Preparing for the Climb: What to expect in your first therapy session

Congratulations on scheduling your first counseling appointment! If this is your first time in therapy, you may be wondering what it’s going to be like that first appointment. Even if it’s not your first venture into counseling, it’s helpful to know what to expect with your new counselor (me). 

I like to think of undertaking therapy as similar to climbing a mountain. Just like the steps one takes to prepare for an intense climb, the therapy process starts with gathering information, taking stock of your equipment/tools, and making a plan. Using this metaphor, let’s talk about the first step in therapy: the intake appointment. 

Step 1: Meet your climbing partner 

Climbing a mountain is hard work. It helps to take a climbing partner with you – ideally someone who has climbed before and is dedicated to walking with you through the most challenging parts. The same is true with counseling. During your first session, I will introduce myself to you and go over a few important details about the counseling process. 

A little bit about your climbing partner/therapist: Right now I am a Supervised Therapist at South Tampa Therapy, which means I am counseling under the supervision and licensure of Dr. Elizabeth Mahaney while I finish up my final 18 weeks of my Masters in Counseling program Northwestern University. (Previously, I spent 12 years working in corporate America.) My current education has qualified and prepared me to counsel individuals, couples, and families experiencing a variety of life challenges, and over the past year I have accumulated 1,000 hours of experience in clinical mental health settings. I take a collaborative, integrative, and holistic approach, which means I look at the whole person and pull in evidence-based tools from various counseling theories based on what we both believe will be most helpful for you. (Approaches I often use for individuals include Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT) including Exposure with Response Prevention (ERP), Narrative, Internal Family Systems, and Psychodynamic; for couples, I also use Gottman and Emotion-Focused Therapy.) 

Step 2: Learn about the climb

A climber needs to be informed about the mountain they are climbing, including any risks, benefits, requirements, and special considerations. You should know the same at the outset of your counseling journey. During the first session, I will tell you what counseling is, what you can generally hope to accomplish, any risks, and what the process will entail. Counseling is a collaborative process aimed at helping clients achieve mental health and wellness. It takes work on the part of the therapist and the client. Together, we will identify goals, gain insight, work through challenges, and practice new skills. If you are here for couples counseling, we will develop insight into what is underlying any relationship problems and then work to heal wounds, resolve conflict, and improve communication. 

Now, about the risks. While counseling is successful for many people, like any endeavor, there is not 100% certainty. It might not be the right time to climb the mountain, or I might not be the best climbing partner for you – and that’s ok if we find that out! I want the best for you. Also, talking about hard things can bring up difficult emotions – similar to training your muscles for a long climb, you may experience some emotional “soreness” along the way. That is why your counselor is here to train alongside you – so you’re not facing the journey alone!

Another important aspect of the therapy process is confidentiality and its limits. Confidentiality is of utmost importance to me, and I am also bound by law and my professional ethics to uphold it. Everything we talk about in session will stay in session. I may seek supervision from my supervisor (who is also bound by confidentiality) on aspects of your case to ensure I am providing the best possible care. There are only a few instances where I would be required by law to break confidentiality: if I believe you are going to harm yourself or another person, if there is suspected abuse of a child or vulnerable adult, or if my court records were to be subpoenaed (which is highly unlikely). 

Beyond confidentiality, we will cover policies and communication expectations – things like what to do if we run into each other out of the therapy room, how to get in touch between sessions, and cancellation/rescheduling expectations. I highly encourage questions about anything – I want you to feel confident and comfortable as we begin the journey. 

Step 3: Check equipment and readiness level

Embarking on a mountain climb without checking one’s equipment (what you bring with you) and readiness levels would not likely result in a successful outcome. My goal for counseling is to help you achieve your goals. And in order to do that, I need to get to know what you’re bringing with you in your emotional backpack! That’s why this first session will be more question-heavy than other sessions we will have together (where you will be doing most of the talking). I will ask you about your health, family history, and what symptoms you’re currently experiencing. Since we’re shaped by both nature (our genetic makeup) and nurture (family, community, experiences, and global events and messages), gathering information about these topics helps us get a sense of how these factors may be impacting you. Most importantly, I’ll ask what brings you to counseling now and what you’re hoping to get out of it. I may also administer one or more assessments that we can come back to over the course of treatment to check on progress. 

Step 4: Map out the journey 

During our first session, we’ll start to hone in on goals for our time together – you might think about it like determining which mountain (or mountains) we want to climb, how frequently it makes sense to train, and a goal for how quickly we can reach the top. Each person has unique goals. For instance, a goal may be to reduce the frequency, intensity, and duration of anxious  thoughts and feelings. Perhaps it could be to find clarity on a difficult, stressful decision. Or maybe it could be to improve communication in a relationship, process through a trauma, grieve a loss, or increase self-esteem. It’s possible that the goals will start out more general and become more specific as we gain more clarity on symptomatology. As we dive deeper, they may also shift. We might even add additional goals along the way! 

Goals are important because they provide direction for our work together. They also let us know if we’re on the right track or if we need to switch approaches. Finally, if we are successful during our time together, our goals will help inform when it’s time to begin winding down our sessions. 

With our goals set, we will discuss how frequently we want to meet (I usually recommend weekly to start with) and set our next appointment time. I may also ask you if you are ok with taking part in “practice” (which I find is a more palatable word than “homework”) between the intake and the next session. This could be, for example, reading a brief article, tracking your thoughts and feelings, journaling, or trying out a new coping tool. We can both expect to leave the intake with an idea of where we’ll be headed in therapy as well as what we’ll focus on in the next session. 

What to keep in mind when beginning counseling

Embarking on the counseling journey is a big decision – akin to standing in front of a tall mountain and making the decision to climb it. And the intake session is sort of like meeting your climbing partner for the first time, taking stock of your equipment, and mapping your route before the journey. It’s ok to feel a little nervous at this stage. It makes sense – talking about hard things and putting in the work is difficult! But know that as a counselor I am there with you, creating a nonjudgmental space to feel, process, and work through the most difficult parts of your experience. It’s so much easier to climb when you know you’re not doing it alone. And the view at the top? Well, it’s pretty spectacular.

Book with author of this blog post, Kaitlin Lowey, here: https://SouthTampaTherapyBOOKAPPT.as.me/KaitlinLowey

Why your therapist won’t tell you what to do

One question us therapists often hear from our clients is, “What should I do?”

It makes sense that a client would want our advice. After all, we are often the only people in our clients’ lives who know all of the intricate matters of their hearts. We sit with the ambivalent feelings, desires, and conundrums our clients find themselves encountering. And, because we aren’t interwoven in our clients lives in the way that a friend or family member is, we aren’t directly impacted by the decisions our clients make. In short, we get the full picture without being in the picture. So, why shouldn’t we give them advice? 

Let me answer this question by painting a picture of a hypothetical client scenario. In this situation, a client has been dissatisfied with her relationship for quite some time. She feels that her partner cannot connect with her on an emotional level, and their sex life has been lackluster for the past year. She explains the full details of her situation to her therapist and asks, “What should I do?” Her therapist says, “Well, it sounds like this may not be the best relationship for you. I think you should leave.” 

What are the possibilities coming out of this? Let’s consider a few. 1. The client leaves her partner but later feels she has made a mistake. 2. The client leaves her partner and is thrilled about making the decision, but she is robbed of her confidence in her ability to make her own decisions and relies on her therapist for all future major decisions. 3. The client stays in the relationship and no longer trusts the therapist's opinion. 4. The client finds that she actually resents being told what to do and ghosts her therapist, losing faith in therapy and never getting the therapeutic help that would have helped her confront her deeper underlying reasons for seeking help in the first place.

As you can see, there is no winning when we provide advice to our clients.

In fact, this can do more harm than good. When providing an opinion, we may also fall into the unethical trap of imposing our own beliefs and values onto our clients – a direct violation of our ethical code. We also strip our clients of the very empowerment they come to therapy to build. While providing an answer to our clients’ problems may temporarily provide relief from uncertainty, it also reinforces reliance on the therapist to provide a sense of certainty. We want our clients to stand in their own power and trust in themselves – and to believe that no matter what the outcome of their dilemma, they will be able to handle it. 

So, what do we do when our clients ask us, “What should I do?”

We have several approaches we can take. We can help our clients to think through the pros and cons of each choice. Through this process, we may collectively uncover possibilities our clients had not thought of before. We might even go deeper than the surface level questions, challenging catastrophizing, black-and-white thinking, and other cognitive distortions. Perhaps we’ll find that the situation is not as bleak as it seems. If a client seems to be intellectualizing a choice, we might focus on expressing feelings and underlying needs. Contrary to popular belief, feelings and needs play an important role in decision-making and should not be ignored. Finally, we might explore how similar situations in the past are connected to the client’s emotions and beliefs about the current situation – or even confront the concepts of uncertainty and control more abstractly. 

We therapists are certainly flattered that our clients think our opinions are worth seeking on-high stakes decisions. But we also care about our clients enough to not tell them what to do. What we can do – and what is ultimately far more helpful – is  help them gain more insight into themselves. And this in itself is so powerful. Because when our clients know themselves better, they can make better-informed decisions that are aligned with their own goals, values, and beliefs.  

Book with Author Kaitlin Lowey: https://SouthTampaTherapyBOOKAPPT.as.me/KaitlinLowey

What is the difference between LMHC and MFT?

When it comes to seeking therapy, there are a variety of mental health professionals to choose from. Two common options are Licensed Mental Health Counselors (LMHCs) and Marriage and Family Therapists (MFTs). While both professions offer valuable support to individuals and families, there are some important differences to consider. In this blog post, we'll explore the difference between licensed mental health counselors and marriage and family therapists.

Elizabeth Mahaney, MA, LMHC, MFT, LPC, LCPC, CCTP, NCC, DCC, Ph.D has a MA in both mental health counseling and marriage and family therapy with specialized training in communication, trauma and many certifications. Here is why this is important:

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Licensed Mental Health Counselors (LMHCs)

LMHCs are mental health professionals who provide counseling services to individuals, couples, and families. They are trained to diagnose and treat a variety of mental health issues, including depression, anxiety, and trauma. LMHCs use evidence-based therapies such as cognitive-behavioral therapy (CBT) and psychodynamic therapy to help clients work through their challenges.

LMHCs typically hold a Master's degree in counseling or a related field and are licensed by their state's licensing board. In order to become licensed, LMHCs must complete a certain number of supervised clinical hours and pass a licensing exam.

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Marriage and Family Therapists (MFTs)

MFTs are mental health professionals who specialize in working with couples and families. They are trained to address the unique challenges that arise in family systems, such as communication breakdowns and relationship conflicts. MFTs use a variety of therapeutic approaches, such as Emotionally Focused Therapy (EFT), Gottman Approach, and Internal Family Systems, to help families and couples improve their relationships.

MFTs typically hold a Master's degree in Marriage and Family Therapy and are licensed by their state's licensing board. In order to become licensed, MFTs must complete a certain number of supervised clinical hours and pass a licensing exam.

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Differences between LMHCs and MFTs

While both LMHCs and MFTs provide counseling services, there are some key differences between the two professions. The main difference lies in their areas of specialization. LMHCs are trained to address a wide range of mental health issues, while MFTs focus specifically on relationship and family dynamics.

Another difference is the types of clients they see. While LMHCs work with individuals, couples, and families, MFTs primarily work with couples and families. MFTs use a systemic approach, meaning they view individuals within the context of their family and larger social systems.

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Which one is right for you?

The decision between seeing an LMHC or an MFT ultimately depends on your individual needs. If you are struggling with a specific mental health issue, an LMHC may be a better fit. If you are experiencing challenges within your relationships or family system, an MFT may be a better choice.

It's important to do your research and choose a therapist who is licensed and trained in the areas that are most relevant to your needs. Additionally, it's always a good idea to schedule an initial consultation with a therapist to get a sense of their approach and determine if they are a good fit for you.

Author: Crystin Nichols
Book Appointment: https://SouthTampaTherapyBOOKAPPT.as.me/CrystinNicholsMFTI

Book with Dr. Liz: https://southtampacounselor.com/bookappointment

Can Gottman Couples Therapy Help Your Relationship Improve?

If you are facing relationship struggles, Gottman Couples Therapy can provide you and your partner with the support you need to work through your problems. This approach to couple’s therapy is based on over 40 years of research conducted by Dr. John Gottman and his wife Dr. Julie Gottman.

The main goal of Gottman Couples Therapy is to help couples strengthen their relationships by improving communication, enhancing love, and building trust. The therapy process focuses on evidence-based interventions that have been shown to be effective in strengthening relationships.

One of the key elements of this therapy is the concept of “The Four Horsemen of the Apocalypse” which refers to four negative communication patterns: criticism, contempt, defensiveness, and stonewalling. These patterns can be some of the most significant predictors of relationship breakdown. During the therapy sessions, the couples learn to recognize and avoid these patterns, which helps them to communicate more effectively.

Another essential component of Gottman Couples Therapy is the “Love Maps” exercise. This exercise involves creating a detailed understanding of each other’s inner worlds, including dreams, hopes, and fears. By building these Love Maps, couples can stay connected and understand each other better.

In addition, Gottman Couples Therapy helps couples to develop conflict management skills. During the therapy sessions, couples learn how to navigate argument and disagreements by expressing their own needs while also listening to their partner's feelings and concerns.

Gottman Couples Therapy also emphasizes the importance of reinforcing positive behavior. Couples are encouraged to express appreciation, admiration, and affection towards one another regularly. This allows the couple to build and maintain a strong foundation of love and positivity.

Overall, Gottman Couples Therapy is an evidence-based approach to counseling that can help couples work through various relationship challenges. By focusing on improved communication, increased trust, and building stronger emotional connections, couples can learn ways to enhance their relationship and increase their overall happiness.

Couples Counseling South Tampa: Couples Reveal What They Have Learned In Therapy

As a marriage and family therapist in Tampa, Florida, I have received feedback from several different clients. I combine some of the most powerful approaches utilizing Internal Family Systems, Compassionate Communication and Non-Violent Communication, The Gottman Method, Emotion Focused Therapy, Holistic Psychology, CBT, and DBT.

Here are the 10 best lessons couples learned from therapy.

1. Go to therapy sooner rather than later.

   It is best to go to a counselor before sh*t hits the fan. This way, you can start to develop conflict resolution and communication skills before resentment builds. Establishing a therapeutic relationship with a counselor early on can be beneficial when and if you find yourselves in a rut. Having an unbiased and supportive counselor can help you and your partner maintain a healthy relationship when and if you need support along your relationship journey.

2. You are on the same team.

   There is no winning and you don’t need to fight against each other. Therapy is a great tool and safe space to really work through things together. Meeting both of our needs, growing, and thriving together is the goal. We often ask ourselves, are you trying to listen to understand or are you trying to be right?

3. Play and have fun together.

   Unstructured quality time to just be living purely in the moment increases connection, creativity, and releases negativity. A couple that plays together stays together!

4. Unfinished business of childhood can show up in adulthood.

   Continuing to work on intrinsic positive change is a lifelong learning process. Insight and empathy can help partners understand conflict in a whole new light. When we create an awareness of patterns and habits we are able to create awareness regarding intentional choices in real time. If we are not aware, we keep reacting. Responding intentionally knowing what is happening is being awake to our inner experiences. Self-witnessing is a tremendous tool that can be used in so many facets of our lives. Practicing compassion for our partner's story, and becoming more empathetic to each other, we could actually help our partner heal from their painful childhood experiences.

5. It is not about changing the issue, it is about understanding.

   We have learned so much about communication and the ways to really listen to understand one another. Most people listen to try to change the other person’s perspective. When we get into trying to change the other person, defensiveness comes into the game. When defensiveness shows up, it creates disconnect. Communication either connects us and helps us get needs met or it disconnects us and sabotages our needs. We feel all sorts of negative feelings when our needs are not being met. However, we are in homeostasis when our needs are met and feel positive emotions. Our feelings are always signals to pay attention to which provide data about whether our needs are being met or not. When we know what we need, we are in a powerful position to get the needs met intentionally. When we do not know what we need, we will probably be in autopilot, reactionary-mode. Tune into your inner worlds so that you can understand yourself. When we understand, we can communicate honestly about what is happening internally.

6. Our thoughts are the root cause of anger.

   Anger masks more vulnerable feelings like hurt, disappointment, and sadness. It's helpful when both partners understand that the words or behavior hurts their partner, even when their partner tends to react with anger or stonewalling. Therapy can help couples connect — which includes learning how to get calmer and go slower rather than to lay out their arguments about who's "right".

7. Hear your partner out before letting emotions get in the way.

   Getting guidance from a therapist around how to listen to each other without being emotionally charged about the topic can help couples stay engaged in the conversation, to accept influence from one another, and compromise based on needs. This is huge! We can stay curious about what is actually happening in the moment. When our partners feel heard and understood, they are in a better position to hear us too. Listen to each other without reacting! This sounds so simple but bad habits can be hard to break and its beneficial to have a therapist as a sounding board to make neutral observations.

8. Conflict is normal, you will have different perspectives at times, and disagreements are inevitable in every relationship.

   There will be different stages throughout life and couples will never stop getting to know one another. The most important thing is that you listen, respect, and acknowledge each other's viewpoints. Many times, people listen to respond and not to understand — which is one of the biggest reasons why many relationships fail. Attending couples therapy, can help partners communicate feelings, emotions, and concerns more effectively. Counseling equips couples with valuable skills that will be instrumental throughout their lifetime and once they become parents.

9. Marriage therapy taught us how to communicate about our needs and desires without hurting the other person.

   When we are emotionally and intimately disconnected, it is challenging to help each other to feel heard and understood. The way we deal with conflict is directly correlated to intimacy. Change the way we fight, change the way we love. When we trust each other more and give each other the benefit of the doubt, we're less hurt when the other person isn't in the same place as us in the moment, We may still have issues and hurt feelings from time to time, but we're better equipped to handle those problems when they come up.

10. Psycho-education and therapy helped couples identify patterns.

    One partner was pretty direct and the other partner tended to be more thoughtful in the way he delivered information. One partner said the thing that stuck with her the most was that the therapist was able to reframe and articulate her partner's concerns in a way that he couldn't — which then helped her to understand him better. Therapy can help couples become aware of how reactions to difficult situations can be unhelpful. Attempting to respond in a way that is more productive for the relationship can feel very different. Psycho-education can be of tremendous value when co-morbidity plays a role in relationships. Trauma informed therapy can help partners empathize, respond to each others needs, and heal together. It is advantageous to the relationship when partners learn about mental health together.

To learn more about how therapy can help you, please text or call Dr. Mahaney directly 813-240-3237 or book an initial consultation: www.SouthTampaCounselor.com/BookAppointment

How to Find the Best Therapist in Tampa (or the Best Virtual Online Therapist in Florida) for YOU

Tips for Finding the Best Counselor in Tampa, Florida

If you’re considering therapy — whether it’s to restore a relationship, recover from a trauma, adjust to a new life phase, or improve your mental health — finding the best counselor for you is the first hurdle to cross.

Researchers have found that the bond between you and your therapist is likely to have a big impact on your growth. That’s why it’s important to do your research, ask questions, and pay attention to your own responses in your search for the therapist that’s right for you.

You may do a search by typing in any of the below examples based on your specific needs:

“best therapist Tampa” “best counselor tampa” “best online counselor in Florida” “top rated marriage counselor in Tampa” “best marriage therapist in Tampa” “best online couples counselor in Florida”

How do YOU decide who the best psychotherapist, counselor, or psychologist is for YOU when this is very SUBJECTIVE?

It is important to do your research and trust your gut!

Here are some other tried-and-true methods for finding a therapist to help you reach your therapeutic goals.

1. Consult a provider directory 

If you plan to pay for therapy through your insurance plan, your first step might be to look through your plan’s provider network.

It’s also a good idea to find out whether your plan limits the number of sessions you can attend each year and whether using an out-of-network therapist will affect your out-of-pocket costs.

Insurance Provider Directory, www.Psychologytoday.com , www.therapyden.com , www.goodtherapy.org

2. Ask someone you trust

Ask for a recommendation from a friend, colleague, or doctor you trust to find a therapist who might be a good fit for you.

A referral is a good place to start. it’s important to realize that you may have different needs and goals for your therapy than the person giving you the referral.

So, “the best counselor” for one of you might not be as beneficial to the other.

3. Use reliable national online databases 

There are quite a few mental health organizations that maintain up-to-date, searchable databases of licensed therapists.

Your search could start by ZIP code, city, state, specific specialities, and so on including:

• American Psychological Association

• American Association of Marriage and Family Therapists

• Association of LGBTQ+ Psychiatrists

• Gottman Referral Network

4. Explore local resources

Your community may also have resources for example:

Students (all ages), your school may provide access to a counseling center.

Employees, your human resources team might offer a list of therapists through a workplace or employee assistance program.

Local advocacy organizations are available through 211

5. Reach out to organizations that address your area of concern

If you’re looking for a therapist to help with a specific mental health issue, you might find local therapists through a national association, network, or helpline:

• National Eating Disorders Association

• Anxiety and Depression Association of America

• National Center for PTSD

If your job is a source of stress and anxiety, you might find local therapists through a professional organization.

Many trade unions have resources to assist with mental health needs:  

International Association of Firefighters offers help with mental health, PTSD, and substance abuse.

Resources for people of color

Access to culture-conscious therapists and best practices for your well-being. Here are some resources to consider when looking for a therapist:

• The Yellow Couch Collective, an online support group for Black women

• Therapy for Black Girls

• Black Mental Health Alliance

• The National Asian American Pacific Islander Mental Health Association

• WeRNative

• Nina Pop Mental Health Recovery Fund and Tony McDade Mental Health Recovery Fund, a group that offers therapy sessions to help Black transgender people

• Therapy for Latinx

6. Think about your goals

What do you want to accomplish in therapy? 

Are you looking for a specific treatment approaches?

Your goals may change as you work with a therapist. It’s okay to change the direction of your treatment plan as your needs evolve.

7. Online therapy

Online counseling helps you explore convenient and effective ways to implement therapy in your busy schedule.

8. Ask lots of questions

When you meet your therapist, whether it’s online, on the phone, or in person, ask lots of questions and get a feel for whether a therapist is “the best therapist” for YOU!!

Jot down questions as they come up for you.

The American Psychological Association suggests a few questions for you to consider asking your therapist during your first session:

• Are you a licensed in this state?

• How many years have you been in practice?

• How much experience do you have?

• What do you consider to be your specialty or expertise?

• What kinds of treatments have you found that are effective?

• What insurance do you accept?

• Will I need to pay you directly and then seek reimbursement from my insurance company, or do you bill the insurance company?

• Are you part of my insurance network?

9. Pay close attention to your “gut” to find your “best therapist near me”

No matter how many professional accreditations your therapist has, your own feelings of trust and comfort should be your top priority. Will therapy be uncomfortable from time to time? Possibly. After all, you’ll likely be discussing difficult, personal topics.

But if you feel uncomfortable with your therapist for any other reason, it’s all right to look for someone else.

You don’t need a reason to switch therapists. It’s enough that you don’t feel comfortable.

Here are a few things to notice as you talk with your therapist:

• Does the therapist interrupt you, or do they listen carefully to what you’re saying?

• How does your body feel during a therapy session? Do you feel tense?

• Does the therapist respect your time?

• Does the therapist brush off or invalidate your concerns?

• Do you feel seen, heard, and respected during your session?

The bottom line

Whether you’re coping with grief, trauma, or relationship issues, or want treatment for a mental illness, finding a helpful, and the best therapist for you can make a big difference in your journey.

To find a therapist who’s a good fit, start by considering practical matters like licensure, insurance coverage, location, and specialties.

You may find that friends, colleagues, and your healthcare providers are a good source of referrals. You may also find options by using search tools provided by organizations that address your specific concerns.

When you’ve narrowed down your choices, you may find it helpful to think about your goals and questions, so you can be sure you and your therapist are well matched and aligned on your treatment plan.

Ultimately, finding the “BEST” therapist is a SUBJECTIVE personal matter. Human connection is at the heart of effective therapy, and you can build that sense of connection in person, on the phone, or online.

WISHING YOU THE VERY BEST! If you reach out to me and make an appointment, if for ANY reason, we are not a good fit, I will do my very best to find the “best therapist” for YOU!!!

Liz

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