May is Mental Health Awareness Month, and there will be dozens of blog posts, articles, and social media promotions encouraging people to seek help if they are feeling anxious, depressed, or in any other sort of emotional distress. Much of the publicity around mental health awareness will strongly encourage people to seek support, and it will attempt to give therapy a good impression. The press will also aim to reduce the stigma surrounding therapy and normalize the experience, so that people will be more willing to seek the level of care they need. While these are noble intentions, I think it’s even more important to talk about whether you’re ready to start therapy, and how to move forward if you are.
Many people start therapy because they think they should or someone has told them it’s a good idea. But if you aren’t honest about where you are in terms of your willingness and motivation to change, therapy may not be as useful. Thinking through the stages of change — a behavioral psychology model for how we implement and maintain changes in our lives — can help you assess whether or not you’re ready to take this step.
Not everyone is ready to start therapy, even when they are feeling depressed, anxious, or unhappy with their lives. If we are not yet ready to make changes, we are in the precontemplative stage of change. To move from here, a person has to decide for themselves that they want to go to therapy and why. If this describes where you are now, at the end of the blog I offer some questions you can think through to help you move forward.
Once we start asking questions, asking others for their perspective, and reflecting on our current situation and whether we want to change it, we enter the contemplative stage of change. It may not be time to find a therapist or schedule an appointment, but it’s an appropriate time to start thinking about your goals. If you want to feel better, think about what that looks like. Perhaps you have childhood trauma that you want to process, so it may be helpful to think about specific events around which you seek healing. The more specific you can get with your goals, the less stressful and confusing it will be to find a therapist suited to help you accomplish them.
The preparation stage involves doing some research on therapists in your area: who takes insurance, whose rate is within your price range, and most importantly, who is trained professionally to help you reach your goals. For instance, if you want to change your negative thoughts and feelings, cognitive behavior therapy might be a good fit. If you’re seeking healing from trauma, you want to find a clinician who has specialized training in trauma informed approaches to therapy. Doing research beforehand may save you time later because you’re more likely to find a good fit on your first try.
The action stage of therapy involves making an appointment, having an initial consultation, and describing your goals to the therapist. Be prepared to schedule a few intakes with therapists to find a good fit in terms of training, personality, and comfort level. As you move into this stage, it’s important to have reasonable expectations for what you can accomplish in therapy and how much time changes will take. It may take more than one session to feel comfortable with a new therapist. And it can be hard to tell whether those feelings are about your relationship with the therapist or your own discomfort with starting therapy. It’s also important to keep in mind that initial sessions will be focused on gathering background information, rather than starting an intervention. This is yet another reason to make sure that you are ready to begin making changes, and that you find someone who is a good fit for what you want to accomplish.
I was asked recently how to move from the precontemplative stage and begin to prepare to start therapy. Consider the following questions to help you decide whether you’re ready to move forward:
Is therapy scary to you? Are you scared of making changes? If you’re feeling bad, what are you worried will happen if you take action to feel better?
Sometimes, people worry that they will lose a part of themselves if they go to therapy. Psychotherapy is not intended to erase who you are; it’s intended to make you the best version of yourself.
Do you dislike talking about yourself?
Some people tell me they feel selfish for spending the better part of an hour each week talking about themselves and their lives. This is especially true for persons who are struggling with low self-esteem. If you think that you will feel selfish or dislike talking about yourself, you may consider finding a therapist who incorporates strategies other than just talk therapy into the process.
Are you afraid you can’t change, or that others will judge you for not changing quickly enough?
This is a common question, and it can feel intimidating to think that you would start therapy and others around you would want to see tangible evidence of change quickly. You should go to therapy because you feel ready to make changes, to gain insight, or to learn about yourself and your relationships with others. If you choose to start therapy because someone else is urging you to do so, you won’t find therapy as valuable or useful.
If you’re feeling anxious about starting therapy, you are not alone. Not everyone finds therapy exhilarating and life-changing right away. Some people never experience it that way. But you can have a positive experience that results in self-improvement, relief from acute symptoms of emotional distress, and the opportunity to grow.