How to Start or Restart Therapy

The new year is in full swing and people are in the process of making changes. From January-March, I typically see a lot of new people in therapy and I love it! I also have heard time and again how challenging it can feel to start therapy, to restart therapy after taking a break, to find a therapist, and to choose out of the many therapists out there. Maybe you are starting therapy for the first time ever or maybe you realize it is time to get back into therapy. Whatever the case, I hope this guide is helpful for you.

Start with Why
This may seem like a strange place to start a guide for how to seek therapy, but I think it is important. Thankfully, the pendulum has swung and it is more acceptable and even encouraged to go to therapy. You’ve probably seen the dating culture memes saying that going to therapy is a must in a potential partner. Therapy is having a moment, which is a great thing, because therapy truly is for everyone. There are all sorts of reasons you might start therapy including wanting to like yourself more, understand yourself better, have better relationships, work through childhood trauma, reduce depression and anxiety, navigate family patterns, communicate better, set boundaries, and simply feel better. That being said, your search for a therapist will be a little easier when you are clear about why you want to go. Therapy is an active, collaborative relationship that you participate in. You will get what you put into therapy and it works best if you choose to go for yourself.

How to Find a Therapist

There are many of us out there and if you live in the Denver metro area, the ratio of therapists to potential clients is high. If you live in rural Colorado, there might be less therapists, yet telehealth means you have more therapists available to you. It can also seem like all therapists are full and things have sttled since 2020. There are a lot of good therapists out there with current openings. A great way to find a therapist is to ask friends or family for recommendations. If someone has a good experience in therapy, they are usually happy to share that with you. Another word of mouth way would be to ask a provider you already see. Your doctor, acupuncturist, chiropractor, yoga teacher, etc, probably has a list of therapists they have connected with and can recommend to you. There are also directories including Psychology Today, Good Therapy, Mental Health Match, and Therapy Den to name a few. These directories offer a good way to filter out therapists who work with your concern and are most likely to be a good fit for you. Each of these has features to filter so you can find a good match. Last, you can find a decent therapist by searching on Google and going to the therapist’s website to find out more.

If you’ve had therapy before, maybe it was really great and it feels hard to find someone so great again. Maybe it was not so great and you’re worried about starting over. Kudos to you for being willing to give it another shot. Just like you don’t like every person you meet, you might not like all therapists or they simply might not be right for you. Each therapist brings something unique to therapy. It is also okay to take your time looking and ask questions to find a good fit. Speaking as a therapist who goes to therapy, I met with a few people before finding a really good fit for me. All the other therapists were good therapists and may have been good for me at that moment in life.

How to Filter out Therapists to Find a Good Match

No matter how you find a therapist, pay attention to your gut feeling as you would when you meet a new person in the world. Does their website or profile on the directory resonate with you? When you read through their profile or see their picture even, do you feel you could open up to this person? Does it seem like this person understands what you’re going through? Note, I said gut feeling, not fear. Many people have fears and anxieties about seeking help or looking for a new therapist. Your fears are normal and take heart that therapists are generally compassionate, want to help you, and understand the fear and excitement with starting therapy.

As you think about therapists you’d like to work with, keep in mind that therapists are humans and there is not going to be a perfect match. If we get wrapped up in finding the perfect match, it could be a way of avoiding getting started. Sometimes, it is helpful to pick someone who is good enough, try a few sessions, and see how it goes. Just like any other relationship, it takes time to build trust and rapport.

That being said, here are some filters you might think about that may be important in starting a therapeutic relationship:

Identity including gender, race, sexual orientation, religion or spirituality, lived experience, and even if the therapist is vegan or not, could be a way of narrowing down. I know I prefer to see a therapist who values nature, like I do, since nature is a major part of my life. At other times in my life, it felt important to work with a queer therapist. If you are queer, it is probably best to work with a queer affirming therapist at the least.

Specialties. After a few years in the field, most therapists gravitate toward working with one type of client or presenting problem, learn a lot about that niche, and become more expert. There are generalists out there who like to work with every problem and person too, but they might not have the depth of knowledge around a particular area. If you feel you’re struggling with OCD, you will probably get the most out of seeing an OCD specialist. Particularly, if you have childhood trauma, complex trauma, dissociation, and relationship anxieties, I highly recommend seeing a trauma specialist. I say this because these specialists will have taken advanced training, have years of experience, and be able to help you get relief quicker. At the same time, if you’re not sure of what you need, pick someone who you feel safe with and trust.

Types of Therapy. I don’t think I could cover all the types of therapy in one blog post, but there are many. No one type of therapy is superior than the rest. The therapeutic relationship and motivation to change are more likely to create change than the specific type of therapy. If you need help with mindset, managing your thoughts, and basic mental health care, cognitive behavioral therapy may be a good starting point. If you feel it would be important to feel more connected to your body, you might choose a somatic therapist. If you just want to talk, humanistic or person centered therapy might be your ticket. Last, if you have long standing or stuck trauma you want to process, EMDR or eye movement desensitization and reprocessing may be a good fit.

Online or In Person. There are advantages and disadvantages to both. I happen to offer both telehealth and in person appointments. For some people, in person therapy helps them focus more, have a container for therapy, have more privacy, and feels more effective. For others, online is a better fit to not have to drive across town, to have more options of therapists, and to be able to do therapy in the comfort of your home. Last, some therapists offer walk and talk therapy.

How to Pay for Therapy

Paying for therapy makes people apprehensive and I get it. It is an ongoing investment in yourself and a service, so there isn’t a tangible product you get. At the same time, the personal growth, relief, and understanding of yourself that you gain is hard to put a price tag on. I’m biased, but I think therapy is worth every penny I’ve paid for it. I’ve seen therapists that take my insurance and paid out of pocket, even when I was broke. When you pay a therapist out of pocket, the therapy is truly between you and the therapist, no insurance companies will look at notes, and you could see the therapist for anything, diagnosable or not. If you have the means to pay your therapist out of pocket, it also means your therapist can see less clients, not get burnt out, do better work with you, and have a livable wage. Insurance companies are frankly, greedy, and don’t reimburse therapists well. Last, know that the fee you are paying is not just for the hour, but the hours the therapist does training and for the therapist’s education and experience they bring to that session.

All though I take some insurance to make therapy accessible for more people, you are probably reading between the lines here, that I really prefer not to take insurance. I prefer to focus less on paperwork, diagnosis, waiting on reimbursement, and more on the relationship and the therapy itself. However, I understand that many people have to use their insurance for therapy. Despite some elitist thinking in the field, there are a lot of great insurance therapists. When you use insurance, the therapist has to give you a diagnosis, make a treatment plan to address the diagnosis, and the therapy has to be “medically necessary”. I remember a friend seeking help and being told he couldn’t schedule anymore, because he didn’t meet criteria for a diagnosis, which is an unfortunate part of using insurance. If you use your insurance, verify with the therapist and your insurance company, that the therapist is in network. If you have a PPO plan, you may be able to use an out of network therapist. This means you pay the therapist out of pocket, submit a bill to your insurance company, and the insurance reimburses you for a percentage of the cost.

One of my goals as a therapist is to make therapy accessible for anyone who needs it. There are still many people who are uninsured, have high deductible plans, and don’t have the means to pay a therapist’s full fee. Most therapists reserve a few slots on their caseload for sliding scale or reduced fee clients. They won’t advertise this, so you’ll have to ask the therapist. There is also a great resource, Open Path Collective, where you can find therapists that offer sessions at a lower fee. Locally, Khesed Wellness, is also a great resource.

Reaching out
Now that you have some ways to narrow down your search, and you have an idea of how to pay for it, pick 3-5 people you want to reach out to. If there is a therapist whose profiles and website described you perfectly, just reach out. They are probably going to be a great fit for you. I encourage people to look at anything the therapist has online including website, social media, and their Google Business to get a sense of who they are and how it might feel to work with them. I know it is a big deal to be reaching out to therapists, so I am okay with people calling, texting, emailing, or just directly scheduling a consultation call.

Here is an example of an email or contact form message you could send to potential therapists: “Hi! My name is____. I am looking for therapy for help with (in 1 or two sentences). Is that something you could help with? You can reach me at (call/text/email). I look forward to hearing from you!”

When I receive that email as a therapist, I am genuinely excited to get the ball rolling, meet you, and figure out how I can best help you. More practically, I respond as soon as possible and offer for people to either have a 15 minute phone call or to schedule an intake. The 15 minute phone call or consultation is an opportunity for you and the therapist to get to know each other and feel out if you are a good match for therapy. I ask you about you, why you’re seeking therapy, why now, share about how I work with people, and then go over scheduling, cost, and next logistical steps. Some questions you might ask about are how a typical session goes, my approach to therapy, cost, frequency, and any other question that helps you understand what it like to work with me. It is a relationship after all and relationships start with basically liking the other person.

I also offer the option to schedule an intake and skip the phone call. I recognize that some people are just ready to get started and I want to honor that. Of course, there is a risk of doing the intake and not being a great fit. If for some reason you and I are not the right fit, I will send you specific referrals of people who would be be a better fit. I know I don’t want to send people back on the hunt for a therapist. My goal is to help you get the help you’re looking for and feel better.

What to Expect Starting Therapy
Once you’ve scheduled your first appointment, you might have some questions about how therapy will go. I can share how therapy goes with me, once you schedule. I send paperwork through a digital, HIPPA secure platform. My paperwork includes practice policies, the risks and benefits of therapy, outlining your right to confidentiality, an intake questionnaire, and payment forms. If you meet with me on video, you also get a video link for our meeting. If it is in person, I’ll email you the address ahead of time.

The 1st session is an intake session. I try to keep this conversational, really listen and learn about the person coming to therapy, listen for their goals, and be as helpful as I can in the first session. This is also a time for you to get to know the therapist and ask questions. There are specific questions that I will ask you about your mental health, support system, work, what you do for fun, trauma history, safety, family history, substance use, and goals for therapy. I am strength based, so through out this first session, I am also listening for what you are already doing well and what your strengths are. We will work together to create a treatment plan, meaning a plan for how you will achieve an outcome with therapy. All though I tend to be more feminine and let things flow, goals are important. We should have some idea of what you are wanting out of therapy and how you will get there. This is part of how we know if therapy is working.

How sessions will go after that is difficult to say, because therapy is not a cookie cutter thing that the therapist is doing to you. It is an active process that two people are participating in, so it will look different depending on the relationship. I’m not a huge small talk person, but I do care about my clients as whole people, so I generally start sessions by asking how you’re doing, what is going on in your week, and what topics you would like help with. With some people, I start sessions by doing some breathing and grounding. With other people, we jump right in to doing exercises, and other people prefer to talk and get feedback. Generally, I try to strike a balance between actively listening and offering strategies or something experiential that changes how you’re feeling or approaching things. Different people need different things, but therapy should feel like a little more than you just venting and the therapist nodding their head. It is okay to ask for more or less structure in your therapy too.

You may be wondering how trauma therapy goes. Many people I’ve talked to are worried they will have to share or relive all of their trauma, face things they’d rather avoid, and even that they won’t be able to handle their feelings. People also often don’t even know where to start with trauma work. I can only speak to my approach as a therapist and the therapy I’ve had. Trauma therapy starts with helping you feel safe enough in your body, in the world, in the present moment, with your feelings, and importantly, in the therapeutic relationship. I start trauma therapy with getting to know the whole you first, how the trauma is impacting you, and helping you feel safe enough. To paraphrase Dr. Gabor Mate, trauma is not what happened to you, but what happened inside of you in response to what happened to you. So, much of trauma work is helping you understand your responses, to live in the present instead of the past or future, and make sense of the impact of what happened to you. Some people choose to talk about the trauma that happened, but it is not required to heal.

Another thing people often wonder about is how long therapy will take. My philosophy is that if you reached out for help, you probably could use some momentum and want things to change sooner rather than later, so I meet with people every week for the first month at least. In every session, I am checking in with people about the relationship, how they feel therapy is going, and whether or not you want to continue. I encourage you to feel out a therapist for three sessions to get a good sense of how you feel with the therapist. If it doesn’t feel like a good fit, be honest with the therapist and ask for referrals. If it is a good fit, I encourage you to stick with therapy for at least a few months, if not more. It is a little like when you take an antibiotic. Even if you feel better, you have to take all the medicine to really get better.

Therapy is a great resource for understanding yourself, resolving the impact of trauma, and feeling better day to day. Like anything, it isn’t the only way to improve your mental health and it is not a magic pill. You will get what you put into therapy and a lot of changes happen outside of your weekly therapy hour. Some people like to write things down in their session, journal after a session, or talk with someone in their life about what they got out of a session. I do my best to summarize each session with some takeaway items that people can try or think about. Therapists and the internet can give you a lot of strategies to cope with and address your mental health. Yet, the magic of therapy is the therapeutic relationship, learning to accept yourself, and taking steps to heal what ails you.

There is more to be said about how you know if therapy is working, how to get the most out of therapy, and when to stop therapy. For now, though, if you are ready to start or restart therapy, I hope this guide is helpful in your search for a therapist and having some idea of what to expect. If you are in Colorado, I encourage you to reach out to me any way you like to get started with your therapy journey.

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Email:Kaylanelsonlpc@gmail.com
Phone: 720-383-4205