Beginning Psychotherapy

Beginning psychotherapy or counseling is an important step, but often not an easy one. It is quite common to be uncomfortable or at least cautious about starting therapy. Indeed, caution and discomfort can be useful; they can alert us to important aspects of the decision-making process. Some people may feel that psychotherapy for themselves or their family members is urgently needed. In these situations someone might be depressed, anxious, profoundly confused, or in situational or emotional crisis. Others may pursue counseling or therapy because they would like to improve their experience in life. They may want to be more efficient or successful, more focused, more at peace, less tense or deal with feelings more effectively. Some may be concerned with problems related to their particular stage of life as a single adult, as part of a new couple, or as first-time parents. Others may be dealing with the challenges of adolescence or with problems of mid-life, aging, illness or loss.

Regardless of your reason for considering psychotherapy, you need to feel certain that you can have confidence in the person in whom you entrust your feelings or emotional and psychological well being. It is important, therefore, for prospective clients to heed their own questions about entering this process. Before embarking on a course of psychotherapy it may be useful to address the following questions during an initial phone conversation with a therapist.

  1. Is the professional well qualified? Does he/she have a mental health degree and is licensed in his/her discipline? What, if any, post-graduate training or supervision has he/she received? Does the therapist have special training and expertise in couples and family therapy?
  2. How much experience does the therapist have in clinical practice? Am I interested in a highly experienced professional who has worked with many clients in a variety of situations?
  3. When I schedule a first meeting, do I make my appointment with an administrative person or do I speak with the therapist directly? What is the sound of his/her voice on the phone? Do I feel as though this person is someone with whom I would want to schedule at least a first interview? What did I like about the conversation? If it was a brief talk, did I get the sense of the person’s professionalism and respect?
  4. After I have had the first interview, do I get the sense that the problem, for which I or we have come, has been addressed? Is the therapist empathic? Do I feel that he/she was interested in connecting with my family members or me? What is my partner’s or my family’s reaction to the therapist? Do I sense that the therapist is competent, that he/she has the leadership and know-how to help guide a process? If I am skeptical about the interview, is the therapist flexible in her/his response to my skepticism, but at the same time able to take a position based on professional training and clinical experience?

In conclusion, the beginning of therapy is an important phase. One needs to get the sense, within the first session or two, that one has chosen the professional that is a good fit for the couple or family entering treatment. Once the process has begun, results can often be seen within the first few meetings. Problems that have been of long duration may require more time before change is felt. Every situation is different and complex and the process of change varies according to the nature of each situation.

It is not unusual to have questions about beginnings or about the nature and duration of treatment. It is absolutely essential, therefore, that any questions regarding the process of treatment can be discussed honestly and comfortably with the therapist.

- Hinda Winawer