How to Start Therapy: 9 Tips from a Therapist

Why Consider Starting Therapy?

Therapy is a way for people to learn coping skills and progress toward their mental health goals. Studies show that 75% of people experience benefits from therapy.¹ Therapy can benefit many mental health conditions across all age groups, genders, and races. Additionally, the beneficial effects of therapy continue even after the individual has stopped seeing their therapist.²

Important reasons an individual may consider going to therapy include:

• Managing mood disorders, such as depression or bipolar disorder
• Managing anxiety disorders, such as generalized anxiety or specific phobias
• Managing conditions that have been categorized as personality disorders, such as narcissistic personality disorder or borderline personality disorder
• Assistance with adjusting to new life circumstances or significant changes/transitions, including milestones like graduation, a new baby, or a new job.
• Identity exploration and development, such as figuring out your career goals or your gender and sexual orientation.
• Processing grief and loss.
• Healing from trauma and adverse stress events, such as childhood and developmental traumas, sexual trauma, religious trauma, natural and manmade disaster events, racial trauma, and queer trauma.
• Aid in recovery from an eating disorder and body dysmorphia.
• Developing stress management and coping tools.
• Support with family issues, such as dysfunctional family dynamics or estrangement and can even help with parenting concerns.
• Improving marital or managing relationships, such as communication, infidelity, navigating divorce, or addressing a sexless marriage.

What Is the First Step to Starting Therapy?

If you are considering starting therapy, there is a good chance that you already have a reason for doing so. While some professionals advocate for having a primary mental health provider, similar to having a primary care physician, the reality is that many people only seek out therapy when they find themself struggling with their mental health. Whether you are seeking help with mood disorders, identity exploration, trauma, relationship concerns, or navigating life transitions, knowing what you want to focus on in therapy is a good first step and will help you find the right therapist.

Different therapy focuses may fit better for treatment with different types of therapy, so a good first step in therapy is finding a therapist who practices a type of therapy that aligns with what you are seeking help for. Modern therapeutic approaches, like cognitive behavior therapy (CBT) and experiential therapy, have strong evidence bases for treating conditions like anxiety and depression and for developing coping skills. Postmodern therapeutic approaches, like solution-focused brief therapy (SFBT) and narrative therapy, may be especially helpful for individuals who have faced systemic disadvantages or discrimination.

Additionally, there are some specific therapy protocols that focus on specialized treatment, like how eye movement desensitization and reprocessing (EMDR) focuses on treating trauma. Once you know what type of therapy you are looking to start, it becomes easier to take the first step to finding a therapist who will be a good fit for you.

9 Tips for How to Start Therapy

Begin by locating a therapist who practices the type of therapy you are interested in. Second, find a therapist who fits your financial requirements, whether through insurance or out-of-pocket pricing. Finally, find a therapist who you think you will get along with, and make a list of questions you may have for them when you meet.

Here are nine tips for how to start therapy:

1. Find a Therapist

No two therapists are the same. Finding a therapist who is a good fit can be very difficult, and it can be overwhelming to figure out where to start. An online therapist directory is a great place to start your search.You could read through the therapist’s bio, or have a quick consult with them before the session to see if they are a good match. If you have insurance, you can call them and ask for a list of mental health providers in your area that accept your insurance. You could also reach out to your physician and family or friends for referrals. Alternatively, you can try one of the many online therapy platforms that will connect you with a therapist.

Some people can find it comforting to have a therapist who has the same identity as them. Depending on your identity, it may be essential to find an LGBTQ+ affirming therapist, a neurodiversity-affirming therapist, or a BIPOQ therapist. Take your time to search for a therapist that you think you might best align with.

If after a few sessions you’re thinking “I hate my therapist” it may be time to break up with your therapist and find a new one.

2. Consider the Type of Therapy

There are many different evidence-based therapy approaches, and some may be more effective at treating different disorders. Some therapists practice a single method, while others subscribe to multiple techniques. You can ask a therapist what forms of therapy they use when working with clients who have similar concerns, and consider if the approach they take is something you’re willing to try out.

Common types of therapy include:

• Cognitive behavioral therapy (CBT): CBT is the most studied behavioral therapeutic approach and focuses on helping individuals recognize how their thoughts could be impacting their behaviors and moods.³ It is often utilized with clients dealing with anxiety, depression, and OCD.³ There are both in-person and online CBT options.
• Eye movement desensitization and reprocessing therapy (EMDR): EMDR is an approach often used to help with trauma by using bilateral stimulation to help create new associations.⁴ There are both in-person and online EMDR options.
• Dialectical Behavior Therapy (DBT): DBT is very effective in helping individuals diagnosed with borderline personality disorder to learn emotional regulation, mindfulness, distress tolerance, and interpersonal skills.⁵ There are both in-person and online DBT options.
• Solution-Focused Brief Therapy (SFBT): SFBT is a positive and empowering method that focuses on the client’s strengths, rather than their problems, to help create a solution.⁶ SFBT is a short-term therapy lasting six to eight sessions.

3. Consider Therapy Costs

If you are worried about the cost of treatment, you can begin by asking your health insurance if they cover therapy, if you have any deductible, and if there will be a co-pay. If you do not have mental health insurance, you are considered an “out-of-pocket” payer, which means you are paying for the entire session. If that’s the case, your therapist may ask you to fill out a good faith estimate (GFE), which calculates the average you’ll be paying for the number of sessions they think are fitting. Based on the results of the GFE, you will get a chance to see it and decide if that fits into your budget.

You can ask the therapist if they offer sliding-scale therapy options, which means they are flexible with their rate, or do pro-bono work. You can also search out affordable therapy in your area and see if any of them are available, or consider a mental health app, like Happify.

4. Consider Online Vs. In-Person

Online therapy increases the reach of treatment as it can help people from more rural areas or who have more complicated or non-traditional schedules attend therapy more flexibly.⁷ There are many online therapy options and many therapists have added the option of telehealth to their practice.

On the other hand, some people prefer in-person therapy because it provides a space that is distraction-free and can make a person feel more connected with their therapist. Some therapists offer hybrid options, where you can meet online and in-office. Some individuals need in-person help, and depending on your mental health needs, the therapist may request that you meet in person.

5. Know Your Availability

If you are seeing a therapist remotely, consider where you want to be during your session. Ideally, you want to find a space with no disruptions. Look through your schedules for work, school, family care, chores, or any other responsibilities, and consider where you have time to carve out about an hour for a therapy session. This preparation will help you find a therapist available during those times.

6. Be Curious About the Process

If you have things you want to know more about, you can begin to dive into the wealth of information online or get your questions ready for the therapist. For example, you may want to research or ask how to get the most out of therapy sessions. The more knowledge you have, the more your mind may be at ease.

7. Lead With an Open Mind

Depending on your community, there may be a lot of stigma around attending therapy. There are also many misconceptions about psychotherapy due to media and movies, and you may have a wrong idea about how it works. Try to let go of these misconceptions and experience therapy with an open mind.

8.  Schedule an Appointment

Here you are! All that’s left is to reach out to the therapist and schedule a consultation. The therapist will ask you to fill out intake forms and sign an informed consent form. If you feel nervous about signing a consent form, ask the therapist about what confidentiality is and the limits to confidentiality.

A good therapeutic relationship hugely impacts the success of therapy. Keep in mind that the first therapist you reach out to may not feel like a good match. Don’t be discouraged; keep searching until you find someone who feels like the perfect fit.

9. Know What to Expect During Your First Appointment

Some of your first session experiences will depend on if you will be attending an in-person or teletherapy session. If you are attending in person, it is okay to reach out to your therapist and ask them about the check-in process and protocols. This can help put your mind at ease that you will know what to do once you get to the office. If you are attending through teletherapy, it is okay to ask the therapist ahead of time about the online check-in process and when you can expect to receive the link for your session. Most of the teletherapy platforms therapists use today do not require any special applications other than an internet browser to access.

At the beginning of your first session, the therapist will likely introduce themself and go over some of the basics about therapy, like their therapeutic style, fees and payment protocols, confidentiality policies, and go over your intake paperwork. After that, the therapist may do a psychosocial or diagnostic assessment. This may be very structured or conducted conversationally. This first session is about you and the therapist getting to know each other, making sure that you are an appropriate therapeutic fit, so don’t forget to ask questions to help you access if this is the right therapist for you.

How to Prepare for Your First Therapy Session

Begin preparing for your first therapy session by writing down your symptoms, goals, and any questions you want to discuss. Be ready to be open and honest because the therapist will ask you to share about yourself in detail. Feeling embarrassed or nervous about trying out therapy is normal, so be gentle with yourself.

Ways to prepare for your first therapy session include:

• Be ready to share about yourself: The therapist may ask you about your family history, your childhood, daily routines, and how you cope when things get tough. Be prepared to talk about topics that make you feel vulnerable with a stranger. Also, don’t worry about oversharing. It is the therapist’s job to let you know when it is helpful to be brief and when to go more in-depth.
• Be ready to be honest: Honesty can be challenging because you may be afraid of being judged. However, honesty is important for the therapist to understand what is going on. Remember that the therapist has heard it all and therapy is a judgment-free zone.
• Prepare any questions: You will likely have many questions about the therapeutic process. Think about any questions you might have and pose them to the therapist so you do not have to keep wondering.
• Keep track of your symptoms: The therapist might ask you about specific symptoms you have been experiencing, and on the spot, that can be tough to recall in length. Spend the few weeks before therapy noticing emotions or behaviors that may be important for the therapist to know about.
• Think about your goals: The therapist will ask you what goals you want to reach. This question can be overwhelming at the moment, so take time beforehand to think about what you would like to accomplish with therapy.
• Write down why you sought therapy: Take some time to write out why you are considering therapy and what you want to accomplish. Bring this paper or notes on your phone into the first session so that you have something to reference when the therapist asks you about yourself.
• Take some deep breaths: You are trying something new to help yourself feel better and live a more fulfilling life. Take deep breaths, and let the therapist know if you feel nervous about the first session. You got this!