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  • Writer's pictureYvette E. McDonald, LCSW-QS

Starting Therapy/Counseling

Descriptions, processes, benefits and fears about therapy. Counseling unpacked.

Welcome to the world of therapy and I am honored that you are considering me to come alongside your journey of healing, growth, change and transformation. You should also be proud of yourself for putting in the intentionality into finding a counselor that will be the best fit. I hope that I can provide you with some peace of mind as you prepare for your first session with me or if it turns out that we are not a good fit then for your journey.

How To Prepare For Your First Session

Here are 5 things you'll need to know/do to be prepared:

  1. Complete all paperwork electronically 48 hours prior to your scheduled session. The earlier you complete the intake the more time it affords me to read over and prepare for our first session. In the process of preparing for your first session please also feel free to write down any questions you may have in order that we can process it during our time together.

  2. Arrive just a couple of minutes early enough to get yourself a nice beverage and sit for a minute. This will help you take in the scenery and prepare yourself. The office is set up a little more like a living room (with couches and comfortable chairs) than a typical workplace environment or doctor’s office. You may be a little nervous or excited, and if you don’t give yourself a chance to catch your breath you may find that your first session is half way over before you feel present enough to process everything.

  3. What if I need to cancel my counseling session? To accommodate as many clients as possible during the limited time available during a given week, it is necessary to have a cancellation policy that is fair and reasonable for all concerned. It is in the spirit of showing respect for each other that the following policy was created. To avoid being charged the full price of your scheduled session(s), cancellations must be made 24-hours in advance. By providing this notice you are also helping other clients have sufficient time to respond to new appointment opportunities ( I like to call it working together with your invisible family). There is no charge in the case of illness, injury, extreme weather, or family emergency.

  4. Who needs to come? It is important that everyone who will be involved in therapy be present at the first session to cover the basics.

  5. How long will therapy take? I usually tell my clients to think about coming to therapy once a week (therapy sessions typically run 45-50 minutes, for at least the first 2 weeks for the intake & assessment stage.) Following assessment we will go into the treatment part which typically is an 8-week process however for some the process may be shorter , but I feel this is a good estimate of the minimum length of treatment. Many clients stay in therapy longer than that, especially if they have deeper or longer standing issues, or if they simply want to keep improving and moving forward. Often, as a client makes progress in treatment, the visits will be less frequent, perhaps every other week or once a month which you'll hear me use the term phasing out.

In addition to the 5 things listed above I wanted to take the time to go over some misperceptions about treatment by providing you with some education to help you feel more comfortable.


What can I expect in the first few sessions & beyond?

The process of therapy.

The First Phase - Intake & Assessment: We will go over your paperwork, the process of therapy, policies and procedures, confidentiality and answer any counseling questions you may have. Plans for how often we should meet, who will be involved in treatment (for parenting or family issues), and what other possible support or services you may need will also be discussed. We will go over a brief history of the presenting issues and talk about what’s going on now. I will say something like, “Let’s begin with you telling me the story of what brings you here, what you’re hoping to accomplish in coming here, and what some of your nightmares may be in coming here— what you don’t want to see happen.” The next session, we will build rapport and come up with a treatment plan that will be the road map of your goals and how we plan to get there. I will ask many questions in an effort to get to know and understand you, your worldview, strengths, concerns, stresses, needs, family and relationship dynamics and assess the presenting issues. During rapport building and goal formulation it may feel like we are not making any progress however I ask that you trust the process as this lays the foundation for future success.

The Second Phase - Intervention: is the the heavy lifting of the treatment and this is when the therapist and client collaborate to make positive changes in the client’s thinking, self-care, emotional regulation, communication, support network, etc. This phase requires effort both in and out of session, through the process of homework which encompasses the implementation of solutions and skills discussed during session.

The Third Phase – Discharge/Termination: is termination and this occurs when the client is feeling much better and the client and therapist begin to process the end of treatment. The phasing out stage looks different for each person and is tailored for each individual. However, the end of therapy is a very important phase that will be processed to meet your individual needs. This is because the termination or endings of relationships are a critical part of wrapping up the work and getting closure. Very often, I have former clients return to therapy periodically for “mental-health check in's”, which is a normal, proactive and positive thing to do.


Frequently thought over thoughts

“I’m afraid my therapist will judge me or think I’m crazy.”

Know that I am here to help you, not to judge you. I am a human being and am not perfect. I grow, learn, hurt, stumble, grieve and do life just like you. I understand that psychological, transitions and relationship issues are a normal part of the human condition and experience. More than likely, anything you share with me I have heard before, experienced it or heard something more extreme. I know that we all have issues and that your issues are what you wrestle with, but they don't define you. To drive this point home I even have a piece of art in the office that says "We're all cray, it's not a competition." Nobody is perfect and we all have our issues and our work to do. Try not to let the narrative you created in your head either through your own belief system or the experiences of others, create a reality that's to scary to walk through leaving you missing out on the best version of self and relationship available to you.

“I am afraid of revisiting painful memories or thoughts or even disclosing embarrassing stuff.”

You do not need to spill your guts your first session, nor is anyone expecting you or should you. Actually the first couple of times we meet your going to be all over the place and that is large in part your nerves working through and we'll work through that. The first phase of therapy is about building a trusting therapeutic rapport, alliance and relationship with me. It's also about me diving into your life for purposes of understanding into how you navigate through your world emotionally and mentally. You can share things at a rate that feels comfortable for you. You set the pace on the sharing and that's totally okay. Honestly, I don't want you sharing everything off the bat anyways without you having some healthy coping skills in place. When you say not now this is a healthy way of being open and honest with me, and also setting boundaries and pacing the therapy at a rate that feels comfortable for you. As you establish a stronger therapeutic rapport and when I know you are ready, we can collaboratively work together to do the emotional heavy lifting. On a side note, clients report feeling tremendous relief that sharing those experiences wasn’t as difficult or scary as they thought and they are able to process those feelings and thoughts with clarity, insight and perspective. Again, I am not here to judge or condemn you! However, in the same breath you can only experience growth, healing and reach your goals by getting emotionally naked with me and sharing the good, the bad, and the ugly (when you feel ready of course). Don't lose sight of the beauty of therapy. It is a confidential relationship, your own private verbal journal and you do not need to see your therapist outside of sessions. The therapy office can be your own safe should be your own save space to share these experiences, your thoughts and feelings without judgement. Lastly, on the off chance the human side of me messes up and you ever feel like I have judged you, I welcome the feedback in order that we can course correct.

“I worry that my therapist is going to expect me to make changes that I am not ready to make.”

Many people fear that their therapist is going to expect them to immediately abstain from any self-sabotaging behaviors or coping mechanisms, leave a toxic relationship or fix everything about themselves. This will so not be the case! I'm going to meet you “where you are at,” meaning I respect where clients are at in the process of change. Furthermore, I know that people only change when they are ready and when they want to change. In other words, I can't make you change! But, we will do a lot of processing. We will process your yes's and no's of staying in that negative relationship, continuing with negative thinking and self-sabotaging behaviors and patterns, etc. But, at the end of the day you are the one that determines when and how the change takes place at a pace that you're comfortable with. Look change is hard and not always comfortable. If your resistant to the changes that's being brought to the surface with therapy we will process.

“I don’t know if I will like or “click” with my therapist.”

Understandable. But, what if I don't like you? I kid, I joke!!! Sometimes clients will meet with with 2-3 different therapists for an initial session till they find the right fit. This is a big reason why I offer a free 15-minute consultation in order to get a feel for who I am and if we would be a good fit together. I totally understand and expect that I am not everyone's "cup of tea" and that this “therapist shopping” is often a normal part of the process. It's important for me and you to be intentional about this process as this an investment of your time, energy and resources. You need and should feel comfortable, safe, understood and be with someone that is specialized in helping you with the transformation you are about to embark on. The therapeutic relationship is the foundation of treatment, something I am constantly reminding my college students when I have my professor hat on. Stretch yourself to ask me questions and/or voice any concerns that you have about your treatment and/or the process of therapy. Be sure to express any feelings of anxiety open and directly. I always encourage clients to be direct with me about any negative feelings that they are having about me, anything I have said, a session or the therapeutic process. Openly discussing these matters will allow you to do honest and effective work. Often, having a positive therapeutic relationship will help you have more positive relationships outside of the therapy room because you are learning how to communicate in a way that is open, honest and respectful of yourself and others.

“I felt worse after my therapy session and am nervous about the next.”

Understand that it is normal for things to get a little worse before they get better during the initial phase of therapy. In addition some sessions are a little heavier than others with regards to the topics, situations, people, feelings or thoughts we process aka unpack. Communication will be key! Therapy is a process of going through the luggage you have collected over the course of your life's journey. Some luggage you have crammed way to much stuff into, intentionally or unintentionally and with the start of therapy it will be everything of emptying out the suit case's and sorting through your baggage (hence the name Traveling Light Counseling.....unpacking yesterday's baggage for a lighter, brighter tomorrow). We will be learning, sorting, discarding and deciding what needs to stay, go and get rearranged. This can be an overwhelming, draining and a strenuous task that requires courage, patience and commitment, but you don't have to do it alone and that's the BIG thing. Before now you were doing some or all of the heavy lifting by yourself, moving forward that will not be the case. You got me! Learning, sorting, discarding and deciding what needs to stay, go, get rearranged and get burned is all part of the process. Clients report initially that they wish they would have just left things alone because ignorance was working for them. This is so normal and I encourage clients to understand this is an anticipated part of the process and to stick with it. In therapy, we are eventually able to let go of some things, and rework what is left so that traveling is lighter. It is also normal for these negative or worsening feelings to get triggered at various points in the therapeutic process, especially if you and I are hitting on some core issues. Some resistance and defensiveness on your part is normal, those feelings are there to protect you. However, you can work through them by expressing them to me and continuing in treatment knowing that relief and growth are right around the corner. Clients report, "in the beginning it was hard Mrs. Yvette, there were sometimes I just didn't want to come back and bring up a topic but I'm glad I did. I'm glad I just ripped off the band-aid cause I'm in a better place emotionally because of it."


Potential Benefits of therapy

Counseling is both a process and an experience. You are not only going to learn more about yourself but also how you interact with the world around you. Counseling takes on different forms in that you could be learning about a particular condition, transitioning through something, learning a behavioral skill, healing and so forth. Below are some examples of what clients have experienced during our work together:

  • Improved relational interactions

  • Healing & reorganization from affairs (relationship betrays)

  • improved communication and interpersonal skills

  • greater self-acceptance and self-esteem

  • ability to change self-defeating behaviors/habits or thinking

  • better understanding, expression and management of emotions, including anger & anxiety

  • relief from depression, anxiety or other mental health conditions

  • increased confidence and decision-making skills

  • ability to manage stress effectively

  • improved problem-solving and conflict resolution abilities

  • greater understanding of parenting and their children

  • Healing and renewed spirit following a divorce

  • better listener

Above all, congratulate yourself on beginning therapy and doing your emotional, relational, behavioral, or even spiritual heavy lifting. You are working on healing and evolving, which will deeply and profoundly improve your life and positively influence those around you. My clients have reported "The change was hard in the beginning, I didn't always want to do it but now I find myself advocating for therapy in big ways. I want everyone to experience the change. I want everyone to learn more about themselves and how they do life finding healthier ways. I'm defiantly a healthier verision of self. I'm not perfect and still have a lot to learn but I have also grown so much." Reframe your nervousness and resistance the best you can, because you are taking forward steps on the path to healing, wellness and achieving your healthiest self personally, relationally and professionally.


Hi, I'm the owner and counselor at Traveling Light Counseling, a practice for those seeking a healthier relationship with themselves, their children, their family, and/or their partner. If you're in the Saint Lucie or Martin County Area and life isn't quite what you expected it to be at this point in your journey, please give me a call at 772-361-8448 for a free, 15-minute phone consultation.


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