first time therapy advice?

[lemonbunny]

im finally off my ass and about to schedule an online appointment through my university's mental health services. i live in the US btw. does anyone have any implicit guidelines on what not to say, etc. like, is it recommended i dont speak about suicide, etc? also any general advice would be appreciated, im really scared its gonna make me feel worse.

 

[Bed]

you can talk about suicide with a therapist. they're not going to send you to a ward if you're suicidal, you generally have to meet 3 criteria to be sent; method, time and willingness to act on those thoughts. you can say a lot of things so please don't be scared to voice how you're feeling.

the first appointment is more of an interview to get to know each other. i'd ask about what type of therapy they can provide (cbt, dbt, etc.), how they think they can help you, as well as if there's anything you can do to make the sessions worth your time.

remember you can always ask to switch therapists if you find you don't mesh well with them. it's similar to a relationship in some ways.

i hope your first appointment goes well! it's completely normal to be anxious about it, i have definitely been anxious in the past. good luck :)

 

[Enigma the orange]

im finally off my ass and about to schedule an online appointment through my university's mental health services. i live in the US btw. does anyone have any implicit guidelines on what not to say, etc. like, is it recommended i dont speak about suicide, etc? also any general advice would be appreciated, im really scared its gonna make me feel worse.

Therapy sucks so much, been there done that. Therapists will often invalidate your feelings and you will get nowhere.

 

[lemonbunny]

you can talk about suicide with a therapist. they're not going to send you to a ward if you're suicidal, you generally have to meet 3 criteria to be sent; method, time and willingness to act on those thoughts. you can say a lot of things so please don't be scared to voice how you're feeling.

the first appointment is more of an interview to get to know each other. i'd ask about what type of therapy they can provide (cbt, dbt, etc.), how they think they can help you, as well as if there's anything you can do to make the sessions worth your time.

remember you can always ask to switch therapists if you find you don't mesh well with them. it's similar to a relationship in some ways.

i hope your first appointment goes well! it's completely normal to be anxious about it, i have definitely been anxious in the past. good luck :)

thanks i will keep this in mind! i feel like i have to prepare like its an interview, cuz i'll freeze up and not know what to say

 

[Bed]

thanks i will keep this in mind! i feel like i have to prepare like its an interview, cuz i'll freeze up and not know what to say

you can always write down the things you'd like to address or even hand them the sheet of paper if you're too anxious

 

[lemonbunny]

also i have the option to choose between psychologist, social worker, or professional counselor, unsure if that makes a difference ?

 

[Enigma the orange]

also i have the option to choose between psychologist, social worker, or professional counselor, unsure if that makes a difference ?

Psychologist would be better.

 

[Grumble]

Definitely a psychologist out of those options.

The more open you can be with the therapist, the better the prospects of making progress.

The path to recovery may involve confronting very uncomfortable or emotional feelings and past experiences. If you think you're going to have a problem handling this, then tell the therapist this. If you're struggling to speak because you feel ashamed or embarrassed or just because your brain locks up in the session, then tell the therapist that's what's happening.

Recovery can be a long process. You'll want to be patient with this process, but also patient with yourself. It's important to be patient with yourself and to give yourself credit for even the smallest steps. For instance, the fact that you're even considering a therapist and asking us for advice here: Give yourself credit for this.

Suicidal ideation is not cause for hospitalization. As @bed said, they look for whether you have a plan, whether you have access to the means to carry out the plan, and whether you are in imminent danger of following through with the plan. If you hide your suicidality, then you hide the severity of your condition, and this would be counterproductive.

The therapist NEEDS to know what you're struggling with. Be as vulnerable and as open as you can be.

 

[lemonbunny]

Definitely a psychologist out of those options.

The more open you can be with the therapist, the better the prospects of making progress.

The path to recovery may involve confronting very uncomfortable or emotional feelings and past experiences. If you think you're going to have a problem handling this, then tell the therapist this. If you're struggling to speak because you feel ashamed or embarrassed or just because your brain locks up in the session, then tell the therapist that's what's happening.

Recovery can be a long process. You'll want to be patient with this process, but also patient with yourself. It's important to be patient with yourself and to give yourself credit for even the smallest steps. For instance, the fact that you're even considering a therapist and asking us for advice here: Give yourself credit for this.

Suicidal ideation is not cause for hospitalization. As @bed said, they look for whether you have a plan, whether you have access to the means to carry out the plan, and whether you are in imminent danger of following through with the plan. If you hide your suicidality, then you hide the severity of your condition, and this would be counterproductive.

The therapist NEEDS to know what you're struggling with. Be as vulnerable and as open as you can be.

thanks. considering i dont open up to anybody irl, this might be hard but im gonna try and keep a sheet of things i want to get through

 

[Valky]

Ngl, been too lazy to read the other replies so sorry if I say something others already said, this is just my advice.

1. MOST IMPORTANTLY:
A lot, and I mean (sadly) A LOT of therapists suck. Not every therapist is gonna be a great match for you. Okay, maybe not all suck but obviously every one differs. Maybe you need someone who is more straightforward, maybe you need someone gentle, maybe you need someone to kick you back into reality, maybe you need someone to reach into your bubble first. Don't be discouraged if this one doesn't fit, or the next one, or the one after that. Finding the right one is worth it. I promise.

2. What you should not say:
If you are comfortable enough, you can voice that you are feeling suicidal. Depending on the therapist, this will not immediately get you yeeted into a psych ward. What you should not do, as it raised alarm clocks, is voicing that you have a concrete plan. This usually wakes up the alarm clocks. Give them the feeling, that you are trustworthy to be true when saying, that you do not plan on taking your own life aka ability to follow agreements.
However: if you really feel like you will not make it another day, do not be scared to say that. They can help you. It doesn't necessarily have to be directly a psych ward, they have other ways to help. I am not encouraging you to not say when you feel like your life or the lives of others is threatened.

3. Remember:
- it is okay to cry, that means you are processing things
-it is okay to take your time with answers (even if your therapist is a dickhead and tells you otherwise)
-it is okay to be cautious at first
-it is okay to be honest
-it is okay to trust them (whenever you feel ready to)
-it is okay to be uncertain
-it is okay and normal to feel miserable afterwards, after all you are finally pouring your heart out to someone that will try their best to understand you
-things take time, allow yourself that time to cry, to progress and to heal
-do NOT listen to them if they try to tell you that others have it worse and to stop self pitying yourself, these people are NOT professionals, just assholes
- and therefore, it is okay to change therapists if you feel like it is not working out


I hope my reply is not too late or maybe someone else in a similar situation may find this helpful. I am proud of you for taking that step towards recovery!
Best of luck, you got this!!

 

[lemonbunny]

Ngl, been too lazy to read the other replies so sorry if I say something others already said, this is just my advice.

1. MOST IMPORTANTLY:
A lot, and I mean (sadly) A LOT of therapists suck. Not every therapist is gonna be a great match for you.

thank u sm this was super helpful. my biggest fear is that the therapist will not be a good match for me, good to be warned in advance

 

[Adûnâi]

-it is okay to take your time with answers (even if your therapist is a dickhead and tells you otherwise)

But aren't you paying by the hour? (Or is it free in this case due to school?)

I'm seeing my 1.5th therapist on Monday, too, but I'm Ukrainian, so no idea whether any of this applies. I don't even know whether I'm struggling with psychological issues, or just genetic autismus. (But I shouldn't be hijacking this thread, so whatever.)

 

[Valky]

thank u sm this was super helpful. my biggest fear is that the therapist will not be a good match for me, good to be warned in advance

I am so happy that this was of help!! Report back to us, if you feel like it!

But aren't you paying by the hour? (Or is it free in this case due to school?)

I'm seeing my 1.5th therapist on Monday, too, but I'm Ukrainian, so no idea whether any of this applies. I don't even know whether I'm struggling with psychological issues, or just genetic autismus. (But I shouldn't be hijacking this thread, so whatever.)

Insurance pays for that here, I did not consider that :/

 

[Meteora]

You should normally be able to say everything.
I recommend to not get involved to fast, though.
Someone said its a bit like in a friendship. I agree.
It's best to get to know eachother slowly.

It might be that the therapist wants to set the pace by asking questions or assuming things.
They have different techniques/strategies to make you talk.
So be careful and don't hesitate to just set boundaries.

Good luck!

 

[dragonofenvy]

It may be a good idea to also tell the therapist that you may not be able to lead the sessions very well. One thing with therapy is that you kind of need to have a topic for the session or some kind of goal. For many, like myself, I couldn't really lead sessions very well which led to frustrations as therapists are trained to have the patient lead. If you let your therapist know ahead of time that you need help with that regard they will try their best to do so. Usually, the first couple of sessions are trying to figure out what exactly you want to work on so if you don't know right now it's fine, but knowing beforehand will speed things up a bit.

The biggest thing is to actually work on what you talk about. This is why I failed at therapy. I talked about a lot of things but never actually did anything outside of therapy. I can't give you any advice on how to work outside of the session, unfortunately.

 

[lemonbunny]

It may be a good idea to also tell the therapist that you may not be able to lead the sessions very well. One thing with therapy is that you kind of need to have a topic for the session or some kind of goal. For many, like myself, I couldn't really lead sessions very well which led to frustrations as therapists are trained to have the patient lead. If you let your therapist know ahead of time that you need help with that regard they will try their best to do so. Usually, the first couple of sessions are trying to figure out what exactly you want to work on so if you don't know right now it's fine, but knowing beforehand will speed things up a bit.

that's interesting. i've heard from others that the therapist is supposed to lead or whatever, but ig what u mean. gonna try to prep well for it

 

[dragonofenvy]

that's interesting. i've heard from others that the therapist is supposed to lead or whatever, but ig what u mean. gonna try to prep well for it

They are supposed to "lead" in a way, but they need to know what they're supposed to be leading you on. They also aren't going to just tell you the solution to your problems. Their job is to assist you in figuring yourself out. Understanding yourself is what precedes results.

If you were a therapist, and someone came to you and said "I'm depressed and I don't know why." Well, that's a bit hard to deal with. But if you say "I'm depressed, and I think it's because of..." well now you've got something to work with to help them.

You don't need to prep super hard, but if you have some ideas on what's making you unhappy that's a start. The process might look something like "I am sad that I don't have friends" (problem), which you could leave at that, or go into more detail by saying "I don't have any friends because I don't trust people because of..." which is now starting to get down to where you want to be by adding more details instead of being surface level. Again, you can be surface level at the start, nothing wrong with that, but digging down deeper will help both you and your therapist out.

 

[Young.Werther]

However: if you really feel like you will not make it another day, do not be scared to say that. They can help you. It doesn't necessarily have to be directly a psych ward, they have other ways to help

What other ways? My impression was that they just section you to get you off their hands so you're not any sort of liability to them if you die.

 

[Valky]

What other ways? My impression was that they just section you to get you off their hands so you're not any sort of liability to them if you die.

Depending on the situation that put you in a state of immediate help. Maybe they can help you deescalate any harmful situations, help with communication between any caregivers, family, friends, partners that could benefit you and maybe take extra care of you for a bit.

Obviously, if they get the feeling (which may be because they don't know you that well or they don't trust you enough to be honest when saying that you won't do anything to yourself) they will hospitalise you for legal but also ethical reasons.