What To Expect at Your First Therapy Session

 

 

photo of a woman
Photo by Photos 4 Donations on Pexels.com

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.

Online Therapy

 

 

african american woman black girl black woman chair
Photo by Christina Morillo on Pexels.com

In addition to seeing clients in my office, I also offer online video therapy through a secure HIPAA compliant video platform. When I think about why clients choose online therapy, the first answer that comes to my mind is about convenience: the comfort of being in your own office or home, no travel necessary, the time saved, and the time of sessions is usually more flexible.  I admit I was skeptical about doing online therapy but when I decided to begin offering it in my practice and I read about it, I realized that it is something I wanted to do in addition to seeing clients in a traditional office setting.  I have been providing online video therapy for awhile now and I think it’s a great addition to traditional in office therapy, in the future I hope to  only offer online therapy.

When I’ve asked clients how they feel about seeing me via video rather than in an office, they’ve stated that they feel comfortable working this way and it’s more convenient for them since they do not have to go to an office.  During a snow storm I was able to see 7 clients online, I would not have been able to do this in an office because it would have been very difficult for me or my clients to get to the office.

Another reason some people chose online therapy is that it gives an added layer of confidentiality.  With online therapy, no one else has to know that you’re going to therapy unless you chose to tell them.  I don’t feel as comfortable doing telephone therapy as I prefer to see my clients when we’re speaking however telephone counseling is also an option if video is not available.  I  do not offer texting therapy.

Some clients would not benefit from online therapy and do need to be seen in an office.  Clients who are actively psychotic would not be good candidates for online therapy.  Also clients who have recent suicidal attempts would benefit from  in office therapy until they are more stable.

I have found the outcomes for my clients to be just as good whether I see them online or in my office and I’m so glad I’m able to  offer online therapy.

To Be a Black Woman with Anxiety

 

 

photo of woman wearing eyeglasses
Photo by Femi Sho on Pexels.com

Anxiety is one of the most common reasons for women to seek therapy.  For Black women, anxiety is  often more chronic and the symptoms more intense than white women.

To understand anxiety and Black women,  you need to understand how Black women are viewed.    There are three basic images which we see of Black women, the Strong Black Womanthe Angry Black Woman, and the Overly Sexual Black woman.. These images affect how other people see Black women and how we see ourselves. They also play a role in the development of anxiety.

Strong Black Women -There are some  positive aspects about being a Strong Black Woman, but there are  also many negatives.   A Strong Black Woman  will keep going even when she knows she should stop, this places her mental and physical health at risk.

An Angry Black Woman  is perceived as a woman who is always ready to  “cuss” you out. I have found that many women who are perceived this way are actually very anxious.  The anger is often an outward expression of their discomfort with the negativity associated with anxiety.

The Overly Sexual Black Woman  used to be referred to as a Jezebel, which comes from the Biblical Queen who  was said to have turned her husband against God.  Since slavery, Black women have been sexualized in derogatory ways  Today  this is often seen  in rap and hip-hop videos.

Social Anxiety 

In workplaces, college and professional  settings around the country, Black women often find themselves to be  the only one.   In these situations, we  have  often been taught that we have to be twice as good, that we are representing the race and that we are being watched more closely than our white counterparts.  These beliefs along with the Strong Black Woman image often increases the risk for social anxiety.

PTSD

The rate of sexual assault among Black women is  reported to be 3.5 times higher than that of any other group in this country. Black women are also less likely to report their assault. Many never share with anyone what has happened to them. The trauma  will remain untreated and the symptoms  will worsen.

Racism is another   form of trauma that  affects Black women.  Trauma in the form of racism can be directly or indirectly experienced. Driving while Black, shopping while Black, and racial micoraggressions are direct examples of racial trauma.  Indirect examples are videos of unarmed Black women and men being killed.

Thankfully, the stigma associated with seeking help for anxiety  and other mental health issues is disappearing.  Remember that with the help of a good therapist you can reclaim your life from anxiety.  I was able to reclaim my life and so can you.

 

Beginning Therapy

woman wearing black sweater standing on the field
Photo by Luis Quintero on Pexels.com

It’s not too difficult to  find a therapist but it can be difficult to know if you’ve found one who is right for you.  The first step is often going on the internet and looking at Psychology Today, Therapy for Black Girls or other therapist directories.  After you find a therapist it’s important to see if they are the right fit for you.  Here are some questions to ask yourself  to see if you’ve found the right therapist for yourself.

1. What does it feel like for you to sit with the therapist? Do you feel safe and comfortable?  Is the person down-to-earth and easy to relate to or does he or she feel cold and emotionally removed?  Is the therapist arrogant?   If a therapist  doesn’t feel like a good fit for you, that’s okay; there’s absolutely no contract or rule requiring you to continue working with any therapist. However,  If you find yourself reacting negatively to every therapist you see, then the issue could be yours and may warrant your sticking it out with a therapist in an effort to work through your fears  of beginning therapy.

2. What’s the therapist’s general philosophy and approach to helping? Does your therapist  approach people in a compassionate and optimistic way? Does he or she believe humans are born loving and lovable?

3. Can the therapist clearly define how he or she can help you to solve whatever issue or concern has brought you to therapy?  A therapist should be able to  explain how they can help and  be able  to give you a basic “road map,” to their approach.

4. Can your  therapist accept feedback and admit mistakes? A good therapist  is open to feedback and to learning that something he or she said hurt or offended you. Good therapists are willing to look at themselves and to honestly and openly admit mistakes.

5. Does the therapist  encourage dependence or independence? Therapy doesn’t solve your problems; it helps you to solve your own.  Therapy doesn’t soothe your overwhelming feelings; it helps you learn to soothe your own feelings.  If your therapist never encourages you to access your own resources, it is more likely you will become dependent on your therapist to help you feel better, rather than learning to depend on yourself.

6. Does the therapist have experience helping others with the particular issues for which you are seeking therapy? The more experience a therapist has addressing a particular issue, concern, or problem area, the more expertise they have developed.

9. Does the therapist make guarantees or promises? It’s important for a therapist to provide hope but not give  absolute unconditional guarantees.

10. Is the therapist  licensed? Licensure means  that a therapist has engaged in postgraduate counseling experience which, depending on the state of licensure, may include up to 3,000 hours of required supervised experience. It also means the therapist has passed a licensing exam. There are many unlicensed therapists who have years of experience and do excellent work, but licensed therapists  have (generally but not always) undergone more extensive supervision than unlicensed counselors. You can contact your state professional licensing board to verify the licensure of a provider.

11. Have any complaints been filed with the board? To see if a therapist has a record or is under investigation, you can check with your state licensing board for their profession.

Remember the most important thing is the relationship, if you feel comfortable and have a good rapport with your therapist then you know you’ve found the one for you.

Caribbean Immigrants and Therapy

woman wears multicolored tube dress smiling

Many Caribbean immigrants in particular first generation immigrants are very wary of going to see a mental health professional.  Problems are usually handled at home and many families have someone in their family who is mentally ill but has never gotten treatment and is often whispered about by others in the family and community.  Many immigrants are also very religious and feel that by going to church and praying  will make everything better.  Many Caribbean immigrants also believe that admitting to being depressed or anxious is a moral failing and won’t seek out help and will try to feel better on their own.   Many also wonder if a clinician who does not share their background will be able to understand their background and some beliefs such as “obeah” which is a form of voodoo practiced or believed in by some members of the Black Caribbean community.

Faith, Spirituality And Community

In the West Indian community, family, community and spiritual beliefs are often  great sources of strength and support.  Many West Indians  rely on faith, family and social communities for emotional support rather than turning to health care professionals.

While faith communities can be helpful at times they can be a source of distress and stigma if they are misinformed about mental health or do not know how to support families dealing with these conditions.

 

Reluctance And Inability To Access Mental Health Services

Less than 30% of West Indians  seek mental health care during their lives. Here are some reasons why:

  • Distrust and misdiagnosis. Historically, African Americans and West Indians  have been and continue to be negatively affected by prejudice and discrimination in the health care system. Misdiagnoses, inadequate treatment and lack of cultural competence by health professionals often causes distrust and prevent many people  from seeking or staying in treatment.
  • Lack of  West Indian mental health professionals.   Unfortunately there is a lack of mental health professionals who are from the West Indian or Caribbean community.  Many immigrants feel more comfortable and relate better to people who they perceive as being more familiar with their culture.

Provider Bias And Inequality Of Care

Conscious or unconscious bias from providers and lack of cultural competence result in misdiagnosis and poorer quality of care for African Americans and West Indians. .

West Indians, particularly women, are more likely to experience and mention physical symptoms related to mental health problems. For example,  describing  bodily aches and pains when talking about depression. A health care provider who is not culturally competent might not recognize these as symptoms of a mental health condition. Additionally, men are more likely to receive a misdiagnosis of schizophrenia when expressing symptoms related to mood disorders or PTSD.

Given this bias and the negative impact they have on your care, it is easy to understand why so many people  mistrust health professionals in general and avoid accessing care. While there may be reason to doubt whether professionals will mistreat you or not, don’t let this fear prevent you from seeking care..

Finding The Right Provider

For West Indian and Caribbean people it will be important to find someone whom they feel is culturally competent and understands them.  The therapist doesn’t have to be West Indian but should be someone who understands or is willing to learn the nuances of Caribbean culture.   When meeting with a  provider, ask questions to get a sense of their level of cultural sensitivity. Do not feel bad about asking questions. Providers should expect and welcome questions from their clients  since this helps them better understand you and what is important to you.  If a provider seems put off by being asked questions, they may not be the right provider.  Remember if you need help it’s ok to seek it and don’t feel ashamed about seeing a therapist.

 

 

The Story of Transforming Lives Counseling Service

 

propic22

I have been asked many times what made me decide to start my practice and in particular why my practice is centered around providing psychotherapy to women and adolescents of color in particular Black women and girls.   This post will tell you a little about me and what led me down this path.

I’ve been a therapist for 24 years and I’ve worked in various capacities and several agencies as well as at an inpatient psychiatric hospital.    During this time I’ve worked with many different populations and have also been a speaker at different organizations and written articles about therapy with Afro Caribbean families and women.

Working at agencies is very stressful and although I loved my clients I knew I couldn’t be there forever. I had always wanted a private practice but due to several circumstances I didn’t begin the process until 2016.   After my last position as a clinical supervisor at an outpatient substance  abuse clinic in New York City, I decided that it was time to start my practice.  I’ve always been passionate about helping women of color especially Black women who often feel ashamed to seek mental health treatment.   I started Transforming Lives Counseling Service in July 2016, first it was only online and then as I grew I decided to open an office in addition to seeing people online via video.  My practice has grown so much since this time and I’ve expanded and have a wonderful therapist, Jennifer Dorsey, MHC-LP working with me.

People have also asked if it’s discriminatory that my practice focuses on the mental health needs of women and girls of color in particular Black women and girls.  Psychotherapy is often viewed as a luxury for wealthy white people and I wanted to bring culturally competent care to Black women and girls who often don’t get to see people who look like them as therapists.   All my clients are not women and girls of color.  I will work with anyone who feels they need to begin therapy to learn how to live a fulfilling life however my primary goal and focus will always be helping Black women and girls.  If you want to learn more, take a look at my website, Transforming Lives Online.org  .

Be well

Racquel P. Jones, LCSW

woman wearing white sleeveless lace shirt
Photo by nappy on Pexels.com

Misconceptions about People who go to Therapy

woman wearing yellow knit sweater and blue knit hat
Photo by Thomas Chauke on Pexels.com

 

“Talk to your family and friends, why are paying someone to talk to you”.  “Are you crazy or something?”  These are phrases people often say to others when they hear that you’re seeing a  therapist.   Many people won’t seek therapy because they don’t want to be labeled as “crazy”.   Therefore in order to shed light on the truth about seeing a therapist and raise awareness, I’ve  complied a list of things you shouldn’t assume about people who go to therapy.

1. They’re weak.

Going to therapy is a very courageous and strong thing to do.  You have  to be open to facing every corner of your mind and heart and be completely open about fears, truths and experiences in order to really get the most of what a therapist can offer. This requires strength.  You need strength  in order to explore your own emotional and mental limits and boundaries, strength to be guided in directions you wouldn’t go and strength to learn and actively seek a better place.

2. They’re crazy.

Whether someone  is suffering from a mental illness or seeking help for overwhelming feelings/thoughts, “crazy” is never an appropriate term.

 

3.  Therapy is for rich people.

Therapy can be expensive, but there are different ways to pay for therapy.  Many therapists accept insurance and some have sliding fee scales.  Also Open Path Collective can connect you to therapists who charge between $30-$50 per session.

4. They have no friends.

Therapy is not a replacement for friendship, and a therapist is not a friend. Friendships are two-way streets, which can cause a very biased view of experiences and circumstances; therapy is a one-sided relationship with a professional who has the skills to guide and help you through your struggles and needs.  Most of my clients have many friends who love and care for them.

 

5.  They’re in a bad “place.”

Someone  does not need to be in a “bad” or “dangerous” place to see a therapist.  There’s usually a catalyst for deciding to go, but it could be a culmination of experiences or feelings, not necessarily that something bad recently happened to you.

6. There’s a set time frame for being in therapy.

Some people go to therapy for years while some only go for a few months to work on a specific issue.  The client and therapist will decide together an appropriate plan for treatment.

7.  They’re  on medication.

It’s common for people to believe that if you’re in therapy, you must be on medication.  While some people who are in therapy are also taking medication, many are not taking any medication.  Most of my clients in my practice do not take medication.

8. Their  therapist tells them what to do and what to think.

A therapist is there to help you  uncover your strengths, work through your struggles and help  you to lead a healthier, happier life not tell you  what to do.

 

It’s my hope that these common misconceptions will change and people will feel less ashamed about going to therapy.  Remember there is nothing wrong with reaching out for help.

woman wearing black off shoulder long sleeved top
Photo by Pasha Gray on Pexels.com