Demystifying Therapy Part 2: What to Expect and How to Navigate the Consultation
You know that thing you see on the absolute vast majority of therapy bios? The thing that says “reach out to me for a free 15-20 minute consultation!” How on earth are you supposed to know what to expect during that time?
[This is our part 2 of the Demystifying Therapy series, meant to provide clarity, support, and transparency. If you missed part 1 about finding and reaching out to a therapist, click here.]
Let’s get right into breaking down the consult:
Consultations are free of charge 15-20 minute video or phone meetings meant for you to determine if you would like to pursue working with a therapist or not. It’s basically an interview that has no pressure—it’s just seeing if you would be a good team to create the therapeutic environment you want. It is also a time for the therapist to determine if they feel they would be a good provider for you. I will share from my experience as a therapist in how I structure my consults, and how you can prepare to help yourself determine if you want to move forward with the provider or want to look elsewhere.
How I Structure Consultations as a Provider:
My consultations are structured in 3 parts, which I clearly explain at the start of the phone call or video call (which I would determine with the client following their initial contact with me). My general script to folks who are in the initial consult with me is something like this (so current clients, this is gonna sound familiar):
“My name is Natalie and my pronouns are she/her/hers. I am a Licensed Marriage and Family Therapist and I am looking forward to talking with you today! Today will be a brief meeting (15-20 minutes) for you to determine if I might be a good fit in working with you. You do not have to share anything you don’t want to, and we are not getting into any therapy today. I like to consider 3 parts to our time together, and I will keep track of the time so you don’t have to worry about that. The 3 things I like to cover are: 1) Do you have any questions for me at this time? If at any point in this consult you have any questions feel free to ask me. 2) I would love to share my approach to therapy including my values and therapy style. 3) If you are comfortable, sharing a little bit about what you’d like to work on should we move forward together. How does that sound to you?”
Please note that part 3 is FULLY optional, which I would absolutely reassert to the potential client. I do NOT want anyone to feel pressure to share if they are not feeling comfortable. The point of part 3 is for me as a provider to determine if my modalities/specialties/level of care is appropriate for the client (which I would share with them explicitly). During no part of this should you feel confused or like you have to come prepared in order to benefit, but there are certain things you can have ready if you want to which we will discuss later in this post.
Throughout this structure, I will of course answer any questions people have for me. Common Questions/options include:
How long have you been practicing? What is your experience working with (insert thing here: teens, LGBTQ+ folks, poly folks, transracial adoptees, fat-identified folks, PTSD, etc).
You can also feel empowered to ask a provider if they have lived experience with any of these identities/experiences if that is important to you.
How do you handle situations of suicidality? How do you handle situations of self-harm?
If this is in your history, which for MANY folks it is, I recommend asking this question. Unfortunately, some providers will not work with folks who have history of suicidality. I personally find this absolutely unconscionable, but I would want you to know this right away. For reference, when I am asked this question I will answer by saying that suicidality is extremely common and that it can be a response to intense things happening in our lives. It would mean we have a conversation about your risk level: How frequent are the thoughts? Do you have a plan? What safety factors are in your life? I would not call 911 if you told me you were suicidal, but I would want to ensure you are able to stay safe. I will look to any possible non-police emergency option should there ever arise a situation where we did need to pursue immediate intervention for promoting your safety, but having thoughts would absolutely not warrant this action.
*the following questions are from @DandelionHill*
Do you work with law enforcement? How do you handle reporting requirements?
Again, finding a provider who understands that police are not helpful is really really important for most folks. I respond to this question by stating that I look to any non-police emergency team in your area if an emergency arises. Unfortunately, these are not available in every area (but thankfully are in many!) and if an emergency situation were to arise (immediate danger to self or others), I might be mandated to contact law enforcement. I hate this, it is awful, and I would never do it behind your back or without you. I mean it when I say I will do whatever I can to avoid involving police in your life. You get to decide what feels good for you as a client and how you’d like your provider to respond in ways that make you feel safe.
How do you integrate justice and oppression issues into your therapy work? How do you feel (insert here: racism/patriarchy/capitalism/white supremacy/ableism/homophobia/transphobia, etc) impacts mental health?
How do you define and integrate trauma informed care into your work?
How do you believe change occurs? (This can show if someone believes it is through behavioral interventions, relationship building, trauma and generational work, self-empowerment, and you can see if it feels like how you’d like to pursue change and growth.)
(If you share a little about why you are seeking therapy): How might you conceptualize the trajectory of working with me? This can show a therapist’s thought process and therapy approach, as well as seeing if you are interested in/excited about the way they pursue change and growth. I love this question because my mind’s wheels are always turning to how things could look at the beginning/middle/end of therapy.
You of course do not HAVE to ask any of these questions, but please know this is your time to do so to determine if a provider might show up in the way you want them to, so you absolutely can feel empowered to do so if you desire.
Things to Notice During the Consultation:
How do you feel talking to this person? Do you like the way they word things, the approach the share to therapy, etc? Do you feel comfortable speaking with them? Maybe you even feel excited with how they conceptualize change or the things you’re wanting to work on—these are great signs! If you notice you’re feeling unsafe, unheard, or that you don’t particularly want to speak to this person again that is also great information. You want to feel heard (if you opted to share anything), respected, and generally positive during the conversation.
Does your therapist use common terms? It’s important that the provider you choose speaks to you in accessible terms. If they’re using clinical speak and you’re finding yourself not connecting with it, this is worth noting.
Does the therapist utilize humor? You may really be wanting this (you also can ask how they utilize humor in sessions) and this is a therapist personality that is really important to some folks. I believe in holding the heavy and the light, and if this is also important to you, you can be assessing this at this time as well. That being said, some folks do not want humor in sessions and may not connect well with a therapist who utilizes it.
Overall, from a consultation you will be wanting to feel good and positively about the interaction if you plan to schedule an intake session. You cannot guarantee that a provider will be your ideal one from a brief consultation, but you can utilize the interaction to determine if it feels good for you to want to spend more time with them in the helping relationship.
The consultation usually flies right by time-wise, and is genuinely just to get a feel of if you feel this provider could be right for you, and if the provider feels they can be a good fit from their perspective as well. It is an opportunity for feeling hopeful about sharing a meaningful space with a provider to share in the process of growth, change, and empowerment.
Structurally, after these 3 parts I mentioned earlier (questions for me as a provider, sharing my approach to therapy, (if you want to share) the reason for seeking services), I will once again ask if there are any questions for me, then I will jump into logistics: My fees, what next steps would look like so far as if you were to work with me including signing consent forms electronically, asking about the desired frequency of therapy, etc. I will then encourage them to take some time to think about if I might be a helpful provider for them and that they can reach me via email. I also offer to send a summary email of the logistics (fees, steps for electronic forms, scheduling) if they would like. On my end, as a provider, at this point I will let them know that I hope to hear from them and they can reach out to let me know what they would like to do when they’re ready.
At this point, the consult on the end of the provider is complete. On the end of the potential client, you now can see how you feel following the consultation and if you would like to work with this provider, if you are meeting with other potential providers, or if you have determined that this provider is not the one for you. You can then let the provider know (when you’re ready) if you’d like to move forward. If you do not want to, I appreciate as a provider when they let me know that they’ve decided to work with someone else but please know you do not have to do this—if providers do not hear back from you we know that means you are pursuing working with someone else :)
I hope this was helpful in making transparent the general process and options and opportunities present within an initial consultation. I wish you empowerment, excitement, and a safe holding space as you enter the therapy space.
