Where Should I Start?

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I thought the topic of “starting” would be fitting for my first blog post. In therapy, sometimes the most difficult thing is just to get started (doesn’t that sound similar to the writing process?) People make the decision that they need to change. They decide that want to seek professional help. Maybe they even get a therapy referral from a friend or colleague. But then there is the hurdle of actually getting started.

I am sensitive to the difficulty of starting, especially starting something new and unfamiliar. In both my professional and personal life I have experienced many new beginnings. Last year I relocated to New York, not only did I experience the unfamiliarity of a new city, but many other new beginnings, such as finding a new apartment, beginning a new job and meeting new people. The idea of starting something new can feel overwhelming and provoke anxiety, and this is especially true in therapy as it can bring up a list of unknowns: Will I find a therapist that I like? Will this help me to get better? What if therapy does not work for me? It is no wonder that we become stuck before we even begin.

Picking the right therapist is an important part of starting therapy. There are therapists that specialize in specific disorders or offer various treatment modalities. Some therapists are in network with insurance companies, while others are not. Figuring this out can be stressful, but to simplify, you should focus on the important task of finding a therapist that is likable. Feeling comfortable with your therapist is an important part of building a trusting and warm relationship.

Ask to find the right therapist for you, I always suggest asking your therapist questions to get a sense of who they are as a clinician and how they might help you; be an active participant in your treatment from the very beginning. Discuss the reason you are seeking out therapy and goals that you may have. Be an active participant in your treatment from the very beginning. The start of therapy is essential to the therapeutic process and begins with the engagement phase. In this phase, the therapist and client begin to build a relationship. They address concerns, establish goals and begin to collaborate in the treatment process. It is also an opportunity for the therapist to get to know the client, so honesty is key. Clients should not be concerned with appearing vulnerable or hold back the true reasons for getting involved in therapy. The client should keep in mind that the therapist is there to support the client and help the client to make positive changes in his or her life.

As clinicians, we are taught to “start where the client is”. To me, starting where the client is acknowledging the client’s needs, while also normalizing the challenge of engaging in therapy and beginning a professional relationship. For example, if my adolescent client does not want to be sitting in my office and feels forced into therapy by his parents, then I may chose to explore what the adolescent believes his parents need to see change in order for him to get out of therapy. Or if my adult client exhibits severe anxiety that impacts many areas of her life, but wants to focus solely on her challenges at work, then I may begin by setting goals that will help her to cope effectively at work. In both of these examples, the treatment interventions are likely to change as the therapy progresses. However, starting where the client is, especially in the beginning, helps to create a therapeutic alignment that will set the foundation for future collaboration and work.Starting anything new suggests that there will be questions and unknowns. But the therapeutic process is prepared for this. It allows for clients to express uncertainty and work through the challenge of beginning with a therapist. So where should we start?

For more information about beginning therapy, please find my contact information below.