What To Expect at Your First Therapy Session

 

 

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So you’ve decided to take the step of going to see a therapist.  That’s wonderful and good that you’re taking care of your mental health.   Whatever your reason for seeking help, you will feel  more at ease and get better results if you know what to expect.

In your first session, the therapist will ask  questions about you and your life. This information helps her make an initial assessment of your situation. Questions  might include the following:

Why you sought therapy.  The therapist has to understand your surface problem(s) before she can get to the deeper issues.

Your personal history and current situation. She  will ask you a series of questions about your life.   She’ll  also ask about your family history and current family situation.

Your current symptoms. Other than knowing the reason you sought therapy, the therapist will attempt to find out if you’re suffering from other symptoms of your problem. For example,  are you having difficulties at work.

She will ask these questions to get to know you and understand your situation so you and she  can come up with the best plan for your treatment.

Remember therapy is a team effort and you should take an  an active part in the session or you won’t find the counseling experience valuable. Here are some things you can do to make your first session  successful.

Be open.  It’s important to answer questions  openly and honestly.

Ask questions. The more you understand the counseling experience or how counseling works, the more comfortable you’ll be.  Feel free to ask questions about the therapy process, and ask the therapist to repeat anything you don’t understand.

Be open and honest about your feelings.  Many thoughts will be going through your head during the session. Listen to your own reactions and feelings, and share them with the therapist.

Remember  therapy is not a quick fix for your problem, rather it is a process and it will take time to resolve your problems.  The most important part of the process is feeling comfortable with your therapist and feeling that she is truly trying to help you.

Black Women and Therapy- Why Race Matters

pexels-photo-818819.jpeg“What would a White doctor know about my problems?” “They’ll call me crazy and lock me up!” “The pastor has been helping me,” and “Where would I even find a good Black counselor?”   Although the Black community shares the same concerns and mental health issues as others  and with  even greater stressors due to discrimination and economic inequities,   many shy away from psychotherapy.    This is due to many factors such as feeling unable to find a therapist they feel can truly help them,  being distrustful of White people, the belief that seeking help makes you weak and also the idea that therapy is for “crazy” people.

 

Cultural Mistrust

African Americans have a greater distrust of the medical establishment in general, and many feel that  medical institutions hold racist attitudes. This goes  back to historical abuses of slaves by White doctors for medical experimentation; Blacks could neither consent or refuse to participate because of their low social status and were often victimized, even to the point of being used as examples of surgical techniques for medical students.

Cultural mistrust is partially responsible for  the under use of  mental health  services, leaving many without needed care. Black people may fear mistreatment, being hospitalized involuntarily, or being used as research “guinea pigs.” Black people who regularly encounter prejudice often  develop “healthy paranoia” — a cultural response style based on experiences of racism and oppression in White society.  Worries  about being judged or wrongly  diagnosed may lead many African Americans to exercise caution or avoidance of mental health care. This reaction has lead some clinicians to over diagnose paranoia in  Black clients, which then leads to greater mistrust on the part of the client.

Therapist Factors

White therapists often don’t understand why Black clients  are cautious.  Unfortunately ethnic and racial stereotypes often affect therapeutic relationship.  The therapist’s reaction to the client  can be complicated by unacknowledged prejudice, stereotypes, and feelings of guilt.  An honest discussion of ethnic and racial factors in the therapeutic relationship can increase trust and mutual understanding.  However, many therapists are unsure how to approach racial differences, and may prefer a “colorblind” approach.

Colorblindness Is Not the Answer

A colorblind approach only relieves the therapist of his or her obligation to address racial differences and difficulties.  Being  colorblind allows the denial of uncomfortable racial and cultural differences.    Being colorblind  ignores the experience of being stigmatized by society and represents a failure on the part of the therapist.

 

The Black Client and White Therapist

In my work as a therapist working primarily with Black clients, I have had many clients tell me about difficulties they’ve had with White therapists.  Many clients felt there were subjects they couldn’t discuss with their therapist because they felt the therapist couldn’t possibly understand due to cultural and racial differences.  I have also had clients say that they have discussed racism they’ve experienced and felt that their therapist felt that they were making a “big deal” out of something.  These situations led to clients being distrustful of their therapists.

 

 

Choosing a Therapist

It’s important when choosing a therapist to choose someone who you feel understands you and will be empathetic and non judgmental towards you.  Sometimes it takes going to different therapists to find the right one for you.  Finding a culturally competent therapist can be especially difficult but not impossible.  Remember  no matter what race or ethnic background your therapist is, the most important thing is that you feel heard, understood and safe to express yourself in therapy.