How to Start Therapy

By: Camden Baucke MS LLP

Navigating the world of mental health can feel overwhelming, especially when considering therapy for the first time. Whether you’re facing anxiety, depression, relationship issues, or just feeling stuck, starting therapy can be a pivotal step toward healing and personal growth. Let this article be your guide, exploring why therapy is necessary, the practical steps to start, and all the details in between.

Why Therapy is Necessary

Mental health is just as important as physical health, yet it is highly stigmatized. Therapy is not just laying on a couch and pointing fingers at family members. Therapy is about providing a safe environment to explore the deepest of emotions and memories. It is about understanding behaviors, relationships, and effectively coping with all that life can throw at you.

Therapy is much more than just talk. It’s an evidence-based and thoroughly-researched method of addressing your pain, enhancing your quality of life, and getting you back to feeling like yourself. However, it can be difficult to even know when to start looking.

How to Know When to Seek Therapy

The biggest hurdle of starting therapy is determining if you need it or not. Identifying the right time to start can be difficult, but here are some indicators you can look out for:

Self-Description & Others’ Observations

A decline in your mental health often shows up in your thoughts, feelings, and behaviors. When it comes to your thoughts and emotions, these are sources of information only you can access. To determine if it’s time for therapy, you can ask yourself questions about emotions and thoughts such as:

1. Am I feeling more anxious or depressed on a daily basis?
2. Do I have anything to look forward to or am I starting to not do things I used to like?
3. Do I feel more overwhelmed with smaller and smaller tasks?

This is not a definitive list of questions, but it’s best to sit down, ask yourself some questions and document your answers. To be fair, it can be a challenge to identify how much things have slowly shifted over time. To address the “boiling frog” dilemma, it might be beneficial to turn those questions towards others. People in your life can witness your behaviors as a consequence of your thoughts and feelings. They also do not see you all the time, making any changes much more noticeable. Start by asking some trusted individuals questions like:

1. Do I appear more anxious or depressed than the last time I saw you?
2. Am I acting differently than the last time you saw me?
3. Do you notice me looking more overwhelmed than the last time you saw me?

This is a risk if you’re socially anxious, but sometimes it can serve as an effective mirror to your internal experience. If anyone you know expresses concern about your well-being, it might be something to take seriously. It could be a signal for you to start considering therapy.

Online Quizzes

While it can be difficult to start therapy based on your observations alone, there are some online quizzes to help you answer this question. Websites, such as Psychology Today, Psych Central or Health Central can provide quizzes to help evaluate certain symptoms and readiness for therapy. While quizzes are not definitive, and they can’t capture the total breadth of your experience, they can be another helpful tool in making your decision.

Quality of Life vs. Functioning

While mental health can drastically impact functioning, it is not the primary reason for therapy. Functioning is an important part of life at work, at home, and in our relationships. However, there is a long road of declining quality of life before you arrive at dysfunction. Before work becomes unmanageable, and before you start feeling isolated, you progressively feel worse. Yes, if your ability to be social or to be at work is impacted by your mental health, it’s a sign to seek therapy. However, if you notice your quality of life dropping, that each day is becoming harder than the one before, it’s best to be proactive and seek therapy before it gets to its worst.

How to Know Where to Look

So once you’ve asked yourself the hard questions, asked others for their observations, took a quiz or two, and looked hard at your quality of life and functioning, you might know if you need therapy right now. Let’s say your answer is YES I need therapy, then it’s time to start looking for a therapist. Here are some effective strategies for finding the right therapist for you:

Online Directories

There are plenty of great online directories to help match you with a therapist. Websites like Psychology Today, TherapyDen, and FindATherapist offer a great database to choose from. You can filter through therapists using location, specialties, and treatment approaches, making it easier to find who you need.

Word of Mouth

A great way of finding a therapist can come through personal recommendations. If you have a friend, colleague, or family member who trusts their therapist, then that probably means you can trust them too. This process helps normalize discussions about mental health and can help you find a good therapist quicker.

Insurance Providers

Therapy costs money, so it can be a great idea to check with your insurance company. They can provide options for therapists who are in-network and can take your insurance. Many insurance providers, such as Aetna, Blue Cross Blue Shield (BCBS), and more have directories to help you get connected.

If you are thinking about out-of-pocket expenses, it might be beneficial to look for a therapist who offers a sliding scale fee. This means they match the cost of a therapy session to your income and ability to afford it. If you are having financial difficulties, but are still looking for therapy, you can go to OpenPathCollective.Org to find affordable therapy.

Choosing a Therapist

Now that you’ve either looked at online directories, talked about it with others, or found therapists through your insurance network, it’s time to choose. I’ll repeat this plenty, but this is not a permanent decision. It is better to risk reaching out rather than not starting therapy at all. Therapy is not a one-size-fits-all. There are plenty of therapists to choose from depending on their individual specialties and niches.

Specialties and Niches

Therapists can have a wide array of credentialing and expertise. The most common credentials you will see for therapists are:

• LP – Licensed psychologist
• LLP – Limited License Psychologist
• LISW – Licensed Independent Social Worker
• LMHC – Licensed Mental Health Counselor
• NCC – National Certified Counselor

While that is not an exhaustive list of licenses, it is important for a therapist to be licensed. Licensure means that they have gone through the required training to give you the services you need in a safe and effective manner

Many of the online directories allow you to choose what you would like a therapist to be trained in treating. Also, you can look for specific approaches to therapy as well as situations that are unique to you. To find the right niche for you, it would be good to consider:

• Specific Diagnoses
  • Look for therapists specializing in whatever you find yourself struggling with. If it be anxiety, look for therapists specialized in treating anxiety
  • If you are feeling depressed, look for therapists who treat that as well
  • Your issues don’t have to be a perfect match for the therapist, as long as you feel confident in their ability to treat what you bring in
• Therapeutic Approaches
  • Research different types of therapy to gather a better idea of what you would like to do in therapy
  • Some behavioral treatments are better suited for certain mental conditions than others, so it can often match what challenge you are bringing to therapy
  • Popular treatment methods include Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), or Eye Movement Desensitization and Reprocessing (EMDR). Each approach has its unique focus and techniques
• Specialized Situations
  • There are plenty of therapists who cover a wide range of mental health issues related to specific circumstances.
  • For example, if you struggle with body image, there are therapists who specialize in that
  • If you are recovering from a traumatic birth or experience postpartum depression, there are therapists who specialize in that
  • Whatever situation you find yourself struggling through, there’s a chance a therapist is perfectly suited to address that specific context
• Online or In-person
  • Therapists can offer a range of ways to host therapy sessions
  • Online sessions might fit your schedule better and provide much needed flexibility
  • In-person sessions can provide a sense of connection and collaboration
  • There’s plenty of ways in which you can meet a therapist, but it should fit what you need and want

Taking the First Step: Reaching Out

Now that you have a good idea of who you would like to see, it’s time to start the process of reaching out. Good thing is that most therapists offer an introductory call (usually around 15-20 minutes). This allows you to get a feel for the therapist and gauge whether they’re a good fit for you before you invest any time or money into therapy.

Paperwork and Confidentiality

Once you are determined to start therapy with a certain therapist, be prepared to fill out some paperwork. It might feel overwhelming, but there are many forms necessary to complete before starting therapy. These include consent forms, confidentiality forms, and so on. You’ll also have the opportunity to share some information about yourself before the initial session.

The Intake Process

Your first session will likely be an intake. This is where the therapist gives you their opening spiel about therapy, confidentiality, and fees. Then, you can expect questions about your personal history and ongoing concerns. This is an important part of establishing a foundation for your work together. An intake always feels less collaborative than a typical therapy session, but it’s the first step in a very important journey.

Also, be prepared for reflection on uncomfortable memories or relationships. The therapist won’t dive deep into it, but if you’re seeking therapy to address a specific experience, then you might have to share that experience. It won’t feel good in the moment, but be considerate of yourself and plan for it. Don’t hop off an intake and go straight into a work meeting. If you effectively prepare, open up and be as honest as you can be, the more beneficial therapy will be for you.

It’s Okay Not to Stick with Your Therapist

Finding the right therapist can take time, and it doesn’t always happen on your first try. Please remember that it’s perfectly okay to not stick with the first therapist you meet. If you do not feel like it is a good fit, then you can express your feelings to your therapist or actively search for another. Most therapists understand that a good fit is essential for feeling better, and will most likely respect your decision. Therapy is only effective if you feel comfortable in a space to discuss uncomfortable thoughts or feelings.

Conclusion: Embracing the Journey

Starting therapy is a difficult yet necessary step towards better mental health. While the situation can be ambiguous and daunting, hopefully this article has helped shine some light on the process of determining if you need therapy, what to look for in a therapist, where to find a therapist, and how to begin working towards a better future.

More than anything, give yourself some understanding. Embarking on a mental health journey comes with a mixture of emotions. Allow yourself to navigate this process at your own pace. Your mental well-being is invaluable, and investing your time and energy into it can lead to much-needed changes and happier days ahead.

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