So you made the decision to start therapy. You sorted through lists of available therapists, found Star Meadow, and made an appointment. Congratulations! This is the hardest step, and we’re so proud of you for taking it. For most people who have never been to therapy there is some anxiety about what happens next, so let’s walk through what you can expect.

 

• Paperwork

Before your appointment, you’ll be sent electronic intake paperwork through a secure platform called Simple Practice. You’ll receive information about informed consent for treatment, your therapist’s privacy policy, financial disclosures, etc. While it might be tempting to breeze through these kinds of documents, please slow down and read them thoroughly! Many of the questions you might have will be answered here, and your therapist will provide space to go over anything you want to discuss further. 

 

You’ll also receive some questionnaires and survey forms. Just like when you go to the doctor’s office, these forms are standardized for everyone so there may be questions that don’t seem relevant to you or why you’re coming in.  There is so much more to you than what we can fit on these intake documents, but they are a good starting place so your therapist knows what things might be important to talk about in your intake session.

 

• Arriving For Your Appointment

If your appointment is in-person, you will make your way to our office (10000 NE 7th Ave. Suite 403, Vancouver, WA 98685). We have free parking, and you’ll take either the stairs or elevator to the 4th floor. Inside our waiting room, you’ll take a seat until your therapist comes to call you back to their room. 

 

If your appointment is via telehealth, you’ll receive a link from Simple Practice letting you know it’s time to join your appointment. Make sure you’re in a private, comfortable space with your ID handy. Your therapist will ask you to confirm your identity and that no one else is present in the room, and then you’ll get started!

 

• The Intake Appointment

You made it! If meeting in person, your therapist’s office will have several different seating options; please sit where you feel most comfortable! The beginning of every intake session includes a few more administrative tasks like confirming your insurance details and signing any remaining consent or release forms. The intake process varies between clinicians, but generally, you can expect an introduction and orientation to how they structure their intake sessions, and then an open invitation to let them know what brings you to therapy. If you don’t feel like you know how to sum things up, that’s ok! We’re trained to help guide you, and we will go at your pace. Many therapists ask a series of questions to explore things that might be contributing to how you’re feeling like your family/relationship dynamics, medical history, work or school history, and past experiences. Please know that at any point if you are not comfortable discussing something, it is absolutely appropriate to let your therapist know this. Their goal is to understand what’s happening for you to help you feel better as quickly as possible, but always at your pace. 

 

• What Happens Next

Some therapists start planning structured goals and identifying a treatment plan right away, while others prefer to set broad goals for now with the idea of defining them as they get to know you more. If you are using insurance, your therapist is required to list a diagnosis. This is what tells insurance to authorize covering your sessions.  Sometimes that is clear in a first session, and sometimes they need to list a more general diagnosis, to be more clearly defined once they work with you more. Please remember that your medical information (which includes mental health documents) is confidential and covered by HIPAA. For more information on this please visit: https://www.hhs.gov/sites/default/files/hipaa-privacy-rule-and-sharing-info-related-to-mental-health.pdf

 

The intake session can feel like a lot of information, but most folks find the second session to be more representative of what therapy with your provider will look like. If at any point you are feeling uncomfortable, want to slow down, or need something different please say so! Therapy is intended to be a collaborative process, and your therapist will be open to feedback about what you need. 

 

 

 

 

Suffering. It’s the reason most people come to counseling. It comes in varying intensity, duration, and complication.

 

What’s your brand of suffering? Is it…

• Anxiety that’s no longer manageable?
• Sadness that’s stuck around too long?
• Grief that’s shaken you to your core?
• A relationship in distress?
• A trauma that haunts you?
• Burnout?
• Physical pain that disheartens you?
• A loss of faith or hope?
• The experience of systemic oppression?
• Something else?

 

Human suffering is diverse and multifaceted.  It can be emotional, spiritual, physical, cognitive, societal, or relational. Suffering is also a universal part of what makes us human.

 

Suffering is an internal alarm that something is not right. It’s the toothache that reminds you to see the dentist if you’ve been skipping your check-ups. It’s the “check engine” light that urges you to see your auto mechanic if you’ve skipped the routine tune ups.

 

In the world of mental health counseling, people rarely (if ever) come in for mental health “check ups” when things are otherwise “fine” in life. Much more frequently, they develop a backlog of suffering that builds until their emotions are loud enough to get their attention. The volume of their emotional suffering is what prompts people to seek help.

 

Suffering is a primary source of motivation for people. It’s the thing that breaks down barriers, allowing a person to finally allow in help.

 

Not only does suffering motivate people to reach out for help initially, but it also spurs on the entire change process in therapy. It creates a sense of urgency and readiness for change. It will be what prompts you to follow up on the homework your therapist assigns. It will be what reminds you that the hard work you’ll do toward change is worth it.

 

Let’s be real: The goal of counseling is not to eliminate suffering altogether. That would be impossible. Instead, counselors equip clients to manage their own daily struggles and pain effectively, using the resources learned in sessions.

 

In counseling, you can develop healthy strategies for coping with suffering which do not involve denying or avoiding it. You might even find a strength in the midst of your suffering like perseverance, drive, character, or hope.

 

If you are experiencing a brand of suffering that’s leading you to ask for help, a counselor with Star Meadow Counseling is available to help. Call us (360-952-3070) or schedule an appointment online.

It is a mistake to assume that someone is ready to make a change, just because they tell you they’re thinking about it. Change is more complicated than Nike’s “Just do it!” slogan.

Counselors know that lasting change builds over time. Many counselors use a strategy called “motivational interviewing” to help clients move through the different stages of change:

• Pre-Contemplation
• Contemplation
• Preparation
• Action
• Maintenance

Did you notice that the Action stage doesn’t take place until Stage 4?

People come to counseling in different places of readiness, sometimes entering unsure, only contemplating change. Other times, people are already mid-way through the Action stage when they decide they need some extra help. Regardless, your counselor will tailor therapy for you based on your stage of change.

In the early stages of therapy (and throughout the process) building a solid therapeutic alliance with your counselor is integral to therapeutic success. The two of you must partner together to align on your therapeutic goals. Counselors use skills like empathizing, using open-ended questions, reflective listening, and summarizing to help you make your own decisions about change.  We respect your decision-making process.

Here’s how counseling can help you move through the change process:

1. Counseling honors your resistance.

During the pre-contemplation stage, you may have some blind spots. You might not have considered changing a certain aspect of your life.  Perhaps you’ve been pressured to come to counseling by a nagging spouse, or perhaps you’re are genuinely clueless about how a certain thought-pattern is adversely affecting you. At this point, a counselor will explore your reasons for coming to counseling and directly reflect any reluctance. Maybe there is a good reason why you’ve held back from changing! It’s a counselor’s job to build trust, understand your problem, and gather factual data.

2. Counseling allows you to explore ambivalence, non-judgmentally.

In the contemplation stage of motivational interviewing,your counselor will continue using reflective listening skills to maintain a strong therapeutic relationship while concurrently emphasizing change-talk. You will work together to explore the costs and benefits of change. Clients at this stage remain uncertain about doing anything differently. That’s okay! A therapist can help break down the nature of your ambivalence, understand barriers, get to the root of your deeper values and reasons for changing, and help you to “tip the decisional balance scales” (as described in Miller and Rollnick’s book, “Motivational Interviewing: Helping People Change”).

3. Counseling prompts to refine your vision for the future.

The next stage in motivational interviewing is Preparation. In this stage, you have made an intellectual commitment to change but may not know how to translate your desired change into practice. You might need help setting clear goals and understanding your options for implementing change. Your counselor will work in tandem with you to create a practical and personalized treatment plan.

4. Counselors teach skills for the successful completion of therapy. 

Every therapist has a unique toolbox of skills, based on their therapeutic orientation (ex. Cognitive-behavioral, existential, narrative, art therapy, psychodynamic, EMDR, Acceptance and Commitment Therapy, Gestalt, etc.). Many therapists operate from an eclectic approach, pulling techniques and perspectives from a variety of therapeutic modalities. In choosing a counselor, read their bio online to see if their way of thinking about problems (and solutions) fits with yours.

5. Counselors empower you to act on your vision by taking calculated risks and overcoming obstacles. 

In the Action stage of change, you begin to make headway on your goals. Your counselor will help you identify potential roadblocks and prepare strategies overcoming them. You might even receive homework from your counselor, tailored to helping you take the next step toward your bigger picture goal. Throughout this process, you’ll reinforce your rationale for change. You may encounter obstacles. Keeping your reason for change in mind will help you keep your eyes on the prize, building resilience as you encounter set-backs.

6. Your counselor may help with short-term wins first.

The steps you take may be small at first, but you’ll be moving forward nonetheless. It is important to celebrate small victories. It feels great to experience progress! If improvement reaches a stand still, it may be time to re-evaluate. Maybe there’s a new roadblock? Maybe there’s an old roadblock that came up unexpectedly in the form of a traumatic memory? You will continue to troubleshoot throughout the entire change process, working toward one small “win” at a time.

7. Counselors help you maintain gains.

In the Maintenance stage, clients have achieved their stated goals and are hoping to continue their work through ongoing lifestyle change. This is the part in therapy where you’ll consolidate gains. You might reflect on all of the steps it took to get you here. It didn’t happen on accident! You’ll take stock of the skills, mindsets, and changes to your environment that you’ve made that allowed success to take place.

Are you ready to make a change in life? Maybe you’re ready to shift out of long-standing depression, low self-esteem, or anxiety. Maybe you’re ready to change dynamics in your family or marriage. If you are thinking about a change, a counselor with Star Meadow Counseling may be able to help. Online scheduling is available on our website– www.starmeadowcounseling.com.

1. How does confidentiality work in therapy?

Seeing a counselor is sort of like being in the witness protection program. Even the fact that the counselor knows you is kept private and confidential. That means that when they run into you out in public, the counselor does not flag you down and say– “Hey! It’s me, your therapist! Remember me from counseling?” (How awkward would that be!?)

Instead, therapists wait for you to initiate “hellos” and are usually glad to say “hi” right back. Counselors don’t ever want to put you in that uncomfortable position where you have to explain how you know them to the people you are with.

As you may have heard, there are some exceptions to confidentiality, especially when safety is at risk.

• If you talk about children, elderly people, or disabled people that are being abused or neglected, your counselor is considered a mandatory reporter.
• Your counselor would also break confidentiality if you disclosed plans to harm someone else. Counselors really don’t want anyone to be murdered! (That’s a good thing, right?!)
• Counselors often see clients with thoughts of suicide. That really doesn’t freak us out. It’s more common than you’d think! When we DO break confidentiality is when that person is losing the ability to keep themselves safe. Because teens are a high risk population when they have thoughts of suicide, it’s common for therapists to seek coordination with family supports whenever risks of harm are involved.
• Counselors are required to provide you with a copy of their privacy practices where you can read in more detail about how confidentiality works in this unique setting.

 

2. Why can’t I be Facebook friends with my counselor?

Counselors have to abide by professional standards and ethical guidelines. The 2014 ACA Code of Ethics introduced a requirement asking counselors to separate their professional and personal social media profiles. Those ethical guidelines do not permit counselors to communicate with clients via personal social media accounts. Counseling is unlike other relationships in your life, different from friendships and different from family connections. Part of what makes it effective is that separation and neutrality. Those boundaries help make therapy a safe place to express yourself without worrying about what your therapist is going to think, which can be triggered by social media comparisons. It’s for these reasons that your counselor cannot connect on Facebook or similar platforms.

 

3. What should I get my counselor for Christmas?

Okay, this was a trick question. Please don’t get your counselor anything for Christmas (or any other special occasion). Our ethical codes discourage counselors from receiving gifts from clients. We see some very generous people come through the door who love to show appreciation and gratitude by gift giving. When counselors decline your gift, know that it is not a personal rejection. It is instead another one of those professional boundaries drawn from the ACA Code of Ethics, which advises counselors to remain mindful of putting the therapeutic relationship first. More than anything, your counselor wants to avoid any situations that may cause a conflict of interest.