If you have never tried counseling before, you may be wondering what it's like. I'll try to explain here, but if you have any questions, I'm happy to answer them via email.
What is counseling, anyway?
Counseling involves a unique relationship between you and your counselor. Your counselor is someone who is trained to use relational tools to help you identify and reach your personal goals. Each counselor has a unique style and approach, but the relationship all counselors and clients build are professional relationships that should ethically exist within a set of clear boundaries. The relationship should benefit YOU. Your counselor is trained to keep your best interests a top priority while the relationship exists. If you click with a counselor, what you should experience from them is interest and curiosity about your goals and views and experiences. Once you and your counselor have developed a rapport, your counselor should challenge you at least a little.
What is the first meeting about? What can I expect?
When you first meet your counselor, you may feel nervous or apprehensive. They may be nervous too! A virtual first meeting is to see if this is the right counselor for you. The first session is probably going to simply be a conversation where you will talk a little about what nudged you to contact them, what the counselor can or cannot do, and generally setting some expectations. They are going to want to know if you are safe, so they will ask you some questions to gauge potential urgent or emergency needs. Counselors have to keep your information safe, so they should be using a secure connection and talking with you in a private space, like in an office. If you decide you want to give the counselor a shot at working with you, and you're a good fit for their skillset, you will move on to the intake process.
Intake? That sounds a little permanent.
Intake is just the process of making the counseling relationship "official." It's kind of like negotiating the terms of the relationship. The intake process is the most paperwork-intensive part. Your counselor will want to make sure you are really clear about your rights, what to expect, how much sessions cost and how to handle payments, what the counselor considers to be an emergency, etc. Your counselor will also need to do an assessment. This is really similar to what happens when you go to the doctor and they take some measurements to get a brief look at your overall condition (e.g., blood pressure, temperature, etc.). Because counselors can't use the same kinds of instruments to get that overview, we'll use things like surveys, questionnaires, and interviews. This whole process may take several sessions.
Are you diagnosing me?
How a counselor handles a diagnosis depends on the situation. Because I am private-pay, I hesitate to commit to a diagnosis and would rather focus on reaching goals -- I do not have to justify your services to a third-party payer, so I have that flexibility. I do, however, have to justify your services if I'm ever audited, to my ethical self, and to you. In other situations with other counselors, a diagnosis may be required. I may consider what your experiencing and suggest books or reading that are linked to diagnoses. For example, if you want to get better setting boundaries, there are a lot of resources out there about setting boundaries that come from books on codependency, personality disorders, marital concerns, etc. Sometimes, it's just good information that has nothing to do with a diagnosis. If you want a diagnosis, I can give you my opinion, of course. What I'm mostly concerned about as we talk, though, is how to best move forward rather than which label best applies.
If you are in sessions to help satisfy specific requirements, a diagnosis may be required.
What happens after intake? How will you determine what the plan of treatment is?
Once the intake piece is done, a counselor will hone in on the plan of action. You should have conversations about what, specifically, your goals are. Your goals can be personal or professional, about something private only to you or something more relational in nature. Your goals can be as simple as wanting to be more comfortable speaking your mind, or as complex as improving symptoms or changing some behaviors. Those are up to you. Your counselor should tell you if they believe your goals are feasible or if they see something that might block your path to reaching those goals. As a professional who has worked with others, certain habits and patterns of behavior may be more visible to a counselor than to you. No matter what, your path forward with your counselor should be mutually agreed upon - never just dictated to you.
Personally, I will probably have some initial ideas about the plan of treatment, but I will also do some more reading and researching to see what else is out there that may be especially helpful for you. I'll keep doing that until we feel you have reached your goals.
What do we talk about in counseling?
Your discussions in counseling will depend heavily on your goals. Sometimes, people have extremely focused goals and what they and their counselor talk about are their beliefs and behaviors specific to those goals. Sometimes, the path towards a goal isn't as clear, so you may talk about different experiences and how they link to your thinking, feeling, and behaving. Counselors should encourage their clients to stay within a certain area of safety. For example, if I do not want to talk about someone because it will open an old wound, I may need to gradually work up to it, talking about it a little at a time until it's safe to talk more. I may never talk about it. If I reach my goals, that might be okay. Your counselor will not likely jump right into the deep end right away, though. You can also decide when to change topics. A counselor may point it out to make a note of it, but it's your time and it's your journey.
What is the paperwork like?
One of the certainties of life is paperwork! At intake, you will be presented with forms that explain what counseling is, how I approach counseling, what you can expect, how much per session, how to pay, how to handle commonly encountered issues, your rights, agreeing to be treated by your counselor, how to file a complaint, the limits of your confidentiality, etc. Many of those pages are sign-to-acknowledge types of forms that cover the counselor and provide you with a reference point for most questions. Other forms are meant to gather information about you -- screening or assessment forms. There are probably general screenings that every counselor has to do, and then there will likely be forms more closely related to the concerns you shared with your counselor. Your counselor should screen for common roadblocks or possible dangers. While most of the paperwork is done during intake, you may fill out a quick check-in each week or work through between-session exercises.
In virtual counseling, you will complete paperwork electronically and you will receive an electronic copy. Secure platforms like FormHippo can be used to protect your information.
Do I have to show up early?
Not unless you are explicitly asked to do so. It may be good practice to log on 5 minutes in advance or show up a few minutes early just to make sure there are no glitches or delays, but it's not necessary.
What are you screening me for?
Counselors need to screen for safety issues and a few other things to rule out certain things from being the potential cause of distress. Don't be surprised to answer questions about your thoughts or intentions to harm yourself or others, if you're safe in your current situation, if you've experienced big ups or downs, have a history of any of these things, have medical concerns that could also cause emotional ups and downs or cognitive symptoms, or alcohol or drug use that could also be connected to symptoms or experiences.
How many sessions do you think people usually need?
Research seems to average out to around 12 sessions, give or take, depending on the counseling goals. Given that many of those studies focus on specific issues like depression, anxiety, or trauma, it's possible that self-improvement type goals would take less sessions than goals involving symptom reduction. Your counseling schedule will be unique to you. You may want to meet weekly, every other week, or every few weeks. You may do a lot of work on your goals between sessions or very little. Those things will all really impact the number of sessions it may take to get you moving toward your goal. My suggestion is to take the average into consideration when setting up an appointment with a counselor, discuss your specific goals and an estimate for those, and then check in every few sessions to see if you think you'll need more or less sessions to get where you want to be. Your counselor should want to see you succeed and move on!
What should I think about before we meet?
Odds are, you have been thinking about whatever it is that nudged you to look for a counselor for a while. If I were in your shoes, I would write the following things down to share with my counselor at our first meeting: (1) Either what's been really bothering me or what my goals are, (2) any habits or things I've noticed about myself or wondered about myself that I may want to eventually talk about, (3) the questions you have about counseling and that particular counselor's way of doing things. If you have experience with counseling, you may also want to write down anything you learned from previous experiences.
What if I disagree with you on what I need?
Counselors are here to serve you and help you reach your goals, so agreeing on a plan of care is absolutely critical. We work on minimizing this as a potential problem right from the beginning. At our first meeting, we can talk about some goals. During the first few sessions, we talk about goals and the plan of care. If in those first few sessions, we disagree, I may not be the counselor for you. Your counselor should create your plan collaboratively with you, with your goals in mind, considering your preferences and habits and strengths. If they do that and you still cannot come to an agreement, you can absolutely request a referral to another counselor. It's perfectly okay if they aren't the right fit for you!
How will we know counseling is working?
When we talk about your goals, one of the important things we will do is define what those goals look like. For example, if my goal is to feel more comfortable speaking up for myself, I will define that as using an assertive statement in any situation, personal or professional, where I feel my voice hasn't been heard; setting boundaries and sticking to them. I can describe a few scenarios that I have experienced that I would like to see go a different way in the future, and all of that will help me identify certain skills I want to work on. We can check in on my progress by doing a questionnaire to see if my score rises, keeping a log of how I communicate with others, or any number of things that track change over time. We will look for change, and if we aren't seeing the progress we want to see, we can either change tactics or refer out. In short, we define the goals very clearly and then collect data to see change over time.
What will the focus be in counseling?
That is something you primarily will decide. We all have personal goals. Some of us have multiple personal goals. You decide what your goals are and you can talk with your counselor about prioritizing them. Your counselor may suggest some mini-goals to help break your big goal down into pieces, but the focus will be on reaching the goals you choose for yourself. One caveat, however, is that if your goals are not something your counselor has expertise in, you may be referred to someone who may be a better fit for you. That's something you should establish early, however, even in your introduction meeting so you know you won't waste time with a provider who isn't right for you.
Is my counselor going to tell me things I don't want to hear?
It's possible. Personally, I have done that a few times after building a rapport with a client. Good counselors will, however, avoid YOU statements or SHOULD statements. They will not say "You should make this choice..." or "You shouldn't make that choice..." They can tell you what they observe, what patterns they notice, repeat back to you what you've said, and point out areas where your behavior and your goals do not align. Sometimes, those are things we don't want to hear.
Can you guarantee I'll get better?
No. Unfortunately, there is no guarantee with counseling. In fact, there may even be days when you feel worse as you work through practicing new things. If you feel you aren't making progress, or your counselor feels you aren't making progress, they should refer you to a provider they think may be more beneficial for you.
What is counseling, anyway?
Counseling involves a unique relationship between you and your counselor. Your counselor is someone who is trained to use relational tools to help you identify and reach your personal goals. Each counselor has a unique style and approach, but the relationship all counselors and clients build are professional relationships that should ethically exist within a set of clear boundaries. The relationship should benefit YOU. Your counselor is trained to keep your best interests a top priority while the relationship exists. If you click with a counselor, what you should experience from them is interest and curiosity about your goals and views and experiences. Once you and your counselor have developed a rapport, your counselor should challenge you at least a little.
What is the first meeting about? What can I expect?
When you first meet your counselor, you may feel nervous or apprehensive. They may be nervous too! A virtual first meeting is to see if this is the right counselor for you. The first session is probably going to simply be a conversation where you will talk a little about what nudged you to contact them, what the counselor can or cannot do, and generally setting some expectations. They are going to want to know if you are safe, so they will ask you some questions to gauge potential urgent or emergency needs. Counselors have to keep your information safe, so they should be using a secure connection and talking with you in a private space, like in an office. If you decide you want to give the counselor a shot at working with you, and you're a good fit for their skillset, you will move on to the intake process.
Intake? That sounds a little permanent.
Intake is just the process of making the counseling relationship "official." It's kind of like negotiating the terms of the relationship. The intake process is the most paperwork-intensive part. Your counselor will want to make sure you are really clear about your rights, what to expect, how much sessions cost and how to handle payments, what the counselor considers to be an emergency, etc. Your counselor will also need to do an assessment. This is really similar to what happens when you go to the doctor and they take some measurements to get a brief look at your overall condition (e.g., blood pressure, temperature, etc.). Because counselors can't use the same kinds of instruments to get that overview, we'll use things like surveys, questionnaires, and interviews. This whole process may take several sessions.
Are you diagnosing me?
How a counselor handles a diagnosis depends on the situation. Because I am private-pay, I hesitate to commit to a diagnosis and would rather focus on reaching goals -- I do not have to justify your services to a third-party payer, so I have that flexibility. I do, however, have to justify your services if I'm ever audited, to my ethical self, and to you. In other situations with other counselors, a diagnosis may be required. I may consider what your experiencing and suggest books or reading that are linked to diagnoses. For example, if you want to get better setting boundaries, there are a lot of resources out there about setting boundaries that come from books on codependency, personality disorders, marital concerns, etc. Sometimes, it's just good information that has nothing to do with a diagnosis. If you want a diagnosis, I can give you my opinion, of course. What I'm mostly concerned about as we talk, though, is how to best move forward rather than which label best applies.
If you are in sessions to help satisfy specific requirements, a diagnosis may be required.
What happens after intake? How will you determine what the plan of treatment is?
Once the intake piece is done, a counselor will hone in on the plan of action. You should have conversations about what, specifically, your goals are. Your goals can be personal or professional, about something private only to you or something more relational in nature. Your goals can be as simple as wanting to be more comfortable speaking your mind, or as complex as improving symptoms or changing some behaviors. Those are up to you. Your counselor should tell you if they believe your goals are feasible or if they see something that might block your path to reaching those goals. As a professional who has worked with others, certain habits and patterns of behavior may be more visible to a counselor than to you. No matter what, your path forward with your counselor should be mutually agreed upon - never just dictated to you.
Personally, I will probably have some initial ideas about the plan of treatment, but I will also do some more reading and researching to see what else is out there that may be especially helpful for you. I'll keep doing that until we feel you have reached your goals.
What do we talk about in counseling?
Your discussions in counseling will depend heavily on your goals. Sometimes, people have extremely focused goals and what they and their counselor talk about are their beliefs and behaviors specific to those goals. Sometimes, the path towards a goal isn't as clear, so you may talk about different experiences and how they link to your thinking, feeling, and behaving. Counselors should encourage their clients to stay within a certain area of safety. For example, if I do not want to talk about someone because it will open an old wound, I may need to gradually work up to it, talking about it a little at a time until it's safe to talk more. I may never talk about it. If I reach my goals, that might be okay. Your counselor will not likely jump right into the deep end right away, though. You can also decide when to change topics. A counselor may point it out to make a note of it, but it's your time and it's your journey.
What is the paperwork like?
One of the certainties of life is paperwork! At intake, you will be presented with forms that explain what counseling is, how I approach counseling, what you can expect, how much per session, how to pay, how to handle commonly encountered issues, your rights, agreeing to be treated by your counselor, how to file a complaint, the limits of your confidentiality, etc. Many of those pages are sign-to-acknowledge types of forms that cover the counselor and provide you with a reference point for most questions. Other forms are meant to gather information about you -- screening or assessment forms. There are probably general screenings that every counselor has to do, and then there will likely be forms more closely related to the concerns you shared with your counselor. Your counselor should screen for common roadblocks or possible dangers. While most of the paperwork is done during intake, you may fill out a quick check-in each week or work through between-session exercises.
In virtual counseling, you will complete paperwork electronically and you will receive an electronic copy. Secure platforms like FormHippo can be used to protect your information.
Do I have to show up early?
Not unless you are explicitly asked to do so. It may be good practice to log on 5 minutes in advance or show up a few minutes early just to make sure there are no glitches or delays, but it's not necessary.
What are you screening me for?
Counselors need to screen for safety issues and a few other things to rule out certain things from being the potential cause of distress. Don't be surprised to answer questions about your thoughts or intentions to harm yourself or others, if you're safe in your current situation, if you've experienced big ups or downs, have a history of any of these things, have medical concerns that could also cause emotional ups and downs or cognitive symptoms, or alcohol or drug use that could also be connected to symptoms or experiences.
How many sessions do you think people usually need?
Research seems to average out to around 12 sessions, give or take, depending on the counseling goals. Given that many of those studies focus on specific issues like depression, anxiety, or trauma, it's possible that self-improvement type goals would take less sessions than goals involving symptom reduction. Your counseling schedule will be unique to you. You may want to meet weekly, every other week, or every few weeks. You may do a lot of work on your goals between sessions or very little. Those things will all really impact the number of sessions it may take to get you moving toward your goal. My suggestion is to take the average into consideration when setting up an appointment with a counselor, discuss your specific goals and an estimate for those, and then check in every few sessions to see if you think you'll need more or less sessions to get where you want to be. Your counselor should want to see you succeed and move on!
What should I think about before we meet?
Odds are, you have been thinking about whatever it is that nudged you to look for a counselor for a while. If I were in your shoes, I would write the following things down to share with my counselor at our first meeting: (1) Either what's been really bothering me or what my goals are, (2) any habits or things I've noticed about myself or wondered about myself that I may want to eventually talk about, (3) the questions you have about counseling and that particular counselor's way of doing things. If you have experience with counseling, you may also want to write down anything you learned from previous experiences.
What if I disagree with you on what I need?
Counselors are here to serve you and help you reach your goals, so agreeing on a plan of care is absolutely critical. We work on minimizing this as a potential problem right from the beginning. At our first meeting, we can talk about some goals. During the first few sessions, we talk about goals and the plan of care. If in those first few sessions, we disagree, I may not be the counselor for you. Your counselor should create your plan collaboratively with you, with your goals in mind, considering your preferences and habits and strengths. If they do that and you still cannot come to an agreement, you can absolutely request a referral to another counselor. It's perfectly okay if they aren't the right fit for you!
How will we know counseling is working?
When we talk about your goals, one of the important things we will do is define what those goals look like. For example, if my goal is to feel more comfortable speaking up for myself, I will define that as using an assertive statement in any situation, personal or professional, where I feel my voice hasn't been heard; setting boundaries and sticking to them. I can describe a few scenarios that I have experienced that I would like to see go a different way in the future, and all of that will help me identify certain skills I want to work on. We can check in on my progress by doing a questionnaire to see if my score rises, keeping a log of how I communicate with others, or any number of things that track change over time. We will look for change, and if we aren't seeing the progress we want to see, we can either change tactics or refer out. In short, we define the goals very clearly and then collect data to see change over time.
What will the focus be in counseling?
That is something you primarily will decide. We all have personal goals. Some of us have multiple personal goals. You decide what your goals are and you can talk with your counselor about prioritizing them. Your counselor may suggest some mini-goals to help break your big goal down into pieces, but the focus will be on reaching the goals you choose for yourself. One caveat, however, is that if your goals are not something your counselor has expertise in, you may be referred to someone who may be a better fit for you. That's something you should establish early, however, even in your introduction meeting so you know you won't waste time with a provider who isn't right for you.
Is my counselor going to tell me things I don't want to hear?
It's possible. Personally, I have done that a few times after building a rapport with a client. Good counselors will, however, avoid YOU statements or SHOULD statements. They will not say "You should make this choice..." or "You shouldn't make that choice..." They can tell you what they observe, what patterns they notice, repeat back to you what you've said, and point out areas where your behavior and your goals do not align. Sometimes, those are things we don't want to hear.
Can you guarantee I'll get better?
No. Unfortunately, there is no guarantee with counseling. In fact, there may even be days when you feel worse as you work through practicing new things. If you feel you aren't making progress, or your counselor feels you aren't making progress, they should refer you to a provider they think may be more beneficial for you.