Beginning therapy can be a daunting experience for many people. It often requires navigating new emotions, transitions, and changes in your life that you may not have expected or been prepared for. While therapy can provide a safe space to explore these feelings, it's normal to feel overwhelmed at the thought of starting therapy for the first time. However, with the right therapist and approach, therapy can become an invaluable tool to help you grow and improve your mental health.
If you are new to therapy, you may be feeling the following concerns:
- Feeling uncomfortable talking to a stranger
- Fear of judgment or criticism
- Uncertainty about therapy's effectiveness
- Vulnerability associated with opening up
- Difficulty expressing thoughts and feelings
- Anxiety about therapy costs or insurance coverage
- Embarrassment about mental health issues
- Worrying if therapy will help your situation
- Concerns about privacy
- Not knowing how to find the right therapist
1. Feeling uncomfortable talking to a stranger
It is completely normal and understandable to feel uncomfortable talking to a stranger about your innermost thoughts, feelings, and experiences. You may find yourself feeling awkward, embarrassed, or even overwhelmed when having to share with somebody you don't know yet. It is important to remember that therapy sessions should be a safe space for you to express yourself without fear - but we don't expect that you feel that safety right away! The hope is that you feel safe enough in the beginning to take small steps forward. If it's feeling intolerable or if your interactions with the therapist aren't showing that there's room to move to safety, it's totally ok to try with someone else.
2. Fear of judgment or criticism
It's important to remember that you may feel judged or criticized because you're judging and criticizing yourself and can't imagine that anyone else would not be judging and criticizing you. So, of course that's not going to be something you can just stop feeling right away; it may be important to push yourself to share these fears with your therapist and hear how they respond. Therapists are real people with real reactions, but a good therapist is going to metabolize their feelings before responding and have it be more about you than about them. In therapy, the therapist should make it clear that their goal is not to judge you or tell you how they think you should live your life; instead, they are there to empower you to know yourself and create a life that aligns with your values, intentions, and goals.
3. Uncertainty about therapy's effectiveness
That makes sense! You don't want to invest in something that doesn't work! Fortunately, there is a wealth of literature showing the efficacy of therapy to help so many people. One of the consistent findings in research about therapy's effectiveness is that "therapy outcomes are strongly influenced by the relationship with the therapist." Having good rapport is just the starting point for how crucial the relationship is in affecting positive change for the individual.
4. Vulnerability associated with opening up
Honestly, I think this is a bonus to therapy. You get to be vulnerable! What a gift - when it can be in a space that is protected and cared for and supported and contributes to growth. I think vulnerability is a power that we get to grow into, but I understand that you may have been taught that being vulnerable is weak or that you're just "bad" at being vulnerable. So, it'll probably take time to be vulnerable - maybe you'll be really skittish or defended for a while. And that's ok. We can take our time.
There are going to be parts of starting therapy for the first time that will just be scary vulnerable. The first call. The first time logging on or showing up. The first time saying something out loud that you never have said before. All these things take courage and build that vulnerability muscle.
5. Difficulty expressing thoughts and feelings
It can be difficult for any new therapy client to learn how to express their thoughts and feelings, especially if it's something they're not used to doing. So, it is important to remember that your therapist doesn't expect you to be skilled at something you've never learned before and you won't be bad at therapy if you can't name all your emotions on day one.
Many people find that expressing their thoughts and feelings is intimidating because it can bring up unresolved issues and require them to actually confront these thoughts in their mind and feelings within their body. Your therapist is aware of this and can be a partner in helping make this more tolerable. They can give you skills to manage the distress that comes up; they can give you space as you learn to be with it; they can respond in a way that's different from how others in your life have responded to you in a way that can be corrective and healing.
6. Anxiety about therapy costs or insurance coverage
Yes, therapy is a large financial investment; and in the U.S. healthcare system, there are limitations on having support towards this expense. First, know the facts about how much each therapy session costs.
For in-network providers:
Call your insurance company and hearing specifically from them how much you have to pay all on your own to reach your deductible and then after that, how much your copay will be to your therapist. I'd encourage you to not assume that therapy will cost you nothing and to be sure to ask your insurance if there are any future limitations that may limit your access to care.
For out-of-network providers:
You have two options. If you want to pay totally out of pocket and not include your insurance company at all, this is a right and a privilege you may take on. If you want to utilize any out-of-network benefits through your insurance company, then I recommend the following:
- Call your insurance company and hear specifically what your out-of-network deductible is
- Find out how much the insurance company deems "allowable" for your therapist
- Find out how much your insurance company will then cover of their "allowable" amount after your deductible is met
- Find out if there are any out of pocket maximums in your benefits plan
- And then submit your superbills!
This is obviously all very confusing and frustrating. If finances are limiting, you may want to inquire about "reduced fee" options (or sliding scale fees), or find a lower-cost option through community mental health centers or student/interns who typically charge lower fees.
7. Embarrassment about mental health issues
Fair, there can still be a stigma around mental health. It is important to remember that therapy should never be something you feel ashamed of doing. It does not mean you're sick or broken or unwell, but rather it can be a commitment to yourself to growth, health, and being well. Your therapist isn't going to make fun of you for reaching out and supporting yourself in this way.
8. Worrying if therapy will help your situation
Therapy is not a one-size-fits-all solution, and each individual's experience in therapy will be different. There are different approaches, different theories, different strategies, and what helps your friend or partner may not be the best fit for you. Things will probably feel a little worse before it feels better. And I am confident that therapy will help you in some way and oftentimes this leads to greater changes in other areas of your life.
9. Concerns about privacy
When it comes to therapy, privacy is a major concern for many who are just starting. It's important to know that "your therapy sessions are confidential and private." Your therapist will not talk about you or your therapy sessions to anyone else unless you have given them explicit permission to do so. Even in the rare case where they may need to share information to protect you or others from harm, they will do their best to involve you so that you are not blindsided.
10. Not knowing how to find the right therapist
Yeah, this can be hard and can take a while! "Right therapist" means different things to different people. What are your priorities?
- Expertise, Do you care about your clinician's degree or education? Do you want your therapist to have advanced training in a particular issue that you're working through?
- Financial, What's your budget? How much can you reasonably afford for therapy?
- Being in network with your insurance, Consider also if your insurance ever changes or your therapist leaves that network - would you stay with the therapist?
- Availability, Is it necessary that you have appointment time that is at a specific time of day or day of the week?
- Time frame to get started, Are you in need yesterday? You may consider crisis services. Are you feeling stable and would like to prioritize fit?
- Office / Online, Do you want to go into the office? Do you want the option to switch between virtual and in person?
Many providers offer a first "consultation" which can be either a phone call or a full session at no cost to you. Take advantage of this consultation so at the very least you can hear their voice and feel out if you imagine that maybe at some point you could consider starting to get to the point where you could trust them.
Getting Started
This is not an exhaustive "get started" guide but I do hope it helped demystify the process a bit. With Dr. Claney, the process is to schedule a free 15-minute call with her care coordinator, Ally, who will ask you a little bit about what you're looking for and consider whether Dr. Claney is the best fit for you. Then, you can schedule a first session to get started. You're never locked in and you're allowed to be nervous.
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