What Does “Going To Therapy” Really Look Like?

Six years ago I was freshly postpartum with my second baby. In addition to dealing with all sorts of leaking bodily fluids from both the baby and myself, a very spirited two-year old-who had just had her world rocked by a little sibling, and endless sleepless nights, there it was: the familiar creep of postpartum anxiety returning back to my life.

I was in love with my baby but I was not in love with my mental state. It felt like my mind could never relax and enjoy my two sweet girls. I was always worried, crying at the drop of a hat, feeling like a failure as a parent, wife, friend. These were all feelings I had experienced before but the intensity was amplified. I wasn’t really sure what I needed, but anything was better than being alone in my mind. 

Cue therapy. I had considered trying therapy before but I never thought I was allowed to talk about any and all mental weaknesses. I also never felt like my own bouts of sadness and anxiety were “enough” to justify the cost of money/time compared to others struggling with much worse in their lives. Add a couple of kids in the mix and find any time or an office that was as flexible as I needed and I was really doubtful that making a session would even work.

I started by looking at my insurance plan – and felt lost in a sea of names and addresses, so wary of these unfamiliar people I was supposed to spill my deepest and darkest thoughts out to. Finally, I talked about it with some friends and found a few recommendations. I was with one therapist for about a year before I realized that I needed someone different to guide me through my sessions. Again by word of mouth I landed with the counselor I have been with for the past four years.

My time in therapy gave me the eyes to see that my mental health is – and always has been – worth the time, effort, and money. It has given me space to speak freely about hard stuff from my past, the safety to know that it’s ok to talk about it all. I have been led to diagnoses and treatments that I had always wondered about but wasn’t sure my issues justified such formality.

If you have found yourself nodding along as you read or you’ve thought about therapy or mental health treatment for yourself in the past, you are in the right place. Six years ago I had so many questions about where to start and what sessions would be like. I got lost in too many Google searches to count with no solid answers to be found. To hopefully smooth that path just a little bit for other moms, I chatted recently with Tracy Carson, a licensed professional clinical counselor in San Diego, California. I asked Tracy some of the questions that were hard for me to figure out when I first started down this path, and she’s here to give a peek inside the world of mental healthcare – especially as it relates to supporting moms.

Frequently Asked Questions About Seeking Mental Health Support As A Mom

Tracy Carson, as interviewed by Joanna Martin

Please note that Tracy’s words, and this blog post as a whole, are not intended to serve as professional advice and are not a substitution for mental health services. We hope in reading the interview below that you’ll feel empowered to reach out to a professional in your area! 

Let’s get some background information on you! What brought you into the world of mental health care? How long have you been practicing and what do you specialize in? 

I took an intro to psych class in undergrad and I was hooked. I loved the idea that we all have a story to tell and that no matter what our story is we all have the chance to learn and grow from it…and when we need to: change it. I went on to earn my B.A in Psychology and my M.A in Professional Counseling. I have been practicing for 15 years. Currently we live in San Diego and I am a Licensed Professional Clinical Counselor (#11569) in the state of California. I specialize in helping people understand themselves and those around them better by utilizing a family systems approach through a trauma informed lens. I also have specialized training in nervous system regulation and eating disorders.

What is the very first step to finding a therapist or licensed mental health care professional?

Ask your friends! Seriously, the best referral is a previous client so if you have a trusted friend or colleague you can ask for referrals you are starting in a good place. For children, asking your pediatrician is also a good start. Beyond that, it is completely reasonable to ask for a 15-minute phone interview to touch base with a potential therapist and ask questions about their approach and really just get to know them on the phone. Houses of worship usually have a running referral list as well. Beyond that you can certainly do an online search but I would caution you to make sure you ask for a phone interview. Relying on Yelp or Google reviews is not a good source of information before entering into a therapeutic relationship. 

What can someone expect from their very first session? Can someone expect the stereotypical lying on a couch with a counselor and a clipboard scenario or is it something different entirely?

The first session is always a little nerve racking for clients. A good therapist knows that and will work to put you at ease by normalizing those nerves and honestly just being a human being. By that I mean, I might tell you how crazy my morning was or how I am loving the new season of a particular TV show, anything to let you know that while I might be the “expert” in the room, I am also a real person. Then there are a lot of questions. Unless you are experiencing acute trauma or a crisis the first session is spent doing intake style questions so we can establish a good baseline for your therapeutic journey.Anything from medication you are taking to what your highschool years were like. I might ask what your goals for therapy are or what was the instance that happened that made you reach out. I always tell my clients that they have every right to ask me questions as well and leave room for that at the end. Currently my entire practice is telehealth based but when I was in an office I’ve only had a client lay flat on my couch once. Otherwise it’s just choosing a comfortable position for the client. 

What can a person do to prepare for the first session?

Set yourself up for success. Plan ahead for traffic or missing directions. If its a telehealth client, plan your space ahead of time. Someplace quiet that is free from distractions. Arrange for childcare if you need to or make sure older kiddos know not to disturb you. Other than that, take a deep breath and be ready to engage but don’t feel pressure to set the pace, that is my job. 

How do you know if a therapist is the right fit for you? How many sessions should someone go to before thinking about switching counselors? 

Honestly I think you will know after the first two sessions if this is a good fit or not. If you don’t have a good feeling after two sessions, I would move along. Remember that the first session is more practical information so you might walk away without the warm fuzzies but there should be an element of trust and a general likeability after two sessions. This is why a personal referral can be so helpful. You also have to decide if you prefer a therapist who is a little more to the point or one who is very responsive. Depending on why you are coming to therapy this might differ as well. 

If my therapist is not the right fit do I need to “break up” with them or just cancel my next appointment and move on?

It’s totally up to the client. If you want to give specific feedback you are more than welcome to, and honestly a good therapist will receive that and hopefully validate your poor experience but you can also send an e-mail and just simply let them know you are moving in a different direction. I would add a caveat here that if you have been in an established therapeutic relationship for a while and a session goes awry, use the next session to bring that to your therapist’s attention (if they don’t already have a plan to do that) so you can work through the conflict. There might be some themes that are present in other relationships in your life that you can work through in the safety of a therapeutic session that can lead to better repair outside of the office. 

What are appropriate feelings to have after a session?

This is a very “Therapist” answer but there are no wrong feelings! All feelings are valid! If you are feeling unheard or unsafe then it’s definitely a reason to find a new therapist or discuss the uncomfortableness but all feelings are appropriate. Some people feel relieved after the first session, others feel exhausted. Some others feel empowered, while others may feel scared or apprehensive. All of those feelings are normal and there is no “right” way to feel after a session. 

How “bad” does a person need to feel to justify therapy?

I’m going to push back here and challenge you to think that badness or struggle does not equate a reason to go to therapy. The strongest people I know are my clients. They know they need help and they have made the vulnerable choice to seek it out so they are actually very very strong. I would encourage you to think about therapy as any other specialty medical practice. If you had a naggin knee injury you would see an orthopedist, if you had chronic vision issues you would have a relationship with an optometrist. The same goes for therapy. If you think you could benefit from it, seek it out! 

How long does therapy take for a person to feel better?

This is so specific to each individual client’s needs. I always tell my clients that my goal is to work myself out of a job. WIth some clients that might be a short term contract and with others we may be engaged in years of work. I have found that the best work is often deep, over time, and regarding a number of issues, quite usually not the issue that you may be presenting with. However, if you have a specific need, I want to meet that as soon as possible so it’s my job to help my clients determine what their desires are and what their capacity is to meet that. It’s totally up to the client and their own goals, desires, and (quite honestly) their financial means. 

If a mom is unable to meet in office for any reason (working full time, lack of childcare) what would be the best route to seeking mental health care from a therapist?

Try telehealth! Like I said, I am exclusively telehealth in this season of my life. I don’t know that will always be the case but I do know that even when I go back to an office I will offer telehealth slots because it has been so convenient for clients. So many providers are offering this option right now so it can’t hurt to ask!

How does insurance work with therapy? Can a therapist accept insurance, and how do I navigate this with my therapist?

It really depends on your provider and if they are represented by any insurance panels. If they are then the client would pay a traditional co-pay. If they aren’t then the client would be required to pay the full cost up front. Most therapists will be able to offer you something called a “superbill” regardless of whether they are on insurance panels or not. This is a document that out of network providers will use to determine if they MAY (or may not) reimburse you for services. This is completely between the clients and their insurance provider though. The only obligation the therapist is under is to provide the superbill in a timely manner. Once a month is a usual occurrence. I would like to add that therapy is expensive, your therapist knows this and we know our clients understand this as well. Many therapists will offer a sliding scale based on income if you request it and it never hurts to ask! 

I personally would like to thank Tracy for taking the time to answer these questions so thoughtfully and thoroughly. It can be hard to ask these questions while in the midst of a mental health crisis and I hope in sharing that you feel confident in the assurance that you deserve to take care of your whole self – mental health included. -Joanna

Featured Image property of Joanna Martin, photography by Kate Love Photo, used with permission
In post image by Priscilla Du Preez on Unsplash