Whether you’re going to therapy for the first time or searching for a new provider, your first appointment can be overwhelming. You need to get a lot of information, and it can be easy to forget to ask an important question. DBSA’s Young Adult Council created a printable list to help you feel more prepared. You probably won’t need to ask every question on the list. Choose the questions that apply to your situation. Below, some Young Adult Council members explain why certain questions matter to them.
Questions about your treatment
How long will my first session be?
Jazmine: I found that typically a first (intake) appointment is an introduction. It usually takes about an hour to an hour and a half. Other appointments are usually 45 minutes to an hour. I suggest taking the opportunity to use up that time and ask questions to get to know your therapist.
How should I prepare for each session?
Olivia: I once had a counselor recommend journaling to tide me over between appointments. I found it also helped me have a more productive session. Sometimes I come into a session with discussion topics weighing heavily on my mind, but other times I come up empty. Before I started journaling, I sometimes felt like an “imposter” at counseling. I could go through a rough week but have a couple of good days leading up to my session. It’s important for me to not limit my sessions based on how I am feeling at one moment during a two-week period.
How often should we meet?
Olivia: I prefer providers that can offer some degree of flexibility, if possible. Sometimes I prefer weekly meetings. This is especially true if I am going through a big transition, like moving to college, returning home for winter break, or starting a new job. However, if things are going well and I am managing my symptoms, I’m more comfortable meeting once every two weeks.
What is your stance on medication? Is it an option you sometimes recommend, or do you encourage it for all clients?
Sam: This is a tricky one, and not something to be taken lightly. It is worth mentioning that almost all medications have some form of side effects, and you should absolutely do your own research before taking any medication. That said, if your disorder is severe, long-term medication may be the only way to manage it properly. Personally, I asked my psychiatrist if medication is a necessity in managing symptoms long-term. I would say to consult your psychiatrist, books, and good research outlets online to be able to properly gauge what medication can and cannot do for you.
Do you work with patients’ psychiatrists or primary care providers to discuss medication options?
Sam: I consult psychiatrists (and not psychologists as much) because they are the ones who are licensed to prescribe, and it is their specialty. Keep in mind it is not within the power of a psychologist (even though they have a PhD and put “Dr.” before their name) or therapist (who has a master’s degree, not an M.D.) to prescribe medication because they do not have an M.D. and have not gone to medical school. Although it is important to keep your primary care doctor in the loop about what psychiatric medications you plan to take or are taking, it is better to ask your psychiatrist the more heavy-duty questions because psychiatric medication is the psychiatrist’s specialty, and your primary care doctor will likely not be able to provide more in-depth knowledge.
Questions about your provider
Do you have experience working with people with my diagnoses (an anxiety disorder, personality disorder, PTSD, etc.)?
Olivia: Doctors who treat physical conditions often have specialties. You see a cardiologist for heart issues. You see a dermatologist for skin conditions. Mental health providers often have specialties as well. My experience with a provider who specialized in sexual trauma was more productive than my experience with a provider who specialized in family therapy.
How do you measure success with your clients?
Olivia: It’s very important for me to have a provider that focuses on my feelings and perceptions rather than my external behaviors. For example, one of my symptoms is non-suicidal self-harm. My first therapist made ending that behavior our top priority. I would feel incredibly guilty if I self-harmed. It also made me feel like success was a yes or no scenario, rather than something that exists on a scale. In contrast, my therapist in college worked with me to identify goals. Together, we decided to focus on the feelings behind my self-harm, rather than the behavior. I was able to discuss my behaviors without feeling embarrassed or ashamed, which enabled me to get more out of my sessions.
Nuts and Bolts Questions
Do you have a sliding scale payment system?
Jazmine: When I first started thinking about going to therapy I delayed it due to the cost. I later learned that sliding scale was an option as well as pro-bono.
What is your termination process?
Olivia: This is something I regret not discussing more with my last provider in college. I know it is ultimately my responsibility to find another provider to continue my care. However, it would have been helpful to have someone to hold me accountable and make sure I have a transition plan in place. My former provider also had connections in the city I moved to after college, so I wish I would have asked her for provider recommendations.
Do you offer phone or virtual sessions?
Jazmine: I found that it was more difficult for me to open up during in-person therapy than in the comfort and privacy of my own home. This may be different for you if you don’t have access to that. The comfort of my homemade my virtual experience with therapy much better, and it is now my preferred method.
Sam: I find in-person therapy is best for the things that are tougher to talk about and more sensitive topics. When speaking through a laptop, the “feeling” in the room can be lost. In addition, I find it harder to read the person I am talking to through video compared to sitting across from the person. Communication can be more difficult (missed body language, facial expressions, gestures, etc.), even though tone and words can still be heard if the video quality is good. If there are no therapists/psychologists near you, video therapy sessions are better than none at all in my opinion.
Are there any limits to confidentiality?
Sam: Also a tricky one. I would say it’s not a bad idea to have an emergency contact that your provider can call if need be, especially if living by yourself. If you forget to take the meds you need to stay stable (this is a common one) and no one else is around, it can be a dangerous situation. Make sure you have at least one other person besides your therapist/psychologist that you can confide in. This may mean patching up a relationship with someone to help get on the same page, but if it means that your supporter is there for you in a tight situation, it is absolutely worth making up with that person.
Finding the Right Therapist
The Young Adult Council has an ongoing series about finding the right therapist. Click the buttons below to read more about how some council members overcame challenges to find the right fit.