnostic decisions and formulate treatment plans tailored to your specific needs, while policy agreements equip you with the expectations moving forward in your relationship with the office and counselor. Leave yourself plenty of time to fill out all required documents (I send mine via email a few days in advance of the first session, but some practitioners may have you fill out hard copies when you arrive), which may include collecting necessary contact information, card numbers, medication names and dosages, etc.
Why do counselors ask so many questions?
As I mentioned earlier, counselors want to gain as much information about you during the initial intake as possible so they can make important decisions about your presenting problem and treatment options with confidence. Our questions (both on the intake paperwork and in the actual session) are not meant to pry or embarrass you. We want to ensure that you are receiving the best care we can offer, so the more we can learn about you the better for everyone involved!
Follow-up appointments
After your intake session, your therapist will likely ask you to schedule a follow up appointment. Counselors may want to see you weekly until some good progress has been made, which could take several weeks or months.
A common misconception is that counseling is an over-night fix. However, the first session isn’t even really “counseling”—its history taking and relationship building. Recovery and restoration take time and you may feel worse before you feel better. Counselors can’t wave a wand over you and make all your problems suddenly disappear (like I said, we’re magical, but not that magical). Think of it like scrapping your knee on the sidewalk and having to wash out a wound. Its gonna sting like hell at first, but you have to clean out all the dirt and germs so it won’t become infected. Over time, with proper care and attention, the wound will eventually heal over.
“Goodness of fit” with your new counselor
Success in your counseling experience relies heavily on the relationship you have with your counselor, so make sure they are a good fit for you. If you don’t feel comfortable with them, it’s going to be much more difficult for you to open up about what’s really bothering you. Real work happens when you can allow yourself to be vulnerable.
Starting therapy for the first time can be unnerving, so if you are feeling some discomfort, give yourself a few sessions to figure out if it’s nerves related to talking about your issues or if it’s the counselor themselves that puts you off. Listen to your gut! If it isn’t working out and you think you’d like to try someone else, COMMUNICATE to your counselor about that. This can be a great opportunity to work on confronting your feelings and expressing them in a clear and respectful way. If you feel so inclined, you may ask your counselor for recommendations of another practitioner or agency that might be more to your liking. By all means, if you don’t feel safe asking for other options, don’t. But remember, ghosting them will only result in the counselor continuing to reach out to you and both parties feeling uncomfortable.
With these tips, I hope you can walk into a new counseling experience with confidence!
