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Giving the gift of therapy

Quick book update: Starvation is now out as an audiobook on Audible! I'm so excited for this to be released, especially because John Andrews did a phenomenal job narrating. If you got audible credits for the holidays, this is a great way to use one!

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The holidays tend to bring out the best (and worst) in all of us. Whether being around family is beneficial, or detrimental, to your mental health, this time of year likely has you thinking about ways to be happier and healthier.


It's unlikely that you, and everyone around you, is getting the mental healthcare they need. But it's probably a lot easier than you think to start (or restart) therapy!


I also have some tips for talking to others about starting their therapy journey (spoiler: it likely involves a lot less work on your part than you think).

For yourself:

Think about what areas in your life could be better. On the more extreme end, you may have a serious mental illness (diagnosed or not) that is drastically interfering with your life. You may also just get easily overwhelmed or want to be better at communicating your thoughts and feelings. If there isn't something specific, but you just don't feel like yourself, that's reason enough too!


In my opinion, everyone can benefit from therapy. However, therapy is especially important if you're experiencing trouble with life activities (i.e. sleeping, eating, socializing, relationships, and feeling emotions like happiness or relaxation).


Ultimately, it's your therapist's job to determine if you should be in therapy, and with what regularity. If you are even thinking about going, schedule an intake so they can make that decision with you!


There are also lots of low- or no-cost options (below) if finances are a barrier for you.


Before going:

  1. Figure out what you want to get out of it. If you're not sure how you can benefit or what to expect, that can be a great thing to talk about with your therapist. A big part of their job is psychoeducation - teaching you about healthy and unhealthy coping, what therapy can and can't do, and more.

  2. Be open to trying different therapists until you find the right fit. Just like you've probably had some doctors who were better than others, some therapists may work better for your personality, worldview, and/or presenting problem.

  3. Pick which format makes the most sense. If you're having marital or couples problems, a couples format is likely best. For family dysfunction and some disorders in youth, family therapy may be warranted. Group therapy is often less costly, and can be an additive to individual therapy, or a replacement if individual therapists are not available. In other cases, or if you're not sure, individual therapy is a great place to start.

To find someone:

  1. Primary care provider referral. You can often message your PCP to ask for a referral to a mental health professional.

  2. Psychology Today tool. You can search by location, specialty, insurance type, therapy type, age (i.e. child psychologists), language, price (i.e. sliding scale for those with lower income), and therapist gender. They usually have contact information so you can reach out to potential therapists directly.

  3. HRSA Health Centers offer sliding scale costs, based on income.

  4. References/word of mouth. The only caveat -- you likely don't want to see the same therapist as someone very close to you (i.e. close family member or significant other). Their perception of you will be more biased, and some therapists won't accept related clients due to ethical issues. You can see a different provider at the same clinic, though.

You may wonder about the differences between someone with an MSW, LICSW, Clinical or Counseling PhD, MD and PsyD. Generally, all are qualified and can be great therapists. MSW and LICSW (social workers) and PsyD (doctorate in psychology) usually focus on clinical practice in graduate school. Counseling PhDs usually focus on those who are less impaired, meaning they often work at outpatient and educational settings. Clinical PhDs are often also trained in research and neuropsychological testing. MDs (psychiatrists) are the only ones who can prescribe medication, and many nowadays prescribe more than they do psychotherapy. Ultimately, see a psychiatrist MD if you need medication. Otherwise, pick based off of specialty, insurance accepted, and personality fit more than degree type.


After finding someone

  1. Call or email to set up an intake appointment. Most should take 45-60 minutes.

  2. They will likely send you forms to fill out, or have you do them in the waiting room at your appointment. Most will ask about personal and family health, mental health, relationships, and other areas of life.

  3. You can double-check that they are covered by your insurance, if you have it, by calling the company directly with the number on your card. You can also look on their website, just make sure you're looking under the specific plan you have.

What to expect on the 1st visit

  1. You likely will not start "therapy" on the first visit. Many therapists spend the time going through the paperwork you filled out to get a good idea of you and what you want help with.

  2. Yes, there may be a couch for you to sit on. No, you don't have to lie on it, or jump right into talking about your childhood, or do hypnosis.


Look for these green flags that the therapist is a good fit for you:

  1. Collaborative - rather than telling you what has to happen, they seek your input and ask for feedback.

  2. Communicating expectations, timeline, etc - at the end of the session you should know how often they want you to come in, if they have an idea of how long therapy will take, and what to expect working with them.

  3. Comfort - you may be uncertain or apprehensive, but you should feel as though you can trust the therapist and that they are listening to you.

  4. Cash - they should be upfront about costs, insurance coverage, and more.

For others:

You can't force anyone to go that doesn't want to.


Especially if they are experiencing a lack of motivation due to mental illness, it may be hard for them to find or schedule resources. Offer to book them together, offer to go with them, or provide them a list they can look at on their own. Mention how much it would mean to you if they went, without guilt-tripping. It is not your job to make them do these things, but being there as a support can be helpful.


Don't schedule a visit without them knowing, force them to go, or nag until they relent. As hard as it is to do so, waiting until they make the decision can make therapy much more effective. If you're supporting someone with alcohol or substance abuse, groups like Al-Anon can be great.


In the meantime, you can connect them to interim or additional services such as warmlines, hotlines, support groups, and more. I have a whole list of these on my resources page.



Want more information?

See if you're prepared to handle a mental health crisis (for yourself or those around you) with a free quiz. Learn what you don't know, before you need to!


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