Sam Himelstein, PhD
What actually happens when you start therapy
The short version
It takes a lot to realize you may need therapy. When you reach out, we (Family Spring) get back to you within one business day (two tops), we spend a few minutes on the phone figuring out what you need, we match you with a therapist who fits, and you start. When we have openings, most people have their first appointment within one to two weeks.
The longer version (5 minute read)
It usually starts with awareness
You might notice something’s felt off for a while: Sleep, self-care, work stress that keeps building, your relationship, or it could just be a sense that you don’t “feel like yourself.” Maybe you’ve even been telling yourself you can manage it alone. Then someone says something. A doctor brings it up at a checkup. Your significant other mentions it. A friend asks how you’re really doing. You start to get feedback from those around you that something seems off.
It takes a lot of people a LOT of time to take action. Sometimes it’s weeks, sometimes even years. That isn’t a character flaw.
Reaching out means saying out loud that something is wrong, to a stranger, and most of the dread people feel about therapy lives in that first phone call rather than in therapy itself.
If you’re having the above experience right now, or something like it, the below is what the rest of the process looks like (and the goal of this post is to help you get there).
Reaching out
You can either call and leave a message or reach us via our HIPAA compliant web form. We recommend the inquiry form online because we get more information up front and call you back, usually with your insurance verified by the time we have the call. The form also asks why you’re looking for therapy, whether you have preferences in a therapist, and what days and times you could realistically commit to. It takes just a few minutes to complete.
Either way, someone gets back to you within a business day.
The consult call itself
This call is with our intake coordinator, not a therapist (though our intake coordinator is in the process of becoming a therapist herself). It isn’t a therapy session but it can feel vulnerable. We’ll ask what’s bringing you in, what your schedule allows, and confirm your insurance (as I wrote above, usually we have that confirmed by the time we call back).
We’ll also ask what you’re looking for in a therapist: gender, language, cultural background, or specific expertise (i.e., the challenges you’re struggling with like anxiety, depression, trauma, etc.).
Do you or someone you know need mental health support?
Getting matched with the right therapist
Our intake coordinator matches you with a therapist who has the right expertise (i.e., experience with what you’re struggling with), your and the therapist’s availability, and your preferences. Matching isn’t random, it’s not first-come-first-serve, and at Family Spring it is definitely not done by an AI or algorithm. Our intake coordinator knows all of our therapists personally and keeps their expertise top of mind.
We (and most therapists and practices) are not a fit for everyone.
That means you may have an issue that we can’t help with because the level of care you need isn’t what we (or another practice) may offer. If you need inpatient treatment for example, you’d get referred out of an outpatient clinic like ours. Although this can be a frustrating process, we believe it’s best because getting the care you need from the start is better than having to switch therapists after already building rapport and a sense of safety.
Paperwork, then your first appointment (your intake)
We send a link to our electronic health record (EHR) portal, which is safe and secure, and everything is signed electronically before your first appointment. We ask a few follow up questions via survey as well.
Your first appointment is a little different from the sessions that follow. It’s a fuller conversation, where your therapist gets the whole picture, and often involves the therapist asking more questions than usual. That doesn’t mean you won’t get to the challenges you’re facing in this first session. The intake itself oftentimes involves you and the therapist coming up collaboratively with some initial goals for your therapy (that of course can be altered).
If you’re waiting
When our therapists have openings that align with your schedule (this is oftentimes the biggest hurdle) the first appointment is usually within a week or two depending on your schedule. If you’re struggling while you wait, or if it seems like the wait is too long, we offer some self-care and stress management resources and/or the ability to get referred to another clinic or your health plan to try and get therapy faster.
Therapy
Therapy itself is oftentimes a weekly commitment during the same day and time, with the same therapist. Please check out our previous blog post on why therapy deserves a solidified spot on your schedule. It’s extremely important to centralize your therapy in your life (e.g., don’t cancel therapy for the dentist appointment that comes up every 6 months, reschedule your dentist appointment around your therapy).
How long therapy lasts depends on what you’re working on, and what your goals are. What we call a “treatment plan” is a collaborative process that your therapist and you will develop, and it could be adapted over time.
Your therapist will establish rapport with you in the early stages with the hopes of building a strong alliance. You should feel emotionally safe with your therapist and supported. That said, there may be times when therapy feels hard (e.g., delving into conversations that are tough) and that’s normal and okay.
One last thing
You don’t have to have it figured out before you start. Not being able to explain what’s wrong is one of the most common reasons people give for putting this off, and it’s also one of the most common reasons people come in.