Is This Gonna Hurt?

My kids always seemed to ask "Is this gonna hurt?" when they were at the doctor for their immunizations.  There's no simple answer because everyone's experience is different.  This week I had several clients mention that they weren't sure what to expect when they walked in for the first time.  Seeking out counseling can be a scary task.  Some people might even put it off because of the fear of the unknown.  According to an article published in Time.com on December 3, 2014, 65% of adults with symptoms of depression were not seeking help from a mental health professional (Park, 2014). Sixty-five percent!  Depression is just one reason why someone might seek counseling, but that statistic still gives us a glimpse into the number of people who reach out for help.

So, what keeps people away?  There are many factors to consider: finances, transportation, limited access due to geography, and perhaps cultural beliefs.  I might discuss each of these at some point on this blog.  For tonight, I want to talk about the one factor that was mentioned to me this week, "I didn't know what to expect."

After the decision has been made to seek counseling, then the search is on to find someone.  Generally speaking, people tend to find a counselor through personal referrals, a doctor referral, or through internet searches.  After the selection is made, then there is the initial contact.  The first contact is usually made via telephone, although some practices may offer online scheduling assistance.  At this point you are typically asked several questions (in no particular order):

• Your name, age, contact information
• What insurance do you carry?
• Do you prefer private pay (not billed through insurance)?
• The concerns you are calling about (depression, divorce, anxiety, etc)
• Who you would like to see (if there is more than one counselor/therapist available)

Then you will talk about availability of the counselor and when you can come in.  This is where some issues may come into play.  Some practices have a waiting list of a month or more, and this can lead to some very understandable frustration.  They want to help you, they really do.  Unfortunately, there are sometimes significant waiting periods.  Be patient with these practitioners and trust that there is a reason they are so busy.  HOWEVER...if you have a crisis, please let them know and/or call 911.  Do not wait a month to resolve a crisis situation!

Other practices may be able to see you within a couple of days.  This doesn't mean the practice isn't busy and that they aren't competent.  Each practice handles their scheduling in their own way and some practices have found a way to keep wait times to a minimum.  

After the appointment is set, and before you go for your first appointment, you may have some intake paperwork to complete.  Take your time with this paperwork and answer the questions honestly and thoroughly.  If you have questions about something, make a note of it and ask your counselor.  This might be a great way to open up the conversation about what is on your mind during your first meeting.

Arrive to your appointment early, especially if you still need to complete the paperwork.  Some offices have a waiting area with a receptionist, others may not.  Each office setting looks different.  Depending on the age of the clientele, there might be toys, books, magazines, coffee, music, and/or television.  You should feel comfortable and welcome.  Where I work, we make a point to make sure everyone who walks in feels welcome and comfortable.  I had a client recently tell me that our office felt like home, like her living room.  What a wonderful compliment!  

If you walk in and don't see anyone (but you know you are in the right place) have a seat and wait until your appointment time.  The counselor(s) is/are most likely in session with other client(s).  This is a great time to gather your thoughts.  Are there specific questions you want answered?  Are there specific topics you want to touch on in the first session?  Maybe some topics you don't want to discuss right away?

Your counselor will help guide you from here.  He/she will greet you and bring you to the office space.  You will sit in his or her office and have your session.  Sessions can last from 45-60 minutes, or may even vary from there depending on different factors.  Speak freely, ask questions if you have them, and be proud of yourself for taking this step.  If you cry a little, that is okay.  If you don't cry, that is okay too.  There isn't really a right or wrong way to "do counseling."  

If a receptionist didn't already take care of it, you will pay for your session at the end.  Payment amounts vary due to insurance, clinician training/education (Master's level vs. Doctoral level), and maybe a sliding scale negotiated rate.  That's right!  Some practices let you negotiate a rate if you have financial need and aren't using insurance.  You will also use this time to schedule your next appointment.  Trust the professional recommendation on frequency of treatment.  

Many times, the client is left with some homework to do for the next session.  Homework is what helps connect the discussion that happens in the office to your real life scenarios.  Homework takes various forms.  As always, ask questions about it if you aren't sure what is being asked of you.

I hope this description helps ease some fears you may have about what to expect when you reach out for counseling for the first time.  Please feel free to comment and let me know your experiences.