Starting Therapy

So, You’re Starting Therapy: Here’s What to Know

The Nystrom & Associates providers consulted for this article on starting therapy were Marriage and Family Therapist (LMFT) Brett Cushing, Co-Host of Psyched for Psychology, and Licensed Independent Clinical Social Worker (LICSW) Marcy Tatro, Co-Host of Mental Health Fridays with Marcy.

So, you did it! You got set up to start therapy with a mental health provider. Maybe you have some doubts, questions, or concerns. Maybe you've heard a lot about therapy or have a loved one that goes regularly, but you're still unsure what it will look like. Do you have to lie down on a couch? Will your therapist contact your family members if you talk about them? We will answer all these questions and more in this article.

Congratulate Yourself on Starting Therapy

Seriously. You've taken a big step on the journey of becoming the best version of yourself. It takes a lot of bravery to say that you can't do this on your own. And it requires real strength to admit you need some adjustment in your thinking, habits, or how you relate to pain from your past. Never forget that asking for help is a sign of strength. We are immensely proud of you for deciding to better yourself. Marcy Tatro, an outpatient therapist, believes it takes a lot of bravery to start therapy.

It takes a lot of courage to take that first step forward... At first, it's hard to see somebody for therapy because of all the different beliefs we may have about going to see somebody for our mental health and what [this] means for us... A lot of people struggle, and you're not alone.

Please be sure to give yourself some credit.

Related: 5 Reasons to Go To Therapy  

It's Confidential

You never need to worry about your information being shared without your permission. The information you share in a session with your therapist is 100% confidential by law. No one besides a legal guardian has privy to what you share or do in a therapy session. If you are your own guardian, even a spouse, parent, or sibling cannot access information without your written permission. The only time your therapist will have to share your information is if they believe you are in danger of harming yourself or someone else. Otherwise, nothing leaves the office.

Brett Cushing, a DBT Therapist, assures his patient that their information is safe with him.

Coming to my office is kind of like going to Vegas. Because the adage there is, "What happens in Vegas, stays in Vegas." And I tell my clients, "What happens here, stays here."

Speaking of an office, what does a therapy office even look like?

You Don't Lie on a Couch

An odd image comes to mind when we think about starting therapy. We may see a classic picture of a bearded psychoanalyst sitting back, notepad in one hand, pipe in the other, while his patient lies on a sofa free-associating random thoughts. Or perhaps we picture a kindly Robin Williams in a derby hat sitting on a park bench with a young Matt Damon saying things like, "It's not your fault, chief." While these make for some compelling movie scenes, they don't do a great job of reflecting reality. So what does a therapist's office look like?

As with anything, it depends on the therapist. Marcy chose blue for her walls, a glam couch, and several impressionist paintings, including one of a castle. She says some clients do call her office "The Princess Office. "

And while Brett admits he does have the "standard couch," he jokingly says it's so that he can take naps during the day.

Most therapy offices will look like comfortable business offices with a couple of chairs, perhaps a couch, and a desk where the therapist does her paperwork between patients. It's intentionally a laid-back environment to encourage natural conversation. Brett invites his clients to bring their own beverages. He tells them to think of sessions like coffee with a friend.

Related: How to Start Therapy: A Step-By-Step Guide 

You Don't Need to Get Too Deep When You Start Therapy

Just like when you meet a friend for coffee for the first time, you won't start talking about the most painful parts of your life immediately. You will get deep with your therapist eventually, but you don't have to start there. Every therapist understands that trust and connection take time to build. They will ask you a series of questions to get to know you but don't feel the need to dive into every manifestation of your issues if you don't want to. There will be plenty of time for that.

When you start therapy, your therapist will complete a "Diagnostic Assessment." This is the set of questions they ask to figure out what your main concerns are, your family history, and things along those lines.  After the assessment, your therapist will make a diagnosis to bill insurance. But don't worry. They will treat you like an individual - not a diagnosis. They will also get to know what your goals are for therapy and determine what is working for you.

It's Okay to Change Therapists

If you feel it isn't working with your particular therapist, it's completely fine to ask to change therapists. No therapist will take this personally. They know that they will not be the best fit for everybody. Marcy says every therapist knows you may need to find a different provider if you're not clicking.

It's important to have a connection with your therapist, and it's okay if you change. And we all know that. We know you're not going to fit with everybody, and that's okay.

Therapy can be life-changing, but only if you ask for what you need.

Related: 10 Tips to Make Therapy More Effective 

When in Doubt, Ask

There are so many special terms and abbreviations therapists use that it might make you want to pull out your phone and Google what they're saying in real time. Maybe your therapist says you should try Cognitive Behavioral Therapy (CBT) or that you might have Complex Post Traumatic Stress Disorder (CPTSD), but you don't know what these terms mean. Sometimes professionals who use this language every day forget that the rest of us don't have the same knowledge as they do, so it's completely fine to ask and clarify what a term means. "It's always okay to ask," says Marcy, "What are those acronyms?"

If you're unsure what an acronym means, ask ASAP.

Related: What is Dialectical Behavior Therapy?  

A Word from Nystrom & Associates on Starting Therapy

Therapy can help you navigate many different challenges. A therapist can help you identify and change negative patterns in your life, improve your self-esteem, and give you the tools to manage stress and emotions. We are so grateful you're starting this self-healing process, and we know you'll thank yourself for this decision.

If you haven't started therapy yet and you're interested, give us a call. Nystrom & Associates offers therapy in person and through telehealth. Talk with us at 1-844-NYSTROM or request an appointment online at any convenient location. 

Related: How Therapy Helps With Depression

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