HOW TO FIND OR BREAKUP WITH YOUR THERAPIST
Welcome back for week two of Mental Health Awareness month. You’re going to want to hold on to this week’s newsletter, especially if you’ve been flirting with the idea of starting therapy. I’ve enlisted the help of my best friend Melanie, who also happens to be a licensed clinical social worker, to answer your submitted questions and break down everything you need to know about finding or breaking up with a therapist. I know it can seem like a daunting process, but sometimes our own fears about being in therapy can also get in the way.
Q: What was your path to becoming a therapist?
Melanie: As a teenager, I really liked talking one on one with people. I imagined being a therapist was as simple as catching up with a trusted friend (spoiler alert: it’s not!). When I started college, I was very interested in politics, ending poverty, and social justice. I was almost a poli-sci major! I felt very driven to help others but couldn't see how I would fit into the world of politics. I was curious about human behavior and psychology and how our lived experience shapes us. Within my undergraduate education, I was able to explore psychology, social work, dance, movement, and art therapy. Ultimately, I decided to get a Master’s degree in social work because I felt it encompassed my passion for contributing to a more equitable world with psychotherapy as a vehicle for healing.
Q: How do you know if a therapist is a good fit?
Melanie: Finding a therapist you fit with can be a process, so know going in that it can require time and emotional energy. Have a sense of what you want to get out of therapy and figure out how much of this you are comfortable sharing on a phone consult. There should be some amount of ease and comfort when you're first talking to someone and a sense that they get what's going on for you.
Q: Is it rude to play bachelorette with therapists? I want to find one I love, but hate leading others on.
Melanie: Most therapists expect and encourage potential clients to initially consult with multiple therapists to find someone who feels like a good fit for them. You're going to be investing time weekly working with a therapist, and it’s important to get a sense of what's out there. So you don’t need to worry that you’re leading them on in this process.
Q: I left my first therapist... he became a bit judgmental. How do I build trust with a new one?
Melanie: I'm really sorry you had this experience. Therapists should prioritize being open, curious, and non-judgmental. I wonder if it felt safe to bring up that you were feeling judged so there could be an opportunity to repair? Maybe the relationship was too far gone or that didn't feel safe. Do you feel comfortable sharing your experience of feeling judged with a potential therapist? It can be really helpful to let a therapist know upfront, “my last therapist was judgmental and I'm feeling hesitant to start therapy again.”
Ultimately, the relationship you build with a therapist should be one built on trust, which takes time. No reasonable therapist will expect you to trust them right away, especially if your life experience has included violations of trust.
Q: How should I prepare for my first session? Where do you start?
Melanie: This is such a great question to ask a therapist during a consultation. “What can I expect in the first therapy session? What will the beginning stages of working together look like?” This is an important conversation to have with a therapist because it can relieve anxiety about what to expect.
It's ok to move slowly with a therapist. Only share what you are comfortable sharing. In the beginning, you are still sensing the goodness of fit and building trust in the relationship.
Q: How long should you expect to see a therapist? Is there a time frame?
Melanie: This is so individual. People can be in therapy for a number of months, a year, a handful of years, or decades.
Q: How expensive is therapy?
Melanie: The cost of therapy varies. It’s always good to check with your insurance company about what the cost of a session is, what they're covering, and seeing if you have an in-network deductible or a co-pay. If you are considering a therapist who doesn't take insurance, you want to know what your out-of-network deductible is. If you have met it, you want to know what the reimbursement rate will be after you've met your deductible. Ask if they have a sliding scale. I'm going to share different resources for finding a therapist based on your income and insurance or lack of insurance.
Q: What’s your take on therapists who take notes during the session versus no notes?
Melanie: Ideally, taking notes ensures a therapist remembers important parts of your experience. Sometimes note-taking can feel very cold and disconnected, i.e., if a therapist is mostly focused on a piece of paper or screen. There is a way to take notes that also communicates presence and connection, making eye contact works of acknowledgment.
If your therapist does this, I would be really curious about what's happening as they’re taking notes. What meaning are you making? What's the feeling you're having? Is the therapist not making eye contact and not really being present with you because they’re taking notes?
Q: How do you tell your therapist you want to see a different therapist?
Melanie: This can be so hard! I wonder if it would be okay to discuss with your therapist what's coming up that makes you want to see a different therapist? Has there been some sort of rupture in the relationship with your therapist? Are you feeling like you have outgrown your current therapist? Does your therapist communicate they don't have a skill level or an expertise, so you want to transition to someone who is a better fit? If it’s too difficult to be direct you can say that you’d like to take a break and reassess where you’re at.
Q: How to know when to end the therapeutic relationship?
Melanie: Are you ending the relationship because you feel like you don't need therapy anymore or you want to take a break? Or, are you ending because again there's been or you're at an impasse in therapy? Consider what you need, and is the therapy still serving you? I will say though that no therapist should be invested in keeping you in therapy. If you're feeling like you're done, you're done.
Your Cheat Sheet to Finding a Therapist
Step 1: Decide you want to start therapy.
You do not need to be struggling to seek out a therapist.
Step 2: Begin your search
Ask a friend or a friend’s therapist for a recommendation.
Consult your insurance provider for in-network options.
Try a matchmaking service online where you can filter by what concerns you want to address, identities you hold, if you want to see a therapist who is a person of color, insurance, no insurance, or sliding scale (meaning your fee is adjusted based on your income): Psychologytoday.com, BIPOC Mental Health, Therapy for Black Girls, MyWellbeing, or Alma.
Step 3: Schedule a phone consultation
Prepare a few talking points of things you hope to work on in therapy.
Come with questions you want to ask the therapist regarding their skills and experience.
Confirm the session cost, and if you are using insurance, confirm that they take it.
Make sure they have availability that works with your schedule.
For anything related to finance and scheduling, ask upfront before scheduling a phone call.
Step 4: Trust your gut
Notice how you feel when speaking with a potential therapist.
Do you feel reasonably at ease with this person?
Do they cut you off or do you feel like they really listened to you?
Did they convey a sense of knowing how to help you?
Step 5: Book or Reflect
Schedule your first session if it feels like a good fit from the call. If you still want to see who else is out there, spend some time interviewing other therapists.
Melanie’s Reading List
My Grandmother's Hands
An invaluable book about racism and intergenerational trauma. It includes grounding and present focus body practices in order to get the reader to slow down and tune in to what comes up as they go deeper into understanding experiences of race and racism. It teaches white people emotional resilience and not to run away from feelings of shame when we do the necessary work of confronting our own racism and white supremacy.
Come As You Are
Feels like a deep exhale. It brings a non judgmental lens to the subject of women’s bodies and desire and dispels many cultural myths we hold about sex.
Fearing the Black Body: The Racial Origins of Fat Phobia
Explores the social and cultural forces and intersections of race, class, and gender, that led to the development of fat phobia in our society.
The Mindful Self-Compassion Workbook
Learning to be more compassionate to ourselves is such a crucial skill. We can face painful emotions with greater ease when we have cultivated an inner voice that is kind and nonjudgmental.