The Top 10 Things Your Therapist Wants You to Know

The Top 10 Things Your Therapist Wants You to Know


The first thing I hear from many clients is “I’ve never been to counseling and I don’t know what I’m supposed to do or expect.” In a highly unscientific poll of my fellow providers, I’ve compiled the Top 10 list of things your therapist probably wants you to know.


  1. Most clients are nervous about their first visit. Some clients have told me they had to stare at the elevator button a few minutes before they pushed it to come upstairs for that first visit. Many clients will tell me they have had my card in their car for months before they called. It can be difficult to say “I’m going to go into the office of a complete stranger and tell them my problems.”. You bet that can seem intimidating. Here is the good news: every client that admitted to being terrified at the start of their visit later told me that it was not only not as bad as they thought it would be, but that they felt so much relief and hope after that first session.


  1. You can’t scare me. You can tell me anything. It won’t make me uncomfortable if you need to talk about abuse, suicidal thoughts, self-harm or sexual issues. I’m here to provide a safe space for you to do so. Clients often concerned about “burdening” me with their problems- please don’t worry! The reason I’ve been able to do this for years is that I have good boundaries and don’t emotionally absorb my client’s issues. It’s also ok to curse if you want to. I won’t judge you for letting some creative language fly. It’s also ok if you get mad at me. Sometimes clients will transfer feelings that they are working though in other relationships to their therapist. I can take it, and will help you deal with this as it arises.


  1. I won’t acknowledge you in public. I know that sounds pretty dramatic, but hear me out- therapy is often a very private matter, and I want YOU to get to choose who does and does not know you are in therapy. So if we see each other out in the community I will not approach you or acknowledge that I know you unless you acknowledge me first. I certainly would not want you to have to explain to your co-worker or neighbor how we know each other if you did not want to. If you do want to say hello to me that’s fine, too!


  1. It may feel worse before it feels better. You’ve may have done a great job of pushing down emotional issues, covering them up with a food or substance abuse issue, or keeping yourself so very busy with life that you have not had time to address your pain or problems. Now that you have made the decision to start counseling you may notice that your problems seem to be getting worse. In reality you are just no longer covering them up. You are now allowing them to come to the surface; allowing yourself to actually FEEL. So temporarily things may feel more unbalanced. Different. Uncomfortable. I will help you learn to manage these emotions and assist you in developing ways to contain them in between sessions until they are more easily managed.


  1. There are some bad therapists out there. I’ve had some clients come in with absolute horror stories about their previous therapist. I’d like to take this moment to personally apologize if you’ve had a negative experience with a therapist in the past. We are NOT all the same! If you have had a bad or good experience with someone I really want to know about it. What did you like or dislike about your previous provider? I want to make sure I see what you want or really don’t want, so that I can know how to best meet your needs. It’s also ok if you decide I’m not a good fit for you. My goal is for you to get better, even if it’s not with me. Choosing a therapist is like choosing a house or pair of shoes. There are so many different types, and it’s important that I’m a good fit for what you want and need. If I’m not, then just tell me and we can discuss it. Maybe you just need me to adjust my style, or maybe I need to connect you with someone who is a better fit for you.


  1. You may not be ready for therapy yet. Many clients will tell me that they have tried therapy and that “it just didn’t work”. That may be because you didn’t have the right therapist, but it may also be because you were not ready to work on your issues just yet. There are many components that go into someone being ready for making changes. Do you have a support system in place? If not, that may be one of the first pieces that needs to get worked on before you can safely dive into difficult subjects. You may need to deal with issues of sobriety prior to tackling other issues. Many clients find that while therapy may not have “worked” in the past, they may reach a new stage in life and be ready to work on longstanding issues. Sometimes it’s helpful to come in to the first session with some concrete goals so that we can define what the focus is for counseling so you and I will both know that it is indeed working!


  1. Don’t just show up- be ready to work. This means you can’t just show up and talk for an hour and expect to make huge life changes. I don’t have a magic wand to make everything better, but I can help you develop new skills to better manage what you have going on in your life. So try to do the homework we agree on during session, and practice the skills we talk about in session. Turn off your phone and be ready to give me your full attention. Most therapy session are 70% you talking and 30% me talking.


  1. You can always come back. Some clients may drift away from therapy after a vacation, missed visit or busy life changes. It’s ALWAYS ok to call me and reschedule a visit. I will be happy to take your call and find a slot to fit you into. Just be aware that if you have a highly coveted early morning or evening slot those may not always be available.


  1. I don’t prescribe medication. A social worker, LPC, LMFT or psychologist can’t prescribe medication. The only people who can prescribe are physicians, nurse practitioners or physician assistants. This means if you need medication you will need to see your personal physician or a psychiatrist. I can help you figure out what you need to tell them to make the most of that visit. While some clients choose not to take medication, some do find it beneficial. We can discuss your options, and help connect you with a psychiatrist referral if needed.


  1. Yes, there is a missed visit fee. It’s difficult to stay in business if we don’t make any money. Not being paid for missed visits or co-pays can make a therapist resent their client, and can hurt the therapeutic relationship. Seeing a therapist is like booking an airplane ticket. If you say you will be here I save that spot just for you. If you call 20 minuets before your appointment to cancel I can’t re-book that slot, which means I make less money that day. So, I ask for 24 hours notice, or charge the full fee that would have been paid. Insurance companies don’t cover missed visits.


I hope this has helped answer some questions you may have had about therapy. I see all my clients as people that I get to join on their walk through life, and I would be honored if you would allow me to companion you on a small part of your journey.