The Point of the First Few Posts

You may be wondering why someone would bother breaking down each process of looking for a therapist; after all, isn’t it pretty straightforward?

PC: Marco CBosio

Before I entered the mental health field, I was unfamiliar with the logistics of finding a therapist. I didn’t even know where to start. The only piece of knowledge I had was that as long as I was a student at a university, a few sessions would be free.

My first experience in therapy wasn’t so great. First, I was assigned a therapist, then a few sessions in, I realized that my therapist didn’t see me as a whole person and would not recognize my cultural and familial context despite my bringing it up. I was further confounded by her lack of follow up about the tasks she assigned to me. I found myself to be generally frustrated and anxious about upcoming sessions. I eventually stopped going and didn’t again engage in therapy until approximately a decade later.

Since my first foray into the role of a therapy client, I have come to realize that many people of color, immigrants, refugees, and individuals who have been disenfranchised in their respective communities have had similar – and generally worse – experiences. Young folx, immigrants and refugees of color may not even know how to go about looking for a therapist if they so desire, and when they do show up, they may be gaslighted or their experiences diminished by the use of therapeutic theories and modalities inappropriate to their experiences.

To destigmatize therapy and to make it more accessible, we need to first shed light on exactly what it is and how it looks. We need to make client rights available so that people can make choices appropriate to themselves even before they enter a therapist’s office.

What are other ways we can make therapy accessible and destigmatize it?

What to Expect at Your First Session

PC: Tim Chow

We have established by now that all therapists are not the same, so it only makes sense that your first session (or your first couple of sessions) will differ based on who you end up working with.

Some therapists use the first few sessions to go over their policies and documents indicating agreement with their policies. These policies generally focus on confidentiality, limits to confidentiality, disclosure of the therapist’s background, agreement to payment, policies around scheduling and canceling appointments, and the process of ending therapeutic relationship. If you are doing tele-therapy, policies on online counseling will also be included.

Your therapist may choose to have a structured or a semi-structured interview with you in order to get a better idea of who you are, why you are seeking therapy, what goals for therapy you have, information on your psychical and mental health, etc. They may work on a treatment plan collaboratively with you that you sign as an agreement of the objectives and goals you have for your work together – this is especially true if your insurance will cover your therapy sessions.

Or, your therapist may ask you to sign all the policy-related documents beforehand and welcome questions about them during your first session. They may also provide an intake document – essentially a questionnaire about the topics listed on the third paragraph – that they ask you to send over as soon as you can so that they can review the information before your first meeting. This way, you are free to start the session with any subject, concern, issue, questions you have that day.

It is important for you to know and understand exactly what you are signing. If you are unclear on anything, ask for clarification. You have the right to have a signed copy of all the documents you sign (if you so choose). You have the right to documents pertaining to you as well as to know your diagnosis if there is one.

The Most Important Question

PC: Nikita Kachanovsky

The most important question to ask your therapist is, “what is your experience working with people of diverse backgrounds?” Sounds easy enough, but don’t let this question fool you.

So, why is this question so important?

This question is important because, first and foremost, our psychological, emotional, physical, financial, social well-being are directly tied to our community and our status in our society. Without safety and stability in our day-to-day life, we cannot achieve internal safety. Living in a community that disregards us, dehumanizes us, and strips us of our human dignity is traumatizing, and that trauma will most likely be passed down to our future generations (epigenetics). It is therefore imperative that all therapists understand this and hold themselves responsible for providing a healing space.

It is also important that therapists acknowledge that how anyone – including ourselves – engages with their community and are allowed to engage with their community are political statements and a political reality. Thus, our work is always political.

I will explore these topics in more detail in future posts, so hang on.

What are a few problematic responses and perspectives?

  • That they will rely solely on their clients to teach them about their background, culture, identities, etc.
  • That they can only provide full acceptance of who their clients are.
  • That their mere function is to listen or be a listening ear without judgement.
  • That the modality they use works for everyone.
  • That they are not political or that they choose not to be political – this is impossible!.
  • That they have had diversity and/or inclusivity trainings – this is not sufficient.
  • That they practice cultural competency – another impossible thing to achieve. We are never culturally competent; it is actually about our life-long process of learning and unlearning.

While these responses/work are somewhat helpful, they are not close to being sufficient in reducing harm to individuals who have been exploited and marginalized by their society.

So then, what should you be looking for from a therapist?

  • That we understand our privileges as well as our identities that have been marginalized.
  • How we leverage and use our privilege(s).
  • How we engage with anti-oppression in our professional and personal lives.
  • That we have experience working with a diverse population and engaging in social justice work.

It is about our internal work and external actions, not merely our intentions. It is about the impact we have on our clients and our community. It is about being able to center Black, Indigenous, and other people of color. It is about centering LGBTQIA+ folx. It is about de-centering bodies, race, religions, orientation, identities that have benefitted from and practice colonization.

If your therapist is a social worker, remember that social justice is a part of their professional code of ethics. Without social justice, we will end up harming even those individuals who have privileged identities and bodies.

PC: Clay Banks