6 Things to Know Before You Start Counseling
More people than ever are becoming consumers of mental health resources thanks in part to a current societal trend. Movie stars and sports icons alike are using their platforms to talk about their experiences with depression, anxiety, and substance abuse and how they got the help they needed in therapy.
Some of you found yourselves on a similar path and got help of your own. In counseling, you felt heard and supported as you developed new skills and obtained special tools for coping with your concerns in a much more effective way. You started recommending counseling to all your friends who found themselves stuck, assuring them that relief was right around the corner. A handful of you listened to that advice and gave it a try, only to be disillusioned and no better off than before. And many of you reading this now are still on the fence. Unsure. Skeptical.
I would like to address this to YOU. Your concerns are valid. Your desire to figure things out on your own is understandable and has probably helped you move forward in the past. But if you find yourself unable to make your way to freedom, it might be time to invite someone along to guide your next steps. Perhaps that thought makes your mouth go dry and your heart start to race. Chances are you have some questions about what to expect.
Expectations can play a big role in a person’s experience in counseling. The more you know about what counseling is and what it isn’t, the more you can adjust your expectations and free yourself up to really benefit from the experience. If you’ve never had counseling before, here are a few things to understand:
The first session is typically different than all other sessions. Often called an Intake Appointment, this initial session typically lasts an hour (sometimes more) and is geared toward establishing the therapeutic relationship between the counselor and client. Your personal history, current concerns, and goals for counseling will be discussed. The counselor will also cover informed consent information (i.e. confidentiality, practice policies, methods of between-session communications) as well as their personal style of counseling. Consider this first appointment like an interview. You are interviewing the counselor, so to speak, and she is interviewing you so that both of you can determine if it’s a good fit for moving forward. Therapeutic interventions geared toward problem solving are rarely utilized during this intake appointment.
Each counselor has a unique perspective or philosophy about how problems develop and how these problems are resolved or treated. This perspective is known as their theoretical orientation and can significantly impact the nature and course of therapy. During your intake appointment, it’s completely appropriate for you to ask about the counselor’s theoretical orientation and how it influences their treatment methods. Some orientations are more direct and solution-focused while others are more indirect and process-focused; many fall somewhere in between. If you don’t feel like your counselor’s approach is appropriate or helpful for you and your presenting concerns, know that you have the power to seek a different counselor whose orientation is better suited to meet your specific needs! The therapeutic relationship is of utmost importance in counseling, so it’s crucial that you find a good fit!
Counseling is a cooperative venture with responsibility resting on both the counselor and the client. Creating goals for counseling, setting the direction and pace of working through your problems, and even choosing appropriate applications/homework to supplement the process are all things you have a say in. Your counselor will likely make recommendations, but if at any time you feel uncomfortable following through on those recommendations, you have the power to voice your concerns, ask about the rationale behind the recommendation, and discuss alternatives with which you might be more comfortable.
While your counselor may recommend a frequency for future sessions depending on your presenting concerns, you have a say in how often you come as well as what content is explored during those sessions. If you are more comfortable coming every other week or only “as needed”, you have the right to make that decision but be aware that your progress could be impacted. Rarely are an individual’s concerns adequately addressed in two or three sessions. Counselors often recommend weekly counseling sessions in the very beginning to establish the therapeutic relationship and build momentum toward change. After a month, the frequency can be evaluated and either maintained or adjusted to suit the needs of the client.
Once counseling begins addressing the issues for which you sought treatment, it is not uncommon to experience a slight increase in unpleasant emotions. This initial worsening can be attributed to the fact that those difficult emotions and experiences – maybe for the first time – are being looked at and addressed. Like cleaning out your garage, you often have to make a big mess by taking everything out first, sorting through it to decide what stays and what goes, before you can neatly organize the space. Rest assured that this phenomena is temporary and normal. I often tell clients during the intake appointment that things might feel worse before they get better.
The more active a role you play in the direction and course of your counseling, the more benefit you will likely derive from the experience. Come with a journal or notepad to take notes of things explored or insights you gained in your sessions.
Set aside time each day or at least several times each week to process thoughts, emotions, and behavior patterns or to practice new skills. Come prepared each week with something you’d like to explore, and remember that you will benefit most if you give your counselor adequate time to respond to and address the content you bring up in session. For that to be possible, it is often recommended that you focus on one concern at a time rather than everything going on at once. Part of the treatment plan will involve prioritizing your concerns.
Counseling is about you. It’s about you getting the help you need to move forward, to find ways of coping more effectively with difficult circumstances, to develop skills and strategies for managing symptoms, and to gain insight into the patterns that contribute to the problems you face. Because counseling is about you, your counselor welcomes your feedback if have concerns about their approach or the direction of therapy.