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Going to Counseling for the First Time

Melinda Toth, LPCC
Counselor, Insight Clinical Counseling and Wellness, LLC

Deciding to go address your mental health and various stressors with a complete stranger takes a lot of strength and working through discomfort. Whenever I have a new assessment with a client, I always start with the question “Have you ever been to counseling before? If so, what did you like, what did you not like?” This is such an important question, because I want to know where my client’s perspective is on counseling. Even if it has been a significant amount of time going to counseling, it can be quite daunting at first. So whether it has ‘been a while’ or you are seeking counseling for the first time, this read is for you!

I would like to write this from my first experience receiving counseling…I remember finally drudging up the courage to call and make the appointment. I knew it was time to address my stressors and mental health, I had reached a point where I could not do this on my own. When I made the call, they took my information and worked on setting up an appropriate appointment time. Well, that was easier than I thought it would be. The hardest question they asked was “What is your reason for seeking counseling at this time?” My throat closed a bit, I was nervous to tell this stranger on the phone what my ‘problem’ is and how much detail I should go into, what all do they need to know? My thought of “well my life sucks right now” came to mind… no no Melinda, you can’t say that, maybe try “I am struggling with low mood, and anxiety”… yes! That’s it, Melinda, go with that one! Phew! I did it, and they didn’t pass judgment. Okay this was not so bad. And just like that my appointment was set up.

Fast forward to the appointment, I thought about 20x’s to not go, or to just cancel, but I made it in the door. That was my second big step in this process, I can honestly say…I am proud to have made it in. All the back and forth of, should I go to counseling, and I made it in the doors. I now even tell my clients one of the hardest parts of counseling is showing up. Walking through those doors takes A LOT of courage, because that is the moment you are facing you. You get an hour to talk about yourself and face your history, trauma, inner self, and present self….that is intimidating! The thoughts of maybe I don’t really need counseling, or there are people out there that have it worse than me so I shouldn’t go, comes across my mind. It is all thoughts I have been through, and a lot of my clients vocalize. I check in at the front desk, I am asked for my ID and insurance information, then handed paperwork. Ahh paper work, more paper work, what would we do without paperwork? I am so slow at filling out paperwork this will take me forever! The counselor I had at the time called me back, my throat swelled, I am feeling warm, okay, let’s do this. The counselor assured me that I can fill out the paperwork while we talk or after the assessment, phew, it’s like she read my mind!

During the assessment, I was asked “what brought you to counseling.” From there, the clinician introduced themselves and acknowledged what I was saying. I was being heard authentically for the first time, and a bonus, heard without judgment. This feels odd, but kind of good! During the assessment, I was asked questions, but it didn’t feel like an interrogation. Yes, I was still nervous throughout; however, as the session went on, I started to grow more comfortable. I thought my story may be judged or they might try to tell me what I was doing wrong, but it ended up being a safe space, free of judgment, to express who I am as a person and my battle with mental health. I felt heard and seen. This is hope.

I wanted to express a snapshot of my first experience in going to counseling, while every experience will be different, this is a typical experience of going to counseling for the first time. A good thing to remember is every clinician is different in how they provide therapy. To know if your counselor is a “fit for you” (if they don’t already express this in the first session) some helpful questions for your clinician would be: What does a typical session look like structure wise? What is your treatment modality/specialty – can you explain this more? How does this process work? What is one important thing you like all clients to know about mental health?

On the other hand, common questions you will receive during the assessment are: What brings you to counseling? What are your goals / how will you know you do not need counseling anymore? Medical/family history, trauma, psychiatric history questions, social background, strengths, areas of struggles, etc. You will also be informed of confidentiality and the limitations of it. In sum, everything you say in your session and all of your information is protected under confidentiality – aside from reports of intent/plan to harm yourself or another person, child/elderly abuse, and animal abuse. These limitations are for the protection of you and others. Unless you have a signed release of information that you want to share information/sessions with, then nothing else can be disclosed to anyone. The purpose of signing a release of information is for collaboration of treatment, should you have that need, it is not required.

The assessment is a lot to cover in a short amount of time! Another component I like all my clients to know, is if there is ever a question I ask, that you aren’t quite comfortable sharing, we can skip and possibly come back to it another session when you are ready. Share as much or as little as you are comfortable with in this first session. The important piece is that the clinician is capturing a picture of you to best serve you and develop a treatment plan (goals).

Another important thing I express to all my clients is to let me know if there is anything you need differently from me – as in: what isn’t working, what is working, and how is this process so far for you? Do not be afraid to answer or speak up for your needs in counseling…This is your time, your space, so advocate for yourself. This is a space where you do not have to people-please. So take a breath, because you can receive the help and support you deserve. If you are looking for a sign to make a counseling appointment… THIS IS IT.

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