#therapy 101

[beetle-persona]

Therapy: £100 - £500 per session

Persona 5: £23.99

Make the right call 👌

[episodesucks]

shdnfhjf Me too

[thistherapylife]

Hello, if it's not too much trouble to ask, can I ask how someone would go about looking for a therapist in their local area and also, is there any place I can go to look for reviews on specific therapists from past or current patients?

Hi Anon! 

When I was looking for my own therapist, I did three things. 

First - I reached out to my network - who liked their therapist? From there - I asked those therapists if they had any recommendations (I did this before I was a therapist) or would be willing to post on a therapist list for me (I didn’t know I could do this before I was a therapist but I wish I had done it).

Second - I looked at low income options (like https://openpathcollective.org/ and local therapy collectives/non profits) as well as professional associations (AAMFT/ localstatechapterofMFT/ LBGTQ therapist organizations). The professional organizations often have therapist finders (which didn’t super help me because I wasn’t using to insurance but if you are this might be a good option). 

Third - psychologytoday.com. This is where I ultimately found my current therapist. This is a quick search I did for trauma therapists in the Chicago area. You have to do some weeding (I wish you could sort by who has a sliding scale for example). It’s a good way to get started - most people have their orientations and styles and some pricing on that. They will also have websites you can explore. 

Regarding reviews - part of the reason why I asked my friends and colleagues about who they know is good is because I can trust them. Sometimes therapists will have comments on their site from current and former clients. I really really don’t trust things like yelp and the like or general online reviews. If you write a shitty restaurant review, the manager can respond and explain that they are very sorry but they close at 11pm and aren’t able to accommodate a party of 8 at 10:50pm. There is no way a therapist can ever do that. They can’t respond or even acknowledge that they have ever seen the client. It would break confidentiality to confirm to deny a client’s participation in   Clients writing reviews can come from a lot of different perspectives and people but there isn’t a way to say that who is writing the review has actually seen the therapist you know?

Best of luck! I hope you find a good fit. Don’t forget that you can “interview” a bunch of folks and move on from there.

[hazelandglasz]

Me to my therapist: I still shower but I don’t feel the need to do an effort because the only person who is going to see me is my mom and she understands

My therapist: What about you

Me: ...?

My therapist: Taking care of yourself and your appearance is for you, first of all. So, what about you.

Me: Damn, I didn’t need to be slayed today.

My therapist: Think about it. A little facemask, a manicure, some hydrating cream ... Just do something for you, FOR YOU

Me: 

[beetle-persona]

Why don’t I get any weird/funny questions by Anons 😞 😞 😞 😞 😞 😞 😞 😞 😞

I’m a good untrained therapist (Maybe) 🤷‍♂️

Disclaimer: Beetle-Persona is in no way responsible for any further diminishes in mental health or IQ due to his awful advice you’d probably be better off asking a professional..... Just sayin

[thistherapylife]

So I've always been kinda scared of therapists and the therapy process, and recently watching movies like "get out" certainly didn't help. Any tips for building trust when I'm terrified of even the thought of sharing personal info with a stranger?

Hi anon

(side note - if you are therapist, read this ask. Remember new clients may be coming in like this and explain things well <3)

OMG I loved Get Out but I totally whispered “what the fucking fuck” when that character was introduced. It made me mad. 

Anyway! So it makes sense that if you haven’t been in therapy, it’s seems scary. Because good therapy can make some major changes in a person’s life. There are good therapists and bad ones and you have to navigate all that with whatever is going on right? It makes sense to be scared. But therapy isn’t magic that is worked on you. It’s a change that is build in relationship over time with someone who knows you and knows the lay of the land. 

Therapy is about the relationship. The work gets done with trust - which takes time. You have choice in therapy. You get to say, “I don’t want to talk about that.” or “This is too much right now.” or “I need a break”. As long as the client’s choice doesn’t interfere with their safety*, I make sure the client has choice. I’ll guide and contain the sessions, moreso with trauma. But I push some of my clients - absolutely - but not without trust. Even during my assessments when I’m *required* by my agency to explore for abuse issues, I always say, “you don’t have to answer if you aren’t comfortable.” 

Trust will build. It will take time. Don’t beat yourself up for feeling anxious about it. Start small and it’ll grow. Read some of @thehumbledtherapist if you aren’t already. Ask questions to people you know who are in therapy and you trust. Remember if you aren’t comfortable, you can change therapists but it takes time to get comfortable. Once you find someone to try, ask them questions - what’s their style or psychological orientation, what can you expect from a session, etc. 

I hope this helped a little bit. Best of luck to you. 

*(i.e. if you are seeing someone in private practice as an adult, you can get up and leave. For my community based clients who are minors, I can’t just let them leave if I’m not sure they’ll be safe)

[thistherapylife]

I'm seeking to transition, ftm, and would like to speak with a therapist. I've been in therapy before, the first was great but she had to move on, the second (from a different place) was a horror. How can I vet my next therapist to know if she's safe to talk to?

If I had a magic formula for this, I’d give it to you! Trust me! I was looking for a therapist last year and it felt like the worst. I found someone eventually but it took time and patience. 

Think about your first therapist. What made her great? What did you like? What made you feel safe? What questions did they ask that you found were helpful? Was it a private practice therapist? Do they have a website? What words to they use to describe themselves? 

Think about your second therapist. What was horrible? It’s in some ways easier to say, “That therapist was horrible” and leave it at that. But take a minute and really think about it. Did they not listen to you? Did they have their own agenda? Were they anti-trans of any flavor (terf or conservative)? Did you feel like you had to explain the basics to them? - And then think about the opposites of that and you’ll have some things to look for. 

What do you want to work on? Is it the transition? You are going to want a trans aware or trans competent therapist. You can work a bunch of stuff in therapy and over time - but what have you struggled with (if anything)? Depression? Anxiety? Trauma? Psychology Today isn’t a bad way to start and neither is any local therapist organization (your state+LPCC/LMFT/LCSW is a good google query to start).

Go into your first phone call or visit with a bit of a game plan. It’s a bit like a blind date - you are both getting a feel if you can work together. Think about what’s important to you in terms of therapy. This can range from the practical (My max is $XX or I need session during the day) to harder to nail down (I need someone who will be frank and push me but not too much). 

My new go to test is around money. If a therapist won’t address your budgetary concerns in the first meeting or the phone - fuck them. That’s an immediate reject for me. I didn’t listen to it for one of the therapists I vetted before I found my new one and it was a fucking horrible experience {I mean the jokes on her - I’ll never ever refer a client to her nor will I recommend her to other therapists I know.} If your therapist can’t tolerate the discomfort around a discussion of money, it’s a bad sign. A good therapist knows their own power in the room and worth. I understand that not every client can be sliding scale but it’s a good sign when they have a couple of sliding scale slots (even if they are all full).

I wish you the absolute best luck in this. I hope you find someone quickly but stick with it if you don’t. You deserve a good fit <3

[thistherapylife]

Here's a Forbidden Question, can we ask our Ts why they asked a certain question or what they're thinking or what they're writing down or what they're course of action is? I feel like it's taboo to cross that line but also. I want to know.

I am always in favor of questions. All the questions. Ask anything you like (I won’t necessarily answer all the questions but asking them is important.) I’m very comfortable with it and good therapists usually are too. Newer therapists may flub around a bit because they are still getting practice at it but it’s worth asking. Even if the answer is curiosity or a feeling like they need to explore whatever they are asking about. And “course of action” sounds a lot like a treatment plan or treatment goals and you should ABSOLUTELY be talking to your therapist.

As to the “what are they writing down” question - that’s a little more tricky. I take notes most sessions. For intense sessions I write after. Here’s an example a process note for a made up client (Jane Doe): 

JD - tough weekend; some bound. test w/ phone/texting @ start of sess. bro’s in hos again –> check with cg this week. missed school mon. ++ anxiety. assessed bxs over wkend (mod. sb use, no si). v. angry won’t admit it. not safe for ang? also ang at cg for enabling bx but it was “fine.” follow up with fam att. re anger next wk. Tell sup about contertrans re cg’s bx. Somewhat able to tol. change in sub. Eng grade 65% worried about a presentation in eng –> check with Mr. P re accomodation. explored poss relax. exercise to use. Practiced. Responded well. discussed WHY we do things like that. made plan wk. Follow up ON FRIDAY around 4 to check in.

So would I show that to a client? Probably not. My disclosures about my thoughts and feelings can be very impactful for the client and need to be done only the client’s best interest with a lot of thought and care. It’s why I included “Tell sup(ervisor) about countertransference regarding caregiver’s enabling behavior” - that’s useful information for me and my supervisor or therapist but not the client’s. Sometimes I might be tracking things (see “v. angry won’t admit it”) - is this pattern? Is it safe to hold anger in this family? Is it safe to even feel? So it’s helpful for me but not necessarily for the client who might feel angry or defensive and not be able to express it. Also I try and tell clients when/who I’m going to talk even with consent so Mr. P wouldn’t be a surprise but my to do list doesn’t have therapeutic value. Sometimes I doodle during to session to focus and also if I know that a client has difficulty with eye contact but I’ll let them know why I’m doing it.

Hope it was helpful.