The anxious person's guide to starting therapy
Starting therapy can be scary! You don't know this person who you're about to pour your heart out to and reveal your deepest, darkest secrets and fears. That's terrifying! But it doesn't have to be.
One of the best ways to reduce anxiety about a situation is to add some elements of predictability. When you know generally what to expect, you're more likely to feel comfortable going into that situation and less likely to react badly if things go differently, because your nervous system isn't already on high alert from the start.
So if you've been thinking about starting therapy but don't know where to start or are anxious about the process of getting started, this guide is for you.
I'll explain how I go about booking new clients, which may be similar or different from the way other therapists do things. I'll try to note common differences, but I don't expect that I will capture all of the various ways people run their individual practices.
1) How do I find a therapist in my area?
Clients find me through a Google search, searching on Google Maps for counsellors in Moose Jaw, my profile on Psychology Today, and my business account on Instagram.
2) How do I figure out if a therapist might be a good fit for my personality and be able to help me with my problems?
The most effective therapists are the ones who specialize. There are literally too many different mental health conditions to be able to know enough about all of them to treat them all effectively. In therapy terms, a specialization is called a niche. My niche is working with disabled, chronically ill, and neurodivergent clients. This doesn't mean that I only work with clients who identify as being part of my niche, but it does mean that I think I do some of my best work with these clients. I also really enjoy working with folx across gender and sexuality spectrums, couples, teens, and women who are processing trauma and learning to set boundaries.
In terms of personality, it might take a session or two with a therapist to figure out if the vibe feels right or if something feels off. It's ok if it feels awkward at first, that's normal! You're still getting to know each other. But if you feel that you aren't being understood, that you are being dismissed, or that your therapist is way off in their recommendations, send a quick email to say that you don't think the fit is right and that you're going to continue looking for a therapist. (Please don't ghost them!) When clients are open with me about wrong fit, I'm always happy to recommend a couple of colleagues who I know practice differently from me who might end up being the perfect fit!
3) How do I book my first appointment?
This is where therapists differ a lot. Personally, I'm always happy to offer a free 15 minute phone consultation to talk with someone for a bit before they decide if they'd like to book a session. Other clients are happy proceeding right to that first session because they're comfortable with what they've learned about me on my website. Some therapists require a consultation before they'll book a full session, some only offer paid consultations, some don't offer consultations at all and require all clients to book an initial session. Most therapists will state this on their website, but if they don't, reach out to ask and they will clarify.
As far as booking goes, I use an online practice management system that helps me with appointment scheduling. I can register clients in my system, or clients can register themselves through a link on my website. My system allows me to book appointments for clients or let clients see my availability and request appointments, which I then confirm. I really love being able to offer multiple ways to book appointments and find that allowing clients to self-register and book saves the anxiety of having to contact me to discuss scheduling. For other clients who want to leave the booking to me, we can chat by phone, text, or email to schedule. If a therapist's website isn't clear about the process for booking an appointment, reach out by email to ask.
4) What can I expect next?
Once clients are registered in my online system, they'll read through my informed consent and practice policies. And that's it until the first appointment for me!
Many therapists will have clients fill out some intake paperwork or do a simple assessment prior to that first appointment. Some will require you to do the paperwork before they will even book that first appointment, so definitely ask for clarity on individual practice policies for this.
I don't have clients fill out paperwork beforehand because I prefer for you to be able to tell your story in that first appointment. Often, especially for clients who have trauma histories, writing things out on intake paperwork can be difficult and it's easier to talk about them in session, when you have the support of your therapist. Many clients with trauma also prefer to hold back on talking about it until trust has been established with their therapist, and that's ok!
5) What can I expect at my first appointment?
This is the big anxiety-producing question! If you're doing sessions in person, can you map out or practice your drive to the therapist's office ahead of time? Can you walk the building to figure out exactly where their office door is? Knowing where you're going will reduce a lot of that anxiety. I have photos of my office and waiting area on Google Maps and Psychology Today so people know what they are walking into.
Try to get an accurate idea of what your therapist looks like. This one is a pet-peeve of mine. I can't stand when therapists don't look like their photos online. I wish we could all agree that a natural, recent, no-filter photo is what clients actually want to see! You'll feel more comfortable with your therapist if you recognize their face from how they present themself online.
When you arrive for your first appointment with me, you can either wait in the waiting area outside my office door, or if my door is open, come right in. I’ll close the door for privacy and you’ll hear low, relaxing music coming from my white noise machine. My office building is shared with a hair salon and barbershop and there can sometimes be some outside noise, and the white noise machine helps eliminate that and creates a soothing spa-like atmosphere. I’ll often have a pot of tea made and you’re welcome to grab a cozy blanket from the basket near the couch.
At our first appointment, I’ll introduce myself again, then go through a couple things from my informed consent, namely confidentiality, payment, and my late cancellation policy. I’ll also ask if you have any questions regarding the informed consent or any of my practice policies. Once we complete that “business”, I will turn it over to you to share more about what’s bringing you to therapy and provide more background context for your current struggles. You’re welcome to start wherever you feel most comfortable and don’t feel bad going off on tangents! Often, when we tell our stories, we remember more we want to say as it starts to come out.
When we near the 50 minute mark, I’ll let you know that we’re about at time for this week and we can talk about when you would like to come next. Generally, I like to see new clients weekly for the first 3-4 weeks as this frequency helps us develop a comfortable, trusting relationship quickly. After that, we can switch to biweekly (every other week) as you begin doing more work outside of sessions. Sometimes starting out weekly doesn’t work for scheduling or financial reasons. If this is the case, let me know and we will figure out what works best for you.
Overall, remember that your therapist’s job is to help you feel comfortable coming to therapy and being vulnerable. We have graduate-level training in co-regulation, empathetic listening, and non-judgement. And if you've tried therapy in the past, and it didn't work, keep looking! There are so many different therapists out there, and someone is bound to be a good fit for you.