Q&A: Starting therapy for the first time.

If you are or plan to start counselling or psychotherapy (for short ‘therapy’) for the first time, you probably have some worries that come up. These worries are likely unexplained questions that might not be on the F.A.Q. page of your therapist’s website, but are important and valid nonetheless.

I want to walk you through some of the worries my clients have experienced, as well as myself when I’ve been on the other side of the virtual couch, so you can have more clarity. Hopefully this will give you the push to start therapy or go into the first session with greater hope and confidence in navigating the therapy experience.

Here are the therapy questions I am going to cover:

• What will others think about therapy?

• Can I really trust my therapist?

• Will my therapist ‘get it’?

• Shouldn’t I be able to deal with this on my own?

• Will therapy even work?

What will others think about therapy?

There’s a lot of stigma still out there for people going to therapy, especially men (who I primarily provide therapy for).

Let’s be honest: The feedback will be mixed.

Some people will be supportive and happy for you, while others will judge.

Others will judge because they…

• Don't understand what therapy is and how it works.

• Have had their own ‘bad’ therapy experience, and think that must mean all therapy is ‘bad’.

• Still believe therapy is ONLY for people with severe mental illness or other severe problems.

• Think personal problems should only be dealt with alone or within a family unit, not therapy.

• Don’t understand how much you’ve been struggling, and aren’t willing to wrap their head around what that might be like.

• Think talking about your feelings too much means you are weak and have failed in some way (which might say more about how they deal with their own feelings and let’s just say this doesn’t work out well).

If someone close to you judges you for starting therapy, it’s likely a product of their own experiences. You probably won’t convince them why it’s a great idea. As much as that hurts, it’s also okay.

We don’t need everyone to support decisions we believe our best for us.

Maybe after going to therapy for some time, they’ll see how it’s been helpful. They’ll see that maybe you’re less guarded or moody, or whatever else. And remember: Others not supporting your choice to start therapy, is a great topic for therapy!

Can I really trust my therapist?

Therapy is confidential (with exceptions that your therapist will explain to you). So if you are worried that they are talking around town about you, they can’t. Your therapist has a licence to uphold that requires following ethical guidelines. One of which is confidentiality.

Now, will there be exceptions to this where therapists act unethically? Sure. This is a risk any therapy-seeker takes.

If this ever happens to you or someone you know, which I really wish it never did, you have ability to report that professional to their licensing board. In Ontario, Canada, that means your therapist who is providing “psychotherapy” will fall under the licensing board for:

Registered Social Workers (RSW) or Registered Social Service Workers (RSSW) - Ontario College of Social Workers & Social Service Workers (OCSWSSW)

Registered Nurses (RN) - College of Nurses of Ontario (CNO)

Occupational Therapists (OT) - College of Occupational Therapists of Ontario (COTO)

Registered Psychotherapists (RP) - College of Registered Psychotherapists of Ontario (CRPO)

Medical Doctor (MD) - College of Physicians and Surgeons of Ontario (CPSO) (psychiatrists are medical doctors and fall under this category)

Psychologists (C.Psych) or Psychological Associates (C.Psych.Asso) - College of Psychologists of Ontario (CPO)

Is your distrust about something else?

Now, maybe your not worried about your therapist blabbing.

Maybe the worry about trust is whether you can trust this stranger to hear personal and vulnerable things about you, and rely on them to support you in it.

You don’t want someone who doesn’t honor what you’re saying or take it seriously.

This makes total sense.

I’ll say this: You don’t have to trust your therapist immediately.

You’re allowed to take your time to see if it really is someone you can trust.

Those first few sessions your therapist will likely ask you lots of questions for example. You can be as forthcoming as you choose. You can say: “I’m not ready to dive into that right now.” Dip your toes in before you decide to go in the deep end if that's what you need.

Will my therapist ‘get it’?

Your therapist won’t have all the same experiences as you. That doesn't mean they can't ‘get it’.

They might ‘get it’ by asking questions and clarifying with you so they can imagine exactly how your experience might be. It’s part of empathising. Your therapist will try to put themselves in your shoes.

You might hear your therapist ask:

• Did I get that right? Your thinking that __________?

• When this happened, you felt like _________?

• Was it more like this ______ or like ________?

As well, your therapist might understand a feeling because they’ve also had that feeling, but from a different experience.

For example, when trying to tap into my client’s experience with feeling rejected and abandoned, I can understand personally what that might be like from having felt that way from a completely different scenario.

To be clear, your therapist should not assume they know how you feel because they have also felt ‘grief’ for example, but our ability to tap into similar feelings is an important part of understanding.

When you need your therapist to have the same experience…

There are certain experiences that are important to you for your therapist to have, that would ensure they ‘get it’ in the ways you need. This is okay too!

Some clients starting therapy may want their therapist to:

• Be a certain ethnicity or race

• Have also recovered from an addiction

• Be a parent

• Identify as LGBTQ+

• Have the same political or worldview

  etc.

Shouldn’t I be able to deal with this on my own?

Some things we can, sure. We deal with things on our own all the time. There are other moments in our life though that:

• Even though you COULD deal with it on your own, it would be SO MUCH harder!

• You are emotionally depleted and don’t have the energy and capacity to do it on your own. It’s like you’ve been running for so long and someone told you to help them lift a car - YOU CAN’T do it.

• You’re stuck. You’ve tried to deal with it on your own and it’s not working. You need an outside perspective.

Also, don’t compare. We all need help sometimes. Someone else might be going through the same thing as you and be okay, but you’re not. Their past life experience and current life circumstances are different though. We don’t know all their details. Just like in another moment they struggle with something that you managed perfectly fine. We’re different people with different circumstances!

Will therapy even work?

Maybe. I see it being helpful all the time.

There’s research that supports many types of therapy as being beneficial. There’s a lot of factors that could make it a more or less helpful experience.

Consider:

• Do you jive with your therapist? In other words, do you like them? How did you feel during the consultation phone call?

• Do you like your therapist’s approach? You don’t always have to be in the know of the ins-and-outs of therapy modalities, but think: Do you like how they approached the session with you? Were the questions they asked and the therapist’s responses helpful for you?

• Are you invested and showing up regularly? Are you open to trying this therapy-thing out? Are you bringing topics that are important for you to share to your therapist? If something isn’t working in therapy, are you able to share that?

Final thoughts on starting therapy for the first time

Starting therapy for the first time can be nerve-wracking. It can be especially anxiety-provoking when you don't know much about the mental health or therapy world. For those starting therapy I hope for a great experience. Remember, you may find that the first person you go to isn’t right for you or their approach, and that’s okay too. I encourage you to try again. 

If you have anything to add about these answers or have more questions about starting therapy, feel free to comment below.

Disclaimer: This is general advice. Like all self-help information, it is not personal and tailored to fit for all people and situations. This content should not be taken as a substitute for individual mental health or relationship support.