How to prepare for your meeting with a therapist

Going to therapy for the first time can be intimidating.

It can be hard to seek help — and awkward to imagine opening up to a complete stranger. The process of finding an available therapist alone can be discouraging, especially as the demand for mental health services has been outpacing supply.

But therapy can be extremely helpful for many people, and for many reasons. The Inquirer talked to three area mental health providers about how people can best prepare for a first mental health appointment.

There is no right or wrong reason to go to therapy. Some people go to therapy for help navigating a transition in life. Others go in times of crisis or when they are developing symptoms of anxiety or depression.

In fact, it’s completely legitimate to go to therapy even if you don’t have a specific challenge for which you’re seeking help.

Charlotte Andrews, a licensed psychotherapist practicing in Elkins Park, compared a relationship with a therapist to that with a primary-care provider. People check in with their primary-care provider during annual checkups even when they feel healthy. Then, when people get sick, they know whom to call.

“Therapy should be part of everyone’s wellness plan,” Andrews said. “There doesn’t have to be anything going on in your life, no crisis ... just being able to check in with a mental health professional.”

» READ MORE: Tips from three Philly-area mental health providers about making sure your therapist is the best match

Every therapist is different. The first session is the beginning of a relationship.

In the first session, a therapist might ask about your childhood, upbringing, meaningful relationships, living situations, sexual and gender identity, history of mental health and past therapy, and current symptoms. These formative experiences shape our mental well-being and talking about them can help a therapist know you better.

Andrews said that she knows these questions can be difficult. “I want to be able to make sure that we know enough information to where they don’t have to tell their story a thousand times,” she said.

Therapists also screen for safety by asking questions about self-harm.

Jessica Joseph, licensed clinical psychologist in Philadelphia and a member of Treatment Not Trauma Coalition, a group of mental health professionals advocating for non-police response to mental health crises, said that if any question makes you uncomfortable, or touches an issue that you are not prepared to talk about yet, just say so.

“You don’t have to answer questions,” Joseph said. “It is OK to be, like, ‘I’m not comfortable talking about those things yet or I don’t feel safe sharing.’”

Therapy is about forming a relationship, and the only way to ensure a good fit is by asking the therapist the questions that are important to you.

It’s OK — encouraged, even — to ask for specifics about a provider’s experience, the person’s approach, and whether that person has helped people with a specific issue of concern to you.

Many practices offer a free consultation before the first meeting to allow prospective patients to decide whether they’re a good fit, said Jennifer Reid, a psychiatrist in Philadelphia.

“Those are reasonable questions, and a good therapist should be able to respond to them and be honest,” Reid said.

For instance, many providers call themselves allies of the LGBTQ community or other groups on therapist listing websites, but even when they believe they can help, it doesn’t necessarily mean they have specific training or experience working with those communities, Joseph said.

Ask the provider what it means to to be an “ally” and the person’s approach to working with groups of people with whom you identify, Joseph said.

» READ MORE: Philadelphia hosts world’s largest trans wellness conference, attempts to flip the narrative on trans mental health

If a therapist doesn’t seem to have experience addressing the issues that made you reach out, if you don’t feel comfortable, or if you just don’t feel that you two are connecting, search for a new therapist.

“Try to see if you could find someone that you feel more comfortable with,” Reid said.

The decision to switch therapists can come after a consultation, after a few sessions, or even after a long and productive therapeutic relationship that just ran its course.

Reid recommends talking to the therapist about wanting to make a change. “A good professional therapist will understand that. They are not going to take that personally,” she said.

Chances are, she said, the response will be, “I understand. Let’s help you find someone that will be a better fit.”