Find out how to approach that first consult and how therapists think about privacy.
Anyone who’s never experienced therapy probably has lots of questions about who the process is meant for and what it’s actually like. If you ask licensed therapist Kier Gaines, the answer to the first question is that it’s for everybody, and the answer to the second is that it’s like an oil change for your mental health.
“If I waited until my engine started grinding before I got an oil change, I’d have a big problem,” Gaines says. “One thing I wish people knew about therapy is that you don’t have to wait until you’re in crisis to go.”
In addition to his work as a therapist, Gaines is a husband and father who documents his beautiful family on his YouTube and Instagram accounts, and between the moving personal moments, he also spills eye-opening wisdom about what makes us tick. He’s a big believer in the idea that we’re all better off when we understand our feelings, what’s behind them, and how we can calibrate them, so in honor of Mental Health Awareness Month, we went deep with Gaines about what anyone who’s thinking about trying therapy should be aware of before getting started.
The first thing he wants you to know: There’s absolutely zero shame in seeing a therapist. It doesn’t mean you’re “broken” or “not strong enough” to deal with your problems. In fact, your mental health is one of those things that practically calls out for professional help.
“If you got $2 billion tomorrow and didn’t go and get a financial advisor, I’d be worried about you. If you found out you had stage 4 cancer tomorrow and you didn’t get an oncologist, I’d be worried about you,” Gaines explains. “And if you live life and deal with other people and have a job, and all these things are pulling you in a million directions, and you don’t have someone to help you offload and deconstruct what’s going on, I’d be a little concerned.”
We asked Gaines to share everything you should know before starting therapy so that you’re set up for success, and as you’ll see, kicking things off doesn’t have to be the daunting prospect you might be imagining.
What questions should I ask while picking a therapist?
Finding the right therapist for you is a deeply personal endeavor. Part of it is about their approach, part of it is about what you’re trying to work on, and there’s also the abstract question of who you “click” with best.
Once you’ve researched professionals in your area (or beyond, now that virtual therapy has become so commonplace), you’d schedule an introductory consult. During that conversation, you will explain what you’re looking for and should ask about how they will approach helping you.
“One of the most important questions to ask a potential therapist is what their specialty is in therapy,” Gaines says. “We have a really specific language. Sometimes our answer is cognitive behavioral therapy or dialectical behavior therapy or maybe motivational interviewing. And you’ll probably just blink at me because you have no idea what any of that means. So it’s twofold: One is asking the therapist what their specialty is, and one is being unafraid to say, ‘I don’t know what that means. Can you please explain it to me?’”
To make that a little more concrete, Gaines says he often works in cognitive behavioral therapy, or CBT, which examines a person’s feelings to assess whether they’re rooted in a “cognitive distortion” that affects the way they interpret events. One example is the “fortune-teller,” or a person who jumps to conclusions about what they assume will happen before they’ve gathered all the facts of a situation.
“Someone might say, ‘I’m not even going to start this class because I’m not good at reading, and if I’m not good at reading I’m going to fail, and if I fail I’m going to feel bad, so why even start?’” Gaines says. “CBT stops you right there: Wait a minute, I think you might be fortune-telling right now. What makes you think you won’t be good at this class? It makes you interrogate that thought, then we go through each of those individual fears and break them down.”
These kinds of discussions with your potential therapist will illuminate not only their high-level plan for your treatment but also help you to get a feel for what kind of person they are and whether your personalities are aligned.
What agreements can I expect with my therapist about privacy?
“One thing that I do to set the tone for new clients is establish what’s called a therapeutic alliance,” Gaines says. “I am bound to not share your secrets, not share your life story, and not share the things that we talk about.”
There are a few exceptions, which include if you’re in danger of harming yourself or someone else, or if your therapist was subpoenaed by a court. But other than those special cases, you can be confident that everything you say to your therapist is solely between the two of you, providing an open forum for the kind of honesty you can’t usually engage in with the people in your everyday life.
But that doesn’t mean your therapist will immediately ask for your deepest, darkest secrets.
“When you come in, it doesn’t start as some hardcore questioning. It’s not an interrogation,” Gaines says. “It’s just a conversation between you and another person, and you’re free to share whatever you want. If you’re not comfortable enough with me yet to dive deep, that’s OK. I haven’t earned that from you yet. But over time, we’ll build trust and a rapport where you won’t think about what you say because it’ll be less important for you to hold onto those things and more important for you to release them and share them.”
Should I search for a therapist who looks like me?
Depending on your race, gender, sexuality, or another quality that defines who you are, you may be wondering whether you need a therapist who shares that identity in order for them to truly understand you. Gaines says he’s of two minds about the question.
“There’s an overwhelming amount of research that shows it doesn’t matter what the racial lived experience of your therapist is. What matters is how much cultural competency that person has, how much they understand the nuances of your unique culture, and what your values are versus their own,” he explains. “But on the other hand, there are people all over our society who are severely marginalized. I haven’t met a Black man yet who isn’t looking for a therapist who’s another Black man, and that says something about the level of relatability and not having to explain very specific cultural experiences.”
Ultimately, Gaines is confident that it’s possible to get the help you need from someone with whom you have nothing in common, and he’s had that experience personally.
“The best therapist I ever had was a 64-year-old Jewish grandma,” says Gaines. “She had this fearlessness to ask me really uncomfortable questions. It was her candor and her unique experience in the field. Maybe some of it was her life and what she’s gone through as a mother and a wife. Maybe it was just her personality. Maybe it was an amalgamation of all those things. I don’t know, but she was great, and she helped me through a really tough time.”
How quickly will I know if it’s the right fit?
“You really have to understand that therapists are like any other profession,” Gaines says. “A doctor can be amazing, he or she can diagnose your illness in a matter of seconds, and that’s tremendous, but if they don’t have the bedside manner that works for your personality, it’s not going to be a good match.”
While finding that perfect fit is important, it’s also essential to allow time for finding a rhythm. Unless you spot a dealbreaker right off the bat, you owe it to yourself and your therapist to feel things out and see how the relationship evolves as you settle in. That doesn’t mean sticking with something that’s clearly not working, but it does mean committing to the hope that the therapist you choose will work once you get to know one another.
“My golden rule is about four months,” Gaines says. “I give a therapist four months, and if I feel like it’s not working, then I try to find a relationship that does.”
How long should I expect therapy to last?
You definitely won’t be “cured” of any problems with just a few sessions, but eventually, you may reach a point when you’ve made enough demonstrable progress that you and your therapist mutually agree the work has come to a conclusion. How long it takes to get there varies widely.
“Therapy isn’t supposed to last forever. There is a point when it stops,” Gaines says. “It could be 12 weeks. It could be six months. It could be a year. It just depends on what you’re going in for.”
Deciding when your treatment has reached a natural endpoint is something you’ll rely on your therapist to help with. While you may not be able to solve every single problem that’s plaguing you, a professional can assess when you’ve developed the tools to regulate your emotions on your own, without requiring their help on a regular basis.
“Once we come to the conclusion of one particular issue that we were working with, you find a healthy way to cope,” Gaines says. “It doesn’t stop being an issue in your life, but you’re able to deal with it in a way that’s far more beneficial to your long-term mental and emotional health.”
