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Going to a counselor for the first time, not sure how to prepare


Rihannon

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I need some help and I don't know who to talk to. So I made an appointment with a licensed professional counselor. This is in about a week. I'm not sure how to prepare. I can have up to 8 sessions with her. I want to make the most of them and communicate clearly. I've never talked to a counselor before. Any advice?

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I am not sure you can prepare for a counselor.

 

I went to see a counselor. At the time I was just not coping with everything going on in my life. Different counselors have different schools of thought. The one I went to subscribed to the Bowen Family Therapy. She believed that we learn about relationships from our original family. Some of it made sense. Other parts of it didn't fit my reality. I took the things that helped and discarded the bits that didn't.

 

Perhaps you have different issues. Just talk about the thing that is bothering you and the rest will follow. Hopefully the counselor has the knowledge and skill to guide the conversation

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Where you only have 8 sessions, you want to go in knowing what you want to talk about and what you want to work on. For example, on ENA, someone will write in and say everything is fine except for one little thing, but by the time the thread is finished, you find out that they have a totally different problem that they've been suppressing or thinking was their fault when it was somebody else's fault. And therapists will tell you it takes a while to get to know someone and to find out what their problem really is. Then there's the problem of a therapist concentrating on the wrong thing and giving the wrong advice. If you go to a marriage counselor, for example, they might only see problems regarding your marriage and not see your real problem is with your mother, or something totally different.

 

If you want to run things through with us on ENA, we might be able to come up with suggestions on what to talk about or at least give you something to think about.

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I would tell the therapist your concerns that you are not sure how to communicate in a way that will get to the root of it. Ask her what would work for her. I wouldn't go in with too many preconceived notions. Also treat it like when you see your primary care physician who likely is in a rush -have a bullet point list of the main things that hurt/make you uncomfortable, etc.

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Your first appointment is called an assessment. This is where the counselor learns about you and forms some options for you to select as your treatment plan. Some counselors are more passive and are driven by you, but if this makes you uncomfortable, ask if she or he has a standardized assessment that you both can work from.

 

Familiarize yourself with your 'notes' feature on your phone, or keep a cheap spiral notebook handy to jot down your thoughts and ideas throughout the week. Then before your session, make a short bullet list of your key concerns--then narrow that down to 2 or 3 topics you'll want to address first.

 

Don't hold the number of sessions over your own head, because feeling rushed can stunt your ability to draw on free-flowing thoughts. Consider these 8 sessions as your starting point, and discuss with the counselor whether she or he can work something out with you to continue your work if you both believe it would be beneficial to you.

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I hate our health care system and I'll assume that's why you only have 8 sessions.

 

Write things down and pair it down the most important issues. I get why you are asking. I'd feel uneasy knowing that I probably so much to say and only 8 sessions to say it in.

 

Good luck!

 

i went for free counseling at a women's shelter and i would say 8 weeks made a huge impact - in fact i think i only went for 6. I think its enough to give you some good tools and they can direct you to other things that might help you. If you tend to think around and around in circles - the therapist might help you focus. Decide what the biggest obstacle for you is? Is it the need to control? do you want to get along better with people at work? What about what happened with your husband (the fact that you lost his trust with all the fake reviews, etc, and your need to mother him?) whatever it is, that is impacting your life the most - start with that.

 

Welll-- if someone is diagnosed with something, there is more coverage. If someone wants talk therapy to talk through their relationships, paying for 8 weeks is generous -- i don't think its bad that someone should have some skin in the game.

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I made a list of disorganized but specific issues, fears, and feelings focused on my marriage and my general feelings about the emptiness and meaninglessness of my life, and my feelings of failure and isolation.

 

I think that my threads in this community have not accurately reflected my reality to those who responded. I can see how certain words or explanations I used, focusing on events and actions, led to the deeper issues being skewed, with people focusing on my alleged "mothering" of him which isn't quite accurate. Or at least, it's not that simple.

Although the threads did help me see the more complex, long-term, bigger picture of my situation, I don't want that whole misplaced emphasis to happen again with the counselor, so I think instead I was going to start with my worries and fears etc. instead of "this happened and that happened" as if those single events are the sources of the problems instead of results or consequences of the underlying problems, which they are.

 

I am looking for guidance to help me work through this independently. So I'm hopeful that within 8 sessions she can give me some sort of tools, practices, things I can keep with me.

Going it alone, with no one I trust to talk to, I'm too subjective about it, always second guessing myself.

 

I wish I could talk to my family (my brothers and their wives, my parents, I have a favorite uncle) about it because they know me and love me. Maybe some day I can, but right now it's too many feelings, too overwhelming for those relationships.

 

I feel incredibly lucky, though, to have these free 8 sessions offered through my work. And I feel deeply fortunate that I have a family who is unconditionally loving and supportive and a source of strength and happiness, and a constant home. I know so many people for whom their families are just sources of stress or pain. I'm very lucky.

 

I was thinking about the meaninglessness of my life and I thought, in a few months it's going to be the holiday time and that's when a lot of people start to feel worse about their lives, and even more lonely and depressed than usual. So, knowing I feel like this now, I'm a bit scared about that coming up soon. I want to sort of be prepared, like putting snow tires on a car in preparation. I also thought about how it might help me to be there for someone else who feels worse and doesn't have that fortunate source of love in their family, like I do. But then, I may not be able to be strong enough to help someone else.

 

This particular counselor that I'm going to see, she has a brief bio on her profile that says that she often uses cognitive behavioral therapy and rational emotive behavioral therapy.

Does anyone have experience with those as specific therapeutic practices?

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It's a no bs approach that discourages ruminating, helplessness and help-rejecting complaining. It focuses on improving problems and approaches to them by re-framing cognitive distortions. She may also refer you for medical or psychiatric evaluation if there is underlying medically treatable issues that need to be addressed before any therapy works. Talking to disrupted neurochemistry doesn't work. The objective is to address current issues and find solutions.

she often uses cognitive behavioral therapy and rational emotive behavioral therapy.
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It's awesome that it's offered through work, but it also sucks that it's limited to 8 sessions. I would bring that list that you prepared to the first session, and then throughout the next 7 weeks update it with the events that are happening in your life. For example, if something triggers a feeling of failure, write it down and be prepared to talk about it. You may not get through everything on your list, or you may not get to the list at all during some sessions, but the list will help you keep focused over that short period of time. I did this the last time I went to therapy.

 

Also, your therapist is most likely not going to present you with a solution to your problems, although some may make suggestions. What I've always found most helpful in therapy is saying the things out loud for myself and another person to hear. Shining a light on things, so to speak.

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I don't want that whole misplaced emphasis to happen again with the counselor, so I think instead I was going to start with my worries and fears etc. instead of "this happened and that happened" as if those single events are the sources of the problems instead of results or consequences of the underlying problems, which they are.

 

The worries and fears are abstractions, while your experiences give specific context to those concerns that your therapist can actually use to help you. So you have a historical tool to use in your sessions that most people don't have. Memories alone can become distorted with time, while your threads have captured snapshots of your concrete perceptions at that moment. That's a gold mine!

 

You may want to consider installing EverNote or TreePad, which are note apps that allow you to move your notes around and group them according to topics and sub-topics. So you can go through your threads and copy some of your text from each into notes. You can reword those to more clearly emphasize whatever you believe people misunderstood. Over time you can re-title notes to better represent any topics as you see fit, and you can group those notes into root topics.

 

This isn't something to accomplish before your first session, but if you consider it part of your 'homework' to revisit and organize the experiences that concerned you enough to write about them, you'll have a notebook from which you can draw examples to discuss during your sessions when appropriate.

 

It may also be useful to copy into sub-notes some of the text from responses that stood out to you as either helpful or the opposite--responses you view as completely missing the mark. Quote that text, then respond to it with an answer you may want to discuss in a session. For instance, > "That's not accurate because..." or "That's an oversimplification because..."

 

You have an advantage because you've been doing a lot of work here in this forum regardless of how valuable you may have viewed it at the time, or even now. You've captured events and emotions. While it may feel dismal to revisit those, understand that therapy isn't like a spa session where we come out feeling fabulous--it can be a grind that stirs up lousy emotions for a while.

 

Just know that if you find yourself feeling worse instead of better for a time, that's not a bad thing. It means you're doing the work, and just as with house cleaning, often that work requires making a mess that you can address in a more thorough way than NOT disturbing the dirt. : )

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