How Does Therapy Work? Part 4 (Completing Your Search as a Beginning)

Updated: Jan 17

Step 4. Connecting with Practitioners

You’ve compiled a list and you’re ready to make some contacts. Call! Email! Do it all! Sometimes therapists don’t get back to you right away. They may be full. They may not have the availability you need. You don’t have to let this impede you— that’s why you made a whole list!

What should you look for in this first phone call? First impressions! Your relationship with your therapist is often thought to be how therapy works. Any first conversation can be awkward; but,

  • Are there kernels of understanding there?

  • Is this someone who meets your needs regarding warmth?

  • Do you feel empathy from the other side of the phone?

  • Does it sound like you’re talking to a genuine person (if that’s what you’re into)?

This phone call is usually brief but can be longer than 15 minutes, depending on the way that the therapist practices. Some of it should be open ended; some of it should be instructive. Often, a therapist has a list of screening questions to ensure prospective clients are within their scope of practice.

Scope of Practice: All of the different kinds of psychotherapists have a governing body that outlines a code of ethics. If we do something very unethical, we could be stripped of our licenses or certifications. Taking clients who are within our “scope of practice” is an ethical obligation. If a therapist has only ever worked and trained for working with anxiety disorders, it would probably be outside of their scope of practice to take on a client with classic symptoms of schizophrenia. If you’ve ever attempted to acquire a therapist and they “refer you out” for this reason, there really is just another clinician who would be a better fit. Although “best fit” could be about diagnosis, it could also be about personalities— not that there’s necessarily a deficit on either side of the phone— not everyone gets along. (And living with that reality, is something to sit with in therapy).

If it’s not going to work, hopefully the clinician will know that in the first phone call. It may take a couple of sessions to find out the relationship is not a good match. In this case, the therapist is obligated to refer you to another practitioner who may be better equipped to work with you.

What's the deal with fees? Why do therapists charge different amounts of money?

It can depend on the market for your area, it can depend on the amount of overhead they have for their practice, it can depend on their schooling (a psychologist who is a doctor may charge more than a social worker who recently graduated with their masters degree). Are any of these helpers better than any others based on price? Maybe? It depends. If you’re looking for someone to do something very specific like a Neurofeedback or EMDR (explanations pending), you may pay more money. Some clinicians make an attempt to make their services more affordable because of the clients with whom they enjoy working. It really depends— don’t judge a book by the price on its cover.

If it sounds like it’s going to work, that’s great! That person on the other end of the phone will most likely discuss next steps with you. If you’ll be seeing each other in person, that information may include directions to the office and parking. If you’re seeing each other virtually, they will most likely provide instructions for the platform they’re using. They will most likely have documents for you to sign including INFORMED CONSENT (i.e., everything’s confidential except if you talk about wanting to kill yourself, someone else, vulnerable populations abuse), their policies and procedures. Read them! Ask Questions! Be involved in your treatment!

Step 5. Start sharing!

Check in with yourself and your therapist. Your therapist should check in with you. I always tell people to give a new therapist three sessions. If you feel like you’re not connecting, feel free to move on.

Sometimes we get stuck in bad relationships.

Sometimes we get stuck for years.

But therapy is supposed to be transformative and a gift you can give yourself is getting yourself out of a relationship with a connection that’s not working.

If a positive, trusting, authentic, relationship with proper boundaries is developing, then congratulations. You did it. You started therapy.

Oh, how does therapy work? That’s in every piece of the process. Stay tuned.

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