BEGINNER'S GUIDE TO THERAPY

If you are reading this, you have already kick-started your therapy! So before reading ahead, give yourself a pat on the shoulder. 

As psychotherapists and counselors we know that the client’s willingness to address their struggle, search for someone, and take contact is already a great sign of positive change, the very same change we will call therapeutic in the counseling office, and the change we will try to nurture, systematize, and make continuous through collaborative efforts. 

Beside this, and as I have explained in “How to find the best kind of therapy for me?”, the first thing to understand in seeking help, is that the technique of the therapist or counselor only counts for a small percentage of the positive therapeutic outcome. This is established science. What counts much more is: 

• your determination in facing yourself and doing something about it .
•  your sense that the therapist is responding empathically, with unconditional positive regard, and with presence and a willingness to ask you plenty of questions. 

With this in mind, let’s have a look at a few common steps along the therapeutic journey you have already begun. 

1. Therapist Selection:

Word of Mouth: Recommendations from trusted friends or colleagues who are empathetic and in touch with their feelings can be more reliable than online searches alone. As a therapist, most of my clients come in the form of organic referrals from clients I have worked with, or people that know me from the community activities I engage with. This is because we therapist, just like any other human, won’t work with just anyone. People who know you, and who know me, can make a loose guess about how well we might be able to work together. The same goes for every other therapist out there, and so talking to friends and trusted others who might have found a particular therapist very helpful, is the shortest route to finding the support you need. Pick someone in your circle that you have an affinity with, or that you see yourself in, or that you feel understands you a lot, or that you have seen is ready to listen, and ask them if they know anyone that works in the field and that they would be willing to recommend. I have a feeling, but it’s just a feeling, that people who are in touch with their feelings, and who seem to be very empathic, are often also more knowledgeable of where to find help in these terms. So if you have a friend or colleague that fits the bill, ask them. 

Having said this, the search won’t come easy, as people are often secretive and not at ease in recommending something so personal, so be patient…news of someone who might be a good fit will surely reach your ears sooner than later. 

Research: If word of mouth isn’t working for you, look into potential therapists or clinics online that operate in your area, or use services like, Therapistden.com and Bark.com for the USA, or Bark.com for UK and Ireland and France, or complicated.life, internationaltherapistdirectory.com and expattherapy4u.com for Europe. On these websites you will be able to look for a therapist by location, and then by various other parameters, including looks and feel. All of these platforms are reliable professional platforms that only host profiles that are verified at a qualification level, so the standard is overall good. Having said this, the question remains “Who do I select?” so here are a few tips:

1. If you are stable in your location and plan to see a therapist for more than 4 times, then look for someone in your area, as nothing beats a face to face conversation. On the other hand, if you are stable but only wish to see a therapist for a one off, or up to only 3 sessions, mainly to solve an urgent specific issue, then whether the counseling happens online or face-to-face, will not matter. This means you have more choice, but in this field too, choice comes with the stress of choosing. So ask those in whom you can confide in if they know someone, and then check these therapists out first. If you don’t find someone close by, enlarge the circle of people you are asking recommendations to, but keep track of how strongly you feel these people you are asking to know you. They are recommending something very personal, so you need to feel they know you enough to make that recommendation. In saying this, a good source of knowing is reviews from previous customers. Read them carefully and see if you see yourself in them, and then when you meet the counselor, see if those reviews match with what you are seeing and feeling.

2. If you are planning to travel and receive therapy on the go, then target counselors that can operate online. If your travels are a regular feature of your life, whether because of work, family, or other reason, then you’ll want to find someone who has a good understanding of how such frequent travel disrupts your emotional life, and the added strains and stresses this implies. Handling traumatic journeys on the go is possible, but you will need someone that has a very good understanding of migration and dealing with the complexity of inhabiting new places.

3. Before checking for any of the techniques or other professional traits a therapist may use, make sure you like them at a physical level (e.g. male/female, ethnicity, etc.) and then check for their prices. There is no point in hoping to work with someone if working with them is going to leave you very stressed about your finances. Aim to find a therapist that you can afford for a regular weekly, or bi-weekly visit for at least 4 times if you are only working on narrow goals, and perhaps over a whole year if you are working on more broad issues like trauma, ongoing relational conflict, addictions, and other conditions. At my hourly rate, that means you need to be able to afford 220 Euros (in 2024) for 4 sessions over 1-2 months, and 2860 Euros for weekly sessions for a year or half of this amount if only 2 times a month. The financial commitment you need to make to get better, is tightly linked to your desire to improve, and your desire to improve should be clear headed that this will take a longer time than you can probably envision right now. Your commitment should therefore be to-the-process, and financially, it should feel affordable and worthy across time. The good news is that there is high quality therapy being offered at all price levels, from 20 euros/dollars an hour all the way to 250, some services being even free. But to find a good therapist that has a bunch of recommendations, some recognisable levels of official qualification, that is able to hold you in the pain you carry, and is happy to let you pay a relatively small fee, is going to take you a lot of searching, and that, I know myself, can be particularly stressful. So price, and the waiting for finding someone, are in a somewhat trade-off relationship.

Final tip here is: be on the lookout and contact at least 2 therapist after 3 months of searching around, no matter how good or bad a match you think you may have. 99.9% of the therapist out there will help you move forward no matter how long or short you may end up working with them, and taking the risk of meeting someone you may not have a good gut feeling for 15 minutes to an hour should not hold you back. 3 months, 2 therapists you have spoken to no matter what.

2. Setting Expectations:

First Sessions: Initial sessions more often than not come with a full fee request. A portion of therapists will offer a 15 minutes free consultation at no cost. In such cases, the meeting will not be real session, but more like a first meeting encounter with anyone, a way to check each other out on first impressions with the aim of establishing a deeper relationship of trust in the future. These very brief sessions can be very helpful for you and your process of finding someone, so don’t refuse the free help and take the leap. In a first session except the least you can, but speak your case out and just make an assessment of how well you felt heard and understood. If your emotional condition is very skewed towards agitation or depression, take a day or two to make up your mind about whether you felt heard or understood. Most of the time, there is no real urgency in these processes, so it’s ok to take a few days to think it over before you contact your therapist again for a follow up.

3. The Therapeutic Relationship:

Once you have felt good enough to contact your therapist again, you’ll want to focus on telling your story. With all my clients I explain that the first 3 sessions are for us to understand the depth of the issue, and from there derive notions of how frequently and for how long a session should be each time. From your perspective all you need to know, by the end of each session, is that you have felt these three things:

You have felt heard and understood

You have felt there is hope in your situation

You have felt a bit more relaxed

If you have felt these three things, and perhaps, depending on the focus of your therapy process, you have gained clarity on how to change a habit, accomplish a goal, or break a negative pattern, that’s fantastic, but it’s also not always necessary. Feeling understood, seen, having hope again and feeling somewhat more relaxed is 90% of having a successful therapy process, the rest is bonus.

By following these guidelines, you can navigate the process of finding and working with a therapist, ensuring a supportive and effective therapeutic relationship

In summary, if you are reading this you have already started your therapy journey. Now take the next steps until you make contact with someone. That will be the beginning of a new chapter.

Look after your Heart,

Your Shrink in Bansko