What Does Starting Therapy Look Like?
So, you’re thinking of starting therapy- that’s great! Taking the first step to healing can be daunting, and for many, wondering what to expect when starting therapy can be a huge barrier. Fearing the unknown is common, and having a rough idea of what you’re stepping into can help you feel more confident when taking this next step.
While the process of beginning therapy is going to look a bit different depending on your therapist or therapy practice you are going to- there is a common general approach here. I’ll share what it looks like to start therapy here at Minnesota Attachment Collective, as well as can touch on some things to ask your therapist if you are looking for more specifics!
Selecting Your Therapist
Once you decide that you’re ready to start therapy, you’ll want to start looking for a therapist that seems like they’ll be a good fit for you and what you are looking for. Research has shown us that within the therapy session, the therapeutic relationship is the most impactful part of therapy. Working with someone you trust and can work on feeling vulnerable with makes all the difference. So, I always recommend that you take your time to select a therapist that you believe you can feel pretty comfortable with.
Here are some factors to consider when selecting your therapist:
Do they seem like someone I think I can eventually feel comfortable with? While of course you’re not going to feel 100% comfortable right off the bat, you can typically get a sense from a therapist’s bio or conversation during an initial consultation (which I’ll talk about below) if you think you’ll vibe with them.
What are the therapist’s specialties? Just like medical doctors don’t specialize in every concern, therapists are not going to be a good fit for every single area of mental health. You’ll want to make sure you’re working with a therapist who has experience in what you’re looking to work through. You might not be totally certain exactly what you’re needing to work on in therapy, but keep an eye out for a therapist who typically works with folks in your season of life or with some of the same presenting concerns you have. For example, if you are pregnant, you will want to look for a therapist who specializes in perinatal mental health.
What are the therapist’s approaches to therapy? Some folks have in mind a specific modality that they’d like to use in therapy, such as Internal Family Systems or Narrative Therapy. If you don’t know what modality of therapy you might enjoy the most- don’t worry, you absolutely don’t need to know about all of the different theories to therapy here. But, you might have an idea of what general approach you are looking for. For example, some folks are looking for a therapist who is warm, supportive, validating, and nurturing. Whereas others may be looking for a therapist who is more direct, to the point, and skills-based.
Do you need your therapist to accept your insurance? If you need to work in-network with insurance, make sure that the therapist you select accepts your specific insurance. It is helpful to verify your benefits with your insurance ahead of time so that you know what to expect for the cost of therapy- I’ll touch more on that below! Some folks prefer to work with therapists out-of-network. Going private pay can open up your options if you are looking for more of a specialist, can increase the privacy of your care, and may not ending up costing much more than an in-network therapist if you have a high deductible insurance plan.
Are you looking for in-person or virtual services? If you are looking for a therapist who you can see in-person, you’ll of course want to look for someone who has an office close by so that a long commute to session doesn’t become a barrier to treatment. But, going virtual can expand the options of the therapists you can see (usually anyone within your state) and can be more convenient. Make sure the therapist you select offers therapy in the format you are looking for.
Where to look for a therapist
Online searches. Many head to google looking for a therapist. Rather than just looking up “therapist near me”, being more specific will help you narrow down your search. For example, you may search for “perinatal therapist” “therapy for moms” or “therapy postpartum anxiety” if you are looking for a therapist to navigate worries that are showing up postpartum.
Online directories. There are quite a few online directories that can help you select exactly what you’re looking for to find therapists in your area. Some popular directories are Psychology Today, Good Therapy, or Therapy Den.
Recommendations. Asking around for therapist recommendations can help you find someone who is a good fit for you! Ask friends, communities you are a part of, or any of your current medical providers who their favorite therapists are.
Utilizing a free consultation
Most therapists offer a free 15-20 minute consultation so that you can make sure they feel like a good fit for you before you get started. While this can feel a little nerve wracking, know that therapists love when you utilize this option- because they want to make sure it feels like a good fit too!
Typically, the therapist will share a bit about their specialities and how they approach therapy. They’ll likely ask you a few questions about your presenting concerns as well as what you are looking for in a therapist so that they can speak to this. While you don’t have to come prepared with specific questions, it can be helpful to ask any questions that you’d like more information on before making your decision.
Here are some common questions we see:
“I’m looking for therapy to work on xyz, is that something you work with, and if so, can you share a bit about how you approach that in therapy?”
“How frequently and for how long do you typically work with clients?”
“What are some of your current openings for weekly sessions?”
“What is the cost of therapy?”
“Can you tell me more about your therapeutic approach?”
“I have had a previous therapy who utilized xyz, I did/did not find that helpful. Is that something that you typically do in therapy?”
Don’t feel pressured to sign up for therapy with them right after that initial consultation. Typically, we end our consultations by giving them some time to think about if they want to work with us and let them know how they can book a session to get started. It is totally okay to let a therapist know that you need time to think about it or plan to connect with a couple of other therapists before making a decision!
Checking your insurance
Insurance can be so confusing! If you plan to use insurance for therapy, here are some things you’ll want to ask your insurance company before starting:
Is my insurance accepted at this clinic/with this therapist?
What is my deductible? This is how much you will have to pay out-of-pocket before your insurance kicks in.
Do I have any co-pays/co-insurance for therapy sessions? It can be helpful to know the CPT code your therapist will be using for your services (which you can ask them ahead of time) as these vary by the type of services you will need. Commonly, an intake session is 90791, ongoing individual sessions are 90834 or 90837 (depending on the length of session), and family sessions are 90847.
Is there a maximum amount of therapy sessions that are covered? Are there any limits to therapy that would need to be authorized by insurance first?
At Minnesota Attachment Collective, we are out-of-network, meaning we do not directly work with insurance. We do this for a number of reasons, but mainly this is so that our therapists have more control and consistency in terms of their pay, and so that session fees are always transparent to our clients. Like many therapists who are out-of-network, we can support you in getting your out-of-network benefits by providing you with a “superbill” that you can submit to your insurance for some reimbursement.
When using your out-of-network benefits, you will pay for your session with us as usual, and then submit the superbill to your insurance- then they will reimburse you for whatever is covered in your benefits. Out-of-network benefits will vary from plan to plan, so here are some questions you can ask your insurance to get an idea of what your benefits will be:
What is my out-of-network deductible? This is what you will pay before your benefits kick in.
What will I be reimbursed for therapy services? Typically for us, the intake session is CPT code 90791, ongoing individual sessions are 90834, and couples/family sessions are 90847.
What is the process for getting reimbursement? It can be helpful to know where you submit your superbills as well as how long you can expect to recieve reimbursement.
The Intake Session
Once you have selected your therapist and gotten on their schedule, you’ll have your intake session. Prior to your first session, you’ll typically have to fill out some intake paperwork. With us, we send over all of the informed consent forms and practice policies to review and sign off on.
We will also send over an intake questionnaire- which allows us to gather information about what brings you into therapy, your history, and current symptoms. Some folks may feel a little uncomfortable filling out such detailed information before really getting to know your therapist- that’s okay! Fill out as much as you feel comfortable so that your therapist has an idea of what additional information to explore when they are meeting with you.
What’s the intake session like?
The intake session tends to feel a bit different than ongoing sessions. Your therapist will likely ask you what prompted you coming to therapy to get an idea of what your goals and focus are. They’ll also ask you for some background information- typically covering a bit about your upbringing and family of origin, getting an idea of your current relationships and support systems, as well as what life looks like in your day to day. And of course, you’ll cover all relevant mental health symptoms. Your therapist will get an assessment of where your current symptoms are at as well as explore your mental health history.
First session nerves are so normal! Most people feel a bit nervous going into their first session with a new therapist. That is totally okay and expected. Your therapist gets that going through vulnerable details about your life and mental health can feel nerve wracking. They’re going to do their best to help you feel comfortable, and give you the space to just share what you feel okay starting out with.
Setting goals for your therapy
After your intake session, you and your therapist will set some goals for your work. At Minnesota Attachment Collective, we look at this as a very collaborative approach, and set up a treatment plan that is going to align with the areas of growth you are interested in. Of course, we will share our recommendations, but overall want to ensure that therapy is fitting what you are looking for.
What if it’s not a good fit?
While rare, sometimes things don’t feel like a good fit after that first therapy session. You may come to the intake session and just don’t feel like the therapist is a good match for you. That’s okay! Any good therapist’s goal is going to be that you get the care that supports you best. They’ll be happy to help you find a therapist that is a better fit for you if you need.
Sometimes after an intake session, a therapist might also identify that they are not going to be the best fit for the client. This may be due to a higher level of care being needed or a different therapeutic approach being more beneficial. Rather than being unethical and wasting your time, a therapist is going to name if they are not the best option for what you are looking for. Again, they will do their best to set you up with referrals so that you can easily transition into the next step.
Ongoing Therapy
Once you get started, your therapist will make recommendations as well as provide information on what ongoing therapy will look like. This again gives you an opportunity to check in if this work is going to feel like a good fit for your needs.
Most of the time, beginning therapy at a weekly frequency is going to set you up for success. We start new clients off at weekly sessions for at least a month to make sure that we are entering the working phase in a way that allows us to really get to know each other, identify your goals, and get you started on them. With sessions more spread out at the beginning, it can be challenging to really get things going.
While it varies from person to person, we see the most therapeutic progress when folks are able to meet weekly for the first 3-6 months. This helps you to build a really solid foundation as you are unpacking the things that keep you feeling stuck, explore new ways to approach situations, and build skills.
Once you are feeling really consistent in the goals that you are working on, you’ll likely decrease the frequency of your sessions. You and your therapist can discuss this as things go along so that you feel well supported in any changes around therapy. It can be helpful to test out sessions at an every other week or monthly frequency to see how that feels, and know that you can always add sessions back in if that frequency isn’t working.
At Minnesota Attachment Collective, trauma is a big specialty of ours, meaning we do a lot of long-term work. This doesn’t necessarily mean that clients will be in therapy every week for the long term, but may mean that at different seasons of their life they return to therapy. Life transitions can bring up some old wounds, and getting back in with your trusted therapist during those times can feel like a major support!
Ending Therapy
While this blog post is specifically about starting therapy- it can feel helpful to have a little idea on what ending therapy looks like before you get started. Therapy gets to be a tool that you can return to whenever you need, but that doesn’t mean you are supposed to consistently stay in therapy forever.
Throughout your work, you and your therapist will discuss your progress and confidence in your goals to make adjustments on the frequency of your therapy. Typically, working towards ending therapy begins by first reducing your frequency and making sure that feels okay. Having a greater time in between sessions can allow you to put your work to the test and gain confidence in being able to stay consistent on your therapy goals on your own. Eventually, this will look like wrapping up your ongoing sessions- potentially with the option to return for a session here and there when needed.
How long will I be in therapy?
This varies so much from person to person, so I can’t give a super clear idea on this. Some may be in therapy for a shorter duration (such as 6 months) if they are working through something more situational like preparing to become parents when mental health symptoms are not very significant. Others may be in therapy for several years if they are working through something more significant, such as unresolved childhood trauma. You can always check in with your therapist as you are getting started to get some initial insights from them as well as continue to check-in as you go.
It can feel daunting to see that therapy is often a bit of a longer-term process, rather than something that we can jump into and wrap up within a few weeks. Keeping in mind that many of the things folks come to therapy have been a product of years of patterns- so it’s going to take time to unlearn those patterns and learn new ones. Taking your time to heal and grow on a deeper level will not only help you to feel like you are actually connecting to those goals, but it will also allow your progress to truly stick with you for long after you wrap up therapy!
Ready to get started?
If you live in Minnesota and are looking for therapy, we would love to support you! At Minnesota Attachment Collective, we specialize in attachment/trauma work as well as supporting folks throughout the tender seasons of growing their family. You can learn more about our providers and specialties here- where you can also schedule a free 15-minute consultation to begin the process.
We work with individuals and couples- and offer sessions in-person at our Eagan, MN office location or virtually for those across Minnesota!