Maybe I Want To? Three Things Holding You Back from Starting Therapy

Erin Sesemann, Therapist, Boone, NC

Dr. Erin Sesemann, PhD, LMFT, CBIS (she/her/hers) takes a holistic approach to counseling with her specialized training in Medical Family Therapy, EMDR therapy, and certification as a Brain Injury Specialist. Her office is based in Boone, North Carolina, offering in-person and online therapy to people across North Carolina.

Maybe I Want To? Three Things Holding You Back from Starting Therapy, New River Counseling & Wellness, Western North Carolina

People often ask “what is keeping me from starting therapy?” The answer to that question can be tough. Anything from the cost of therapy to personal beliefs or biases about mental health can keep people from starting therapy. In fact, it is not uncommon for people to say they considered starting therapy for weeks, months, or even years before attending their first session.

questions about therapy, boone, NC

To get started, let’s start with three barriers that might be keeping you from starting therapy: cost, questioning, and fear. Each barrier is listed below with common questions related to it. 

  1. Cost
  • Do I have time for therapy?
  • Can I afford therapy?
  • Does my insurance cover therapy?
  1. Questioning
  • Are my problems really bad enough to need therapy?
  • If I do not know what is wrong, can a therapist really help me? 
  • Will my therapist and I get along?
  1. Fear
  • Will I be judged for going to therapy? 
  • Does it mean I’m crazy if I go to therapy? 
  • Will I be in therapy for the rest of my life? 

People can get stuck on these questions, leading them to not get the help they need. Let’s talk through a few approaches to address these barriers. Maybe it will help you move forward. 

Learning About Cost

The cost of time and money is a real factor to consider when starting therapy. The reality is that by starting therapy you are making a considerable investment in yourself in both time and money. To learn more about what type of time investment you can make, it can be helpful to create a weekly schedule for yourself to see what days and times you are available for sessions. This schedule will also prepare you to determine how frequently you are able to meet your therapist. Therapists may offer weekly or biweekly appointments. 

To learn more about the financial costs, making a budget is a great place to start to see how much you can afford to spend each week or month on therapy sessions. This amount may also help you figure out how frequently you can meet with your therapist because you will know how much you can afford to pay each week or month. If the hourly rate is higher than you can afford, it is worth asking whether there is an option to pay a reduced fee. 

If you have health insurance, you can find out whether your insurance plan covers mental health care by reviewing your explanation of benefits (EOB) or by calling your insurance company to ask for details about your mental health coverage. You can start by asking your insurance company the following questions:

  1. What are my mental health benefits?
  2. What is the coverage amount per session?
  3. How many therapy sessions does my plan cover?
  4. Will I have a co-pay?
  5. How much does my insurance pay for an Out of Network provider?
  6. Is approval required by a primary care physician? 
  7. How much is my deductible?
  8. How will meeting my deductible change my cost per session?

Thinking Through Your Questioning

There are no metrics for how “bad” a problem needs to be to work with a therapist. People start therapy when they are mildly bothered by particular issues, when their lives are severely disrupted by their mental health or relationship distress, and everything in between. If you are unsure how to describe what is wrong or are not certain whether a therapist can help you, then talking to a therapist about that specific topic might actually be where to start. Therapists are trained to structure conversations and ask questions to help you identify and express your thoughts, emotions, and behaviors. Because you will work closely with your therapist on these topics, it is important to consider your relationship with your therapist. 

An effective relationship with a therapist tends to be empathetic and nonjudgmental. Ideally, you slowly build a positive, supportive relationship with this person. This type of relationship helps set the stage for establishing mutual goals and expectations for therapy. If you are not satisfied with your therapist for any reason (for example, cost, approach to treatment), you do have the right to discuss your questions and concerns with your therapist. It is also the clients’ right to end treatment and request referrals for other therapists should you want to change providers. 

man in woods, Therapy fears, Boone, NC

Acknowledging Your Fears

The fear about being judged is valid given that the stigma of mental health persists in the United States. While people are doing more and more to increase awareness and destigmatize mental health, seeking help for your mental health can be controversial depending on your family, friends, and community.

With that being said, your therapist must uphold specific ethical standards of privacy and confidentiality that does not allow them to confirm or deny your status as their client without your consent. This means that a therapist will not disclose you are a client without your awareness and permission. You have control over who knows you are seeking services.

The limits to this confidentiality include if you are a threat to yourself, someone else, or if there is suspected abuse or neglect occurring with an individual identified as vulnerable (e.g., minor, older adult, person with IDD). Companies involved in billing and health insurance claims will also be aware that you have sought services. Just because the fear is valid does not mean you have to keep yourself from receiving help. It does not mean you are crazy if you are meeting with a therapist because receiving care for your mental health should be treated the same as receiving help for your physical health. Mental health is health. 

Still Feeling Stuck?

We don’t judge people for going to the doctor for help when they hurt their back or get a sinus infection and mental healthcare should be viewed the same way. There will be times when your usual ways of coping or managing no longer works given the demands of your life (work, parenting, marriage, etc.). Or, perhaps something happened to you that overwhelmed your capacity to cope and is making it difficult to get back to feeling “normal.” These are signs that therapy can be helpful but definitely not signs that you are crazy.

If you decide to work with a therapist, research shows that people vary a lot in how many sessions they decide to attend. The reason the length of treatment will vary is because everyone has different expectations, motivations, needs, and resources for accessing therapy. It is good practice to talk about the length of treatment and expectations for care with your therapist regularly. After the initial session, you and your therapist can re-evaluate the treatment plan at regular intervals moving forward. 

Hopefully this article provided you with a few ideas about how to work through what is keeping you stuck in your decision to start therapy. 

We would be happy to help at Dr. Erin Sesemann Counseling in Boone, NC, where I offer individual, couples, and family therapy. Call today for an initial consultation or to schedule your session. 

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