Guest Writer Dan Esterly: Going to Counseling

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Counseling can be intimidating to a lot of people.  If you have never been to counseling before, you may not know what to expect and be nervous to be so vulnerable with someone who is practically a stranger.  We all know the stereotype of lying on a couch spilling your inner-most feelings while a doctor sits and nods silently.  While therapists want you to be comfortable, they also want to be engaging and helpful.

I would like to preface this by saying that seeking treatment is not a sign of weakness. If anything, it takes true courage to allow yourself to be vulnerable and open up to someone.  A common misconception is that it takes strength to keep your emotions bottled up, which is simply not true.  Secondly, you are not alone.  Millions of people go to see therapists every year.  Mental illness affects all ages, races, and genders.

The purpose of this article is to answer questions and dispel myths about counseling.  I hope this will help people learn what to expect and ease some of their worries about seeing someone. I have been to counseling for years and I also have a graduate degree in counseling. I have been on both sides of the “couch.”  It has made me a happy and successful person and I only want the same for others.

What is the first session like?

It’s normal to want to pour your heart out immediately when in crisis. The first session will be very casual- nothing to stress over! The therapist will want to get to know you a little- your family history, occupation, race, gender identity, religious beliefs, etc. All of this information helps the counselor get a picture of who you are. You will not have to go into major details during the first session.

Will they take my insurance?

Just like doctors in the medical field, different counselors cover different things and take different insurance plans. If you’re a student, many universities provide counseling for free on campus. However, the best way to find out is to call and ask if they take your plan. They will be able to tell you if it’s covered and if there is a co-pay. Normally there is a small co-pay for therapy, but some plans may cover it entirely. They may also offer a ‘sliding-scale’ and be able to negotiate prices if you are tight on money. This is definitely worth researching.

Is a counselor a doctor?

Counselors are typically masters-degree-level professionals. They cannot prescribe medication and do not go by “Doctor”. They typically have an MA, M.S., M.Ed., or MSW degree. For the purposes of this article I will not go into what all these letters mean, but each degree allows someone to obtain a license to practice as a therapist/counselor. However, each degree may differ a little in how they clinically view the client and what type of therapy they use. Masters-level therapists/counselors can diagnose mental health disorders, treat them through therapy, and bill insurance.

There are doctor-level therapists that go by “Psychologists”. Only doctor-level therapists can use the title “Dr.” or “Psychologist”. While these people have doctorate-level training, they also cannot prescribe medication. They can use assessments or tests to look at things like IQ, identify a diagnosis, or help assist you in a career path. Only “Psychiatrists” who hold a medical degree and license can prescribe medication.

Every therapist does things a little differently. Just like finding the right doctor or dentist, it may take a while to find the right therapist. It is important to find one that is a good fit so that you can build a healthy relationship and trust.

Can a counselor tell other people what I tell them?

The answer is mostly no (*with some exceptions.) All mental health professionals are bound to keeping what you discuss confidential. They could lose their license to practice if they share anything that you’ve shared with them. This creates a safe environment that helps people open up and feel safe. Their notes are kept to themselves and they are not allowed to share anything with anyone if you are an adult (over 18).

*The exceptions are if you are a current threat to yourself or others. If the therapist believes that you may harm yourself or harm someone else, they have a legal obligation to intervene. However, if you’ve hurt yourself or someone else in the past; they cannot report that because it is already done and there is no current threat.

What happens in therapy after the first-session?

After you’ve broken the ice and given your basic information, you will begin the process of addressing the issues. The therapist will never force you speak about a topic that you are not comfortable discussing. A good therapist will also not give advice. Contrary to what “Dr. Phil” may have you believe, therapy is not about someone telling you what to do. Therapists are there to help you find what you want and need, not what they want or need from you. It’s in this way that a therapist can help you find happiness. Think of them as someone with an unbiased, outsider perspective.  Friends and family may give advice based on their feelings about you, but a therapist will be in a position to provide more unbiased observations.

Each session

The frequency of sessions is entirely up to the patient. The therapist can suggest what they think would be good, but if you feel differently or can’t afford a weekly session, you have the right to tell them what you can do. It is always good practice to trust and follow the therapist’s input. However, do realize that you are the one making the decisions. The therapist may do exercises with you tailored to your life. They may just listen and allow you to talk about whatever is on your mind. They may ask questions to get a better understanding of the problem. They may make observations or give input on your behaviors. Therapy will go until you or the therapist feel that you no longer need it. Once you’ve decided to end treatment it’s best to give the therapist a heads up. They can use the remaining sessions to help you plan for the future and go over what you’ve learned.


I hope that in this article, I have dispelled some of the fear and stigma that is attached to going to therapy. It is important to find a therapist that you can build trust and feel comfortable talking to.  Do not be afraid to be vulnerable- your feelings will be safeguarded! A therapist’s job is to help make you feel better long-term.  The process will not happen overnight, but it is worth the wait to be able to live a happy and healthy life.