After the first appointment… what now?

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You’ve completed the consultation and intake appointment. Often, clients want to know “What’s next?” What are regular sessions like?

Know that this will differ from counselor to counselor. We’ve all got our own styles and way we do things. It can also be influenced by the counseling theory we use for understanding what helps people. This is speaking from my general experiences as a client as well as drawing on my own style as a counselor. I meet with clients for 45-60 minutes per session. Sessions usually occur once a week, especially in the very beginning. (If more frequent meetings are necessary, that’s something to talk about in that first or second session, to see if this is what is most appropriate for you. If not, your counselor should help you find resources.)

So, the intake questions are answered, now what?

For me as a counselor, the intake gave me a framework to begin thinking about what may best serve your needs. I’ll check in during that second (or maybe third) session if we’re on the same page on what you’re looking for from counseling. If it is, we dive into the work together.

Oftentimes, clients will come in and I’ll ask how things have been going. What’s been of note? What’s stuck out from the work we’ve been doing? Often, there are explorations we would’ve talked about in earlier sessions (things to be curious about or tools to try out in your daily life), and I’ll check in about that.

I work from a “client-centered” perspective, which means what matters to you matters to me. At times, I may refocus us back on your goals; often, I find that what people bring into the room with them is related to what they want to work on. I rarely say, “This is what we’ll work on today,” unless we’ve previously discussed working in that way. Rather, I want to create space where you bring up what is relevant, what is most pressing.

I often get asked, “Do I have to talk about x, y, or z?” (the past, my family, whatever). I don’t force anyone to talk about anything – this is your counseling, after all. If things may seem related, I may ask, but you’re in charge of how much or how little you say about it. If there are things in the past that are coming up in the present, we can talk about how it’s affecting you right now, but not necessarily go into detail about the past if you choose not to. Sometimes, staying in the Right Now gives us more to work with and new ways to do things.

We can’t change the past, but we can try out new ways of responding, right?

(I realized I have more to say about this, so I’ll talk more about this next week – that balance of discomfort because of change and the comfort of trust.)

For me as a counselor, this is what we work on. As you come in and have less to say, or we reach your goals, or you find that maybe it’s not working for you – it’s time to talk about what happens then. Check back this weekend to learn about “Okay, I think I’m at a good place. What now?”

What about that first appointment?

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When you’re thinking about your first appointment, there are two “kinds” of first appointments – a consultation and an intake. While I’ve talked a little bit about this in What to Expect, I’ll cover both in today’s Therapy 101 post. But first, some things to consider before that first appointment.

How do you best work with someone?

Do you need someone who is a tell-it-like-it-is, or do you need someone who may be more gentle with those things that are hard to see? Knowing this will help you determine if it’s a good fit in working together.

What are your goals?

What are the things you’re hoping to work on while in counseling? Having somewhat of an idea (knowing that, hey, life happens and this could change) will help you and your potential counselor know if it’s a good fit in working together – does the counselor have the skills and knowledge in that area to help? If not, it will give the counselor a chance to give you appropriate referrals to point you in the right direction.

What is your budget?

Some counselors have a sliding scale (a lower fee to help those for whom the full fee would be an undue burden), some take insurance, some don’t do either. It’s really dependent upon the counselor. Counseling is an investment that you’re making in yourself, in your health and wellness. Your counselor is providing a skill set that she or he worked really hard to get and continues to develop through their work and additional training. Counselors also often want to make their services accessible to people, so know what your budget so it’s something you can talk with the counselor about if you need to.

Okay, so you’ve done some noting of the above and you’re heading off to your first appointment. What should you expect?


Many counselors in private practice (as opposed to a clinic or agency) offer a free 30-minute consultation. I can’t speak for every counselor, but with mine, it’s an opportunity for us to connect and meet, to see if we’re a good fit for working together. It’s kind of like a no-pressure interview.

What does good fit mean, anyway? Because therapists aren’t your friends, but they are people who are going to be working with you on potentially difficult things. This is where knowing what style(s) may work for you comes in handy. If you’ve been in counseling before, or read about some counseling theories (or the counselor’s bio on Psychology Today or their website!) you can ask what they focus on in sessions and how they do the work they do.

Consultations are also a great time to ask any major questions or share (very briefly) what’s going on. Note: You and the counselor won’t have time to get in-depth at this appointment, but will give the counselor a sense if they have the skills and knowledge to best provide what you’re looking for! Consultations are also the time to talk about financial questions, about insurance, etc., so that you and your counselor are on the same page from the very beginning.

If you’re “interviewing” with other counselors, let them know that! I encourage people to find someone they feel might be a good fit; if it’s not me, that’s okay! It’s way more important to find a good fit; your experience and counseling will be much more effective!


Your counselor may have information for you to fill out prior to your intake. Intakes are the time your counselor will begin to take more history (medical, mental health, medications, family, etc.) to get a big picture of what’s been going on and what you’re currently experiencing. Depending on the counselor, this session may be longer or take up to two full regular sessions (generally 45-50 minutes long). It gives you a chance to begin further discussing what’s bringing you in and starting to consider what might be helpful AND what your goals are. Your counselor should then talk with you about what he or she sees as being the major goals and see if you are both on the same page.

During this session (or the consultation), the counselor should go over informed consent (clarifying questions, letting you know what they offer, who they are, financial stuff, confidentiality) at the very least.

The intake can’t get ALL the information EVER, but is a good jumping off point to start your work with your counselor. It’s often a lot more question and answer than many sessions, and counselors vary in how they do this. As through the whole process, you have the right to share as little or as much as you want – just know, the more honest the information, the more your counselor is able to get a clear picture of where to go in counseling.

… and that is the next part of the Therapy 101 series – what to expect in sessions after the intake session.

Did I get everything? Is there something about intakes you really want to know about?

If you’d like to schedule either a consultation or intake with me, I invite you to email me or visit my online scheduler. I’d love to hear from you.

How do I find a therapist?

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So you’ve realized that you may need some extra support in your life and decided you want to try out therapy/counseling.

The next question might be – how do I find someone?

The first thing to know is that you don’t have to go with the first person you see. The relationship between you and your therapist is one of the most important things. If you don’t feel like you could open up to them (eventually… the next 101 post will be what to expect when going to your first appointment!) If the therapist does a free consultation (usually 30 minutes), use it! It’s a way to find out of you might work well together. It’s better to do that then pay for a few sessions and realize, no, this person won’t work for me.

The second thing to think about is what you are looking for in a therapist and what you need from someone who is going to be supporting and working with you through this time in your life. Different people need different things and the first person you meet with might not be that right person.

The third thing to think about is how you want to meet with people. There are some online platforms for some concerns and issues. I don’t have the knowledge base in that to speak to it, as I’m not trained in distance counseling at this time. Note: If you are choosing to use insurance, most companies won’t pay for this mode of counseling at this time (that I am aware of). My guess is this will be changing, but not sure when.

The following are the top three ways to find out about counselors in your area.

Word of Mouth

There’s nothing like getting a good recommendation from a family member, friend, congregation member, another person in your life that you trust. If you feel comfortable letting others know you’re looking, that might be a great first place to go. Note: Counselors/therapists cannot see family members of current (or sometimes past) clients. It’s a confidentiality and ethics perspective. The same often goes for romantic partners. Check with both the therapist and the person who may be recommending them.

Psychology Today

One of the ways I’ve found my therapists when I’ve been in counseling before is through the Psychology Today Therapist Finder. Counselors (like myself) pay a fee to be listed in their database. You can filter counselors by zip code, concern, insurance provider, gender. It’s a super helpful way to learn a little about the therapist. Many of us also have web pages that might give you a better sense of who they are, what they do. Make a list of people who you think might be a good fit to call, or send an email through the Psychology Today website. (GoodTherapy is another site similar to Psychology Today.)

Insurance Company

If you are choosing to use your insurance (this will be another 101 post, as there are definitely pros and cons to using your insurance; in that post, we’ll talk the financials of counseling!), you can also call your insurance company or check their website to see who they have listed as providing services in your area. Note: I’m finding in my area that people are listed with the insurance company, but they don’t take it anymore. You’ll have to check with providers individually if they take a specific insurance.

Next Steps

Next steps would be getting in touch with potential counselors – via phone, email, or their website. It’s a scary prospect at times, so when reaching out, some potential things to ask about:

  • Rates/fees and/or insurance
  • Areas of concern – what would you like to work on?
  • Times/days available (yes, counselors – like myself – may have evenings and weekends available!)

Touching base with a counselor via phone, email, or website is your first contact with them and begins that process of determining if you think you’ll work well with them!

Are there ways you’ve found a counselor that I’ve missed? Let me know in the comments below!

P.S. The Wholefully blog also had a great post about finding a therapist that you may find helpful.

Why would I want to go to therapy?

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You’ve been thinking about how life could be different. Things you want to change, areas of growth, or situations/reactions that are just. not. working anymore.

Or maybe, it feels like everything has exploded and you don’t even know where to start, but you don’t want to stay in the yuck.

We have a lot of ways to deal with these situations. Friends, family, Facebook. Why would you want to go to talk to a stranger?

One of the most powerful parts of therapy/counseling is that the person sitting across from you not only has training in helping people experiencing LOTS of different things, but your counselor is not intimately involved in your every day life. One of the frequent comments clients have shared with me is that “it helps you don’t know me.”

It’s a fine line. As a counselor, I care deeply for my clients, but their choices are their own. If you’ve been thinking about counseling, what would it be like to work with someone who cares about your well-being, but is also separate from your life? Someone who doesn’t have already-formed judgments about you or what you “should” or “shouldn’t” do?

Counseling and therapy can help you make the changes that you want to make in your life – with yourself, with others. Counseling can help you find the pieces and create a new view of things.

Have you been wondering how you can find pause? How you can find change? Contact me or schedule a free 30-minute consultation.

What the heck is therapy/counseling?

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This post launches a series I’m calling Therapy 101 – a way to learn what therapy is, what to expect, ask, and how to get connected to services. Do you have questions or things you’d want to know about therapy? Email or connect with me!

With the multiple ways in which mental health is stigmatized, there are a lot of people who don’t feel comfortable asking about, let alone seeking services. There have been a number of people I’ve worked with, at our first session, ask what to expect and what therapy/counseling is. Totally valid and important questions to ask! Today, let’s talk a bit about what therapy/counseling is.

Therapy and counseling are often used interchangeably. (I use both terms to mean the same thing!) When I talk about them, the process is about finding supports to help you through whatever may be going on – mental health symptoms or struggles, life changes, stress.

The thing to remember is that it’s rarely a linear process. Movies may show that you come in and, in just a few sessions, you’re “all better.” Sometimes. Sometimes not. It’s an ongoing conversation about what your goals are. As a counselor, my goal is to both help you reach your goals and to not be in counseling forever! I want you to go live your life.

What is the process even like? Well, again, movies give us our usual image of going into an office, laying on a couch, and just talking. That’s a particular style of counseling. Most counselors have people sitting in their office, facing one another, and we talk about what is most helpful in the moment, to help you reach your goals (whether feeling better, processing trauma, dealing with issues of addictive behaviors… the list could go on…) We’ll talk more specifically about this later in the series.

One other common concern from clients is that I will try to “change who they are.” For me, as a counselor, I never give advice and I work with people to find their own way. This means not imposing my own views/values on things. I make suggestions and offer potential tools to explore. If they don’t work? No worries! We’ll find others. During this series, we’ll talk more about what types of tools are available and how working with a counselor may help.

As I was writing this, I saw that the American Counseling Association (the professional organization I’m a member of) put together a great Q&A about counseling and counselors for their Counseling Awareness Month (in April!).

So, what questions do you have about counseling? Drop them in the comments below or contact me to start a conversation!