How to Start Therapy - Part 2: Who to Talk To
Illustration by Mia Clow
Great. So you’ve decided this might be something worth trying. I love that. And am proud of you for being willing to give it a chance and looking for ways to be the best version of yourself. If you haven’t read the first part of this and want to learn more about what therapy is or isn’t, you can read part one here.
The first step in my opinion is to talk to your doctor. It’s really important, in my experience, to keep them in the loop especially if you’re feeling symptoms of depression. When I first went to my doctor (while I didn’t have an amazing experience) she did suggest that it would be good to do some blood work just to make sure there isn’t an underlying physical health issue causing some of the feelings I’ve been having. I used to be anemic and so low energy could be factoring in from that. I also just like the idea of everyone knowing what’s going on, so if anything changes, there is a record of what might be causing what. This can also be helpful if you’re exploring the idea of medications. They can also help you find a place to start when it comes to looking for a therapist. This conversation with your doctor can sound a few different ways depending on what kind of relationship you have with them. Here are some different phrasing suggestions:
“I have been feeling really ______ lately and am interested in exploring therapy.”
“I am wondering if a therapist or a psychiatrist would be a good idea, can you give me any information on which would be a better fit?”
“I am really struggling with my mental health and I need some help, but I don’t know where to begin.”
“I just wanted to let you know that I have been feeling ____ lately and will be going to see a therapist/psychiatrist to help.”
“I am going to start seeing a therapist/psychiatrist, do you need any information about this for your records?"
“I would like to start seeing a therapist at a clinic that is covered by OHIP* for some challenges I’ve been facing. Could you refer me to one of them?”
“I think I want to start therapy, but I don’t know where to begin. Do you have any suggestions?”
*OHIP is specific to Ontario but refers to clinics that will cover your costs under healthcare programs, but you need a doctor’s referral to get an appointment.
The other benefit of going to your doctor first is that they may be able to provide you with a list of clinics. When I switched doctors, they gave me a full list of both OHIP covered and non-OHIP covered clinics. Some doctor’s offices may have an “in-house” social worker. This social worker may be equipped with counselling and therapeutic techniques, the only downside is there is often a waitlist to get an appointment, but it will fall under your healthcare coverage here in Ontario. I’m not sure what options there are in other provinces so I’ll have to speak to what I know about healthcare where I am. Please feel free to leave some info about your province in the comments below. And if you don’t feel comfortable or you just can’t get to your doctor first, maybe just let them know next time you see them that you’ve started therapy so that they are in the loop.
From there you need to decide which path is right for you. In an Instagram survey, you all gave me some great answers as to why you haven’t started therapy. One of those reasons is money. Therapy is expensive. It shouldn’t be. But here we are. It can cost about $200 per hour to see a therapist – that is pretty much one session. And while that is a harsh reality I want you to know that there are some options. Some workplaces will have benefits that cover a good chunk of mental health services. Some also partner with companies that provide free counselling for employees and their families. If you’re in school, your school should have a health resources building and have counsellors there for you to see - these will be different from academic counsellors. These sessions are covered by your tuition and shouldn’t cost anything,
If you need something a little more cost-effective, you can try an OHIP covered clinic, just keep in mind that because it’s covered, these tend to have a waiting period for the therapist to have space. I will say, however, though I was originally discouraged by the waitlist, it ended up being much less of a wait than I thought – maybe less than a month. Some therapists offer a sliding scale, which means for a certain number of patients, they can offer a lower cost to accommodate different financial situations. It’s still fairly costly but it’s better than nothing. I have had sliding scales that moved my therapy cost to $165 and others that moved it to $145. Some therapists might also be offering a lower cost since the pandemic hit. My therapist lowered her fees after the first lockdown. It might also be worth looking up low-cost counselling in your area. There is a place here in Toronto called Hard Feelings that offers low-cost counselling services and another called What’s Up Clinic for children, youth and young adults.
If you don’t want to wait and have benefits from work that cover this or have the finances for costs, great! You can probably simply search “therapist (insert your city)” in google and see what comes up. There will be some offices that host multiple therapists - and some therapists may advertise private practice. Read their bios! Therapists will tell you about their background and what they specialize in so you can find someone who sounds like they might have the tools you need at that moment. They will talk about their approach to therapy and a bit about them. This step can be so important because it might increase the chances of success with your first therapist.
If you’re still feeling a little overwhelmed, reach out to people you know that have sought therapy. Multiple people have come to me asking who I see or if I have recommendations and I never say no or leave them hanging. I am always happy to share. Or if you are feeling really brave, speak out on social media! I wouldn’t have found my therapist right now if I hadn’t asked my Facebook hive for recommendations. Doing this allows people to come directly to you with suggestions if you feel a little nervous about going to them. Someone send me a private message with their therapist and she was my absolute favourite therapist to this day.
If you see one you like at a clinic, the clinic will probably provide you with a form to submit to book an appointment right on the website. If it’s someone with a private practice, they will likely have a contact form on their website and lots of information about how it works. Most psychologists/therapists who practice privately will book a phone call with you first just to get to know you, introduce themselves and get a general idea of what you’re looking for. That way if they don’t feel that they are the right fit for you or you don’t feel it’s the right fit you can both say so. They will mostly contact you about upcoming appointments through e-mail, so people with phone anxiety like me can rejoice at fewer phone calls!
Don’t be afraid to explore some different therapists before calling or before booking. Learn a little bit about a few different people, before making your decision. Or if you are willing to take it one step at a time, go ahead and book one, then see how you feel! I have recently started following different therapist on Instagram. This might be a good way to start to get a feel for what kind of vibe you want from your therapist.
My best piece of advice is that it’s okay if your first therapist doesn’t work out. Don’t write it off right away. Talk to your therapist about what you feel your sessions are missing. I have had some amazing therapists and counsellors, but I’ve also heard about some not great ones. More good than bad, but you are allowed to decide if you need someone different. If you take your car in to get serviced, and they tell you what’s wrong with it, but don’t help you fix it, you’re probably going to want your money back. Your therapist is there to help you work through challenges, and if your sessions after some time are still not helping, you’re allowed to seek help elsewhere. I would recommend talking to them first if you’ve built a relationship with them, but it’s your life. It’s okay if it doesn’t click. Your therapist will know this. It’s not your job to protect their feelings. That’s their therapeutic work! (Even therapists see therapists!)
I hope that has helped and as promised, below are some other pieces I’ve written that may help you with what to expect during your first session and onwards.
Best of luck my friend, you’ve got this.
-B