When my doctor suggested I see a therapist, I resisted. “I’ll think about it,” I told him. But I didn’t think much beyond: I don’t want to retell my story yet again. It costs too much. I don’t have the time. And most importantly, it hasn’t worked in the past.
I’ve seen a handful of therapists and psychologists, and I never felt like they helped me address the issue I came to see them for. Most of the time those sessions consisted of me venting or chatting about life. I could do that with my friends for free, thank you, Doc.
But with some more thought, I realized that maybe this could help me, if: (1) I find a therapist who specializes in my condition, and (2) I change my approach.
“A client comes into therapy cold and is expected to know what to do, but they don’t,” clinical psychologist Ryan Howes, Ph.D., tells SELF. “There’s not much out there to prepare them for what therapy is like, plus everyone’s experience is different.”
If you’ve similarly been hesitant about therapy but figure you could probably benefit from it (and truly, who couldn’t these days?), there are a few general guidelines that psychologists say could help make the process a little easier and more effective. Here’s what they suggest:
1. Don’t just go off referrals.
It’s nice that your friend or mom suggested you try Dr. Jill, but does she specialize in what you’re looking for help with? Does she have experience seeing patients that share important aspects of your identity, particularly if you’re a member of a marginalized community? Does her approach to therapy sound like something that you would benefit from? Even if your physician gives you a referral, that doesn’t necessarily mean this psychologist is going to be the one for you.
When it comes to finding a therapist, fit is extremely important. If you can, take your time looking through potential therapists before making an appointment. Do your research—checking out their backgrounds, specialties, and even their fees, Dr. Howes says. He suggests Psychology Today and Good Therapy as good places to start your search. If you’re looking for a therapist who is more experienced in and passionate about diversity-related issues, you could also try databases such as Inclusive Therapists and Therapy for Black Girls. Then narrow down your list to three or four.
2. Before making an appointment, ask for a free phone consultation.
Most therapists will offer free initial phone consultations to new patients. Take advantage of this and ask any preliminary questions you have—like how they work with clients, what their approach might be for whatever you hope to work with them on, and anything else that’s important to you. Then go with your gut. “Who do you feel the most comfortable talking to and feel you can open up to?” Dr. Howes says.
3. Ask your therapist what progress might look like.
When you first start seeing a new therapist, talk to them about how you’ll know if you’re making progress (both in and outside of your sessions). Then make sure that you check in with your therapist from time to time, licensed clinical psychologist Stephanie Smith, Psy.D., tells SELF. See how you’re feeling, take note of any changes, and ask your therapist if they notice anything different (since we don’t always see shifts in ourselves).
“Sometimes people get frustrated because they’re starting at zero and want to be at 10, and that’s going to be a very long road,” clinical psychologist Merav Gur, Ph.D., tells SELF. These check-ins can help you stay motivated and develop short-term goals to work towards.
4. Expect to feel uncomfortable at times.
Just as with your workouts, sometimes you’ll be really excited going to therapy and sometimes you’ll loathe it, Dr. Smith says. This can be particularly true if you’re trying to navigate virtual therapy at the moment.
“Change is hard. It will be uncomfortable at times, but it’s part of the process to get you to where you want to be,” Dr. Smith says, adding that a skilled psychologist will monitor the intensity of the sessions so it’s not minute-after-minute or session-after-session of deep, hard work. Dr. Gur specializes in treating anxiety and depression, and she says that at first clients may feel their symptoms are exacerbated as they work through the uncomfortable issues. But doing so ultimately helps them work toward where they want to be.
Of course, the work you do in therapy—just like your workouts—should never be unbearable or debilitating, so if things are getting to be too much, speak up.
5. Don’t worry about bringing some big thing to discuss into each session.
Sometimes the sessions when you think you have nothing to talk about lead to the biggest breakthroughs, says Dr. Smith. “It’s part of my job to make sure each session is productive and stays on track, so I always have things to ask a client,” she says. “That’s when we can talk about the really good stuff—the meat of the issue.”
This is especially true because we tend to avoid things that are hard to deal with and may not even consider bringing them up in therapy. But with an open agenda, you and your therapist will have the opportunity to talk about a variety of things going on in your life, where you may discover that there’s something you really did want to talk about, after all. (Here’s more advice for what to do when you have seemingly nothing to say in therapy.)
6. Speak up if you don’t agree with your therapist.
Therapy should feel like a safe, comfortable space where you can say anything. And that includes if you don’t understand something, if your therapist pisses you off, if you disagree with something they said, or if you’re fearful of what they will say. “I appreciate it when patients bring these issues up,” Dr. Gur says. “It’s important for me to understand their experiences so I can help them better.” Giving your therapist feedback is actually a really powerful part of therapy.
Not only does this help you practice if you struggle with conflict avoidance or asserting yourself, but it also allows your therapist to tailor treatment to what will work best for you. For example, if you hate journaling and know you won’t do it, let them know that before you miss a homework assignment. “Putting all your cards on the table is the only way you’ll get real help,” Dr. Howes says. “I had a client once say, ‘I’m angry at you for being late’—and then we both celebrated it because he was able to assert himself.”
7. If things aren’t working out, don’t ghost your therapist.
Especially if you have been working together for some time, it’s worth talking about ending your relationship if you feel your therapist is no longer serving you. “It’s important to explore things rather than just leave treatment. There can be a lot of good stuff, and if you don’t address that, you may find the same thing in the next therapist,” Dr. Smith explains. Here’s some more advice on how to know when it’s time to break up with your therapist (and exactly how to do it).
8. Remember: Therapy should be bettering your life—even if it’s work.
When I decided to try therapy this time, I sought out someone who specializes in treating people with my condition. Luckily I found someone in my price range whose approach I liked during an initial phone call. And even luckier, I’ve liked working with her. I don’t just chit-chat when I come in, I’m not afraid to speak up if she says something I disagree with, and I make sure to leave with concrete action items to work on. So far, I feel like I’m getting further than I ever did in the past.
Remember that you are giving your time, money, and emotions to this process and this person. Those aren’t things to waste, so demand that you get what you need, and if you don’t, find someone who will give you that. Being an adult is hard, and therapy can help—don’t give up.
Additional reporting by Casey Gueren.
See more from our Guide to Caring for Your Mental Health here.
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