Your 1st Therapy Session and Soon Thereafter - Part 2

So is it the First Visit and Meeting With a Therapist Whom You Don't Know? Free Consultation? Uhhh. Let's Discuss

I recently discussed the importance of a good fit with therapists and using referrals for finding therapists. To repeat myself, I also joked about this article 7 Things You Should Know Before Your First Therapy Appointment. The joke, if you haven't previously read, was that the article saved me 10 minutes of time and that it saved a new client 30 minutes of their time.  In truth, I believe that if a new client were to read this article and understand it, it might save them about 450 minutes and about $1750.
I believe this.  Working with new clients is a delicate relationship. And that first phone call is a difficult call to navigate from both ends. I have received text asking if I "take insurance" or "what is your fee." Good and appropriate questions. But they are problematic. On multiple levels. Without the meaning behind the questions the answers might just create a false negative. You might have ruled out the therapist that actually is the best therapist for you and your situation. Texting is easier and faster; however, it is the least effective way in making a decision that is about your well being. I have also received request for a free first meeting in order to evaluate if the therapy is to move forward. Some therapist do this. I do not. There are positives and negatives for this. For me, if a client calls that is the time to start working toward positive results and outcomes. Results and "fixing a problem" will not take three sessions. Therapy is a commitment that takes work. If you learned a craft or went to school or excelled in a sport or art it did not take three or five meetings. Time and commitment helps layer and improve your skills. Time also strengthens your confidence in your approach to your craft. It is the same regarding therapy. It takes time (and that means possibly 6 months).

This is my belief. Therapy is expensive. Often clients will say they cannot afford therapy. What is intriguing is that they can afford the insurance hike that occurs after the car accident or after the DUI. All to say: What is the equation? Give up your car and take LYFT/UBER for a year; get rid of car insurance, maintenance on the BMW; car wash expenses, and lease payments? If you did this sacrifice and compared this to my full fee for mental health services you might end up paying less for the services than the car; AND, you might have an outcome that is highly beneficial to your overall life. However people often have a tough time with this ideology. If it isn't the car, it is the recreational AOD (alcohol and other drugs). Or, the Starbucks (I might argue that on month of starbucks purchases might be the same as one session for therapy).

I recently went to a bar to visit a friend who returned from out of of town. I paid for our drinks; which was no big deal. My friend wanted another drink right away and offered to pay for mine but I refrained. I had not finished my drink. Shortly thereafter, one of his friends joined us. I wanted to be cordial, so I offered to pay for this other person's drink thinking nothing of it. I thought it an indirect way to be nice to my friends. Several days later, I saw the receipt and realized the amount of money spent for such a short time. I am not saying I regretted spending the money on someone I didn't know or spending the money for such a short time. I am saying that often we do not make clear priorities about our budgeting and our mental health. How many of us have spent money on AOD and weekend expenditures which don't produce healthy or positive results?


So, the question about cost and fees is highly legitimate. And to ask for a free office consultation is appropriate. If you know you are entering into a commitment why not ask for a free visit? Completely appropriate. However, I and many therapist won't do this. For me, I find that a free consultation in an office is about procrastination. The unconscious mind sometimes plants distractors and coming to a first session with no commitment can lead to looking for faults, excuses, or testing the therapist out in hopes for finding something better. In short, it places the client into the shopping experience, and not the engagement experience. If the therapist is on board to work and empower you to make healthy life choices the then the payoff is possible if the client is on board as well. A good therapist meets the client where he is at that point in time. So, if the client is "shopping" then the therapist is just a retail store with items that will collect dust if the inventory does not move. So the rapport is not established over the phone. It frankly cannot be earned so quickly; however, the therapist should have an understanding if a fit is possible. In the past, 20 year ago, clients did not have the advantages of websites to know about therapists. Now, the client comes into the call having knowledge about the analyst (his orientation, background, what he looks like, and the clients he might work with, ect). The fit, connection, and rapport might not happen at the first meeting. But if the first meeting is a consult then one could argue there are restrictions preventing the therapeutic process.

The delay. Time wasted. Procrastination. This delay or this consult is a great unconscious device to shop for other therapists or to "see what is out there" as one client once said. This consult could translate to over thinking or spending 3 weeks to find the one I like or a wait and see approach only to say "ahhhh, I don't think I need counseling things are better." In my experience the golden first question all therapist were taught is "Why now?" Why did the client call or seek therapy now? Why not last year, why not six months from now why not last month; Why now? This is why I find it crucial to mildly pull the client into session right away. If the client has found the therapist then they are looking for you and what you might represent (assuming they found you on line). If it is a referral then they either asked for therapy or someone felt that they could benefit from therapy. So, it is the analyst's role to mildly pull the client into the room and quickly establish rapport, comfort, emotional safety (which looks different for different people). And to start the work!

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