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10 Things Your Therapist Wishes You Knew, But Might Be Too Embarrassed To Tell You

Disclaimer: As with any blog, this is written with my own personal biases. In no way do I wish to imply that I speak for all therapists out there. We are all different, all unique, and we all value different things within our practice. Most of this list is comprised of my own experiences as well as many of my colleagues who have expressed similar ideals, but overall I hope you take away my own longing for YOU to be happy with your therapeutic services!

1. Sessions are 50 Minutes long.

We aren’t stiffing you 10 minutes, I promise! At the start of your therapeutic relationship, you knew sessions were not the full hour. You read it online, you signed paperwork that confirmed it, and likely your therapist explained it to you verbally…but then you forgot. And that’s ok! Likely, your first few sessions may have run longer, and that set a precedent. However, that space between clients is really necessary for us as therapists. We aren’t just eating snacks and skimming Facebook during our ten minute reprieve. We need that time to write notes, make phone calls on your behalf, and most importantly take a breath. We are likely carrying some pretty heavy stuff from your session, and we don’t want to place that weight on our next client, just as we didn’t carry the weight of our prior session into our time together. And ok, ok…I may have lied a little earlier. Sometimes we eat snacks.

2. Avoid bringing things into your session that may be audibly distracting.

Remember that kid in high school who clicked his pen the whole hour during a test? He didn’t even realize he was doing it, but he was concentrating and focused and just click click clicking? Don’t be that guy. Avoid bringing things that stimulate nervous habits into the office, because it’s likely you’ll subconsciously fidget, distracting your therapist, while simultaneously becoming less engaged yourself. Some common culprits include coats with snaps, click-top water bottles, those green Starbucks splash sticks, bangle bracelets, and purse clips. The list goes on and on, but do you notice something? These are not abnormal things. They aren’t drum sets and tambourines, but if you find you like to make music with everyday items, it might be best to keep those things in the waiting room.

3. And while we are on the subject, turn off your phone if possible. This is also a fidget item, FOR SURE—but it deserves it’s own category. I’m a mother, and I completely understand if you are a parent and need to leave your phone on. However, is there a chance during your session someone else could be on-call for 50 minutes? It doesn’t bother me in the slightest if your phone rings and your daughter needs to know where her coat is, but the question is…does it bother you? I would love for you to take advantage of your entire session, and really invest in yourself. Maybe ask a friend or grandparent to be on-call for your teen children—they’ll survive. I can almost guarantee it. And if you have little ones at home, explain to your babysitter that you’d love for calls to be limited to emergencies for the hour. If you are bringing your teen to therapy, remind them to be respectful, but if you wind up with a therapist like myself—I am happy to tell them to “put that nonsense away for 50 minutes,” and they often giggle and totally understand. Please…if you have a child under the age of 12 with a phone, take it from them before they enter the office. I can’t tell you how many Musically shows I’ve had to put an end to.

4. Snacks might be better for another time.

Again, this is all about YOU. Your therapist wants you to feel fully engaged, completely present, and able to really focus. If you’re trying to tell us about the recent death of your brother, while simultaneously eating a peanut butter and jelly sandwich, it’s hard to know you’re getting the most out of your session. It would be much better to delay your session a few minutes, so you can eat in peace in the waiting room. I know I’m more than happy to start at 5 after the hour, if it means you have a fully belly and full focus! Trust me, you’ll never meet a therapist who understands the dire need for a peanut butter and jelly sandwich more than me.

5. I don’t take insurance for about a million reasons.

I’ve recently gotten some pretty blip emails from potential clients really upset that I don’t take insurance, stating they’re finding it really hard to find a therapist that’s a good fit that DOES take insurance. Here’s the deal. I started out taking insurance. So I don’t necessarily buy into the “therapists that take insurance aren’t as good as the ones that don’t” argument. Wouldn’t that just be dissing myself from a few years ago? However, when you see a therapist who takes insurance, you likely aren’t aware that your information is at risk of becoming anything but confidential. Your insurance company can call and request your notes anytime they please—and the clinician has to oblige or risk not getting paid for those sessions in which they are requested. Also, if you go through insurance, therapists must diagnose you with a disorder immediately after that first session…or again, no payment. It’s a rushed decision and most often, you’re given an inaccurate diagnosis. And if a therapist has a minor for a client and wants to meet with the parents first (this is pretty typical), then there needs to be a diagnosis assigned to that child after that session, even if the child wasn’t present! I’m sorry, but what? How is that okay? That diagnosis will follow their medical record. And that might not really matter…until it does. I felt like that was pretty unethical in nature, and not something I could stand by. Also, many insurances don’t cover couples and family therapy, but it’s pretty common practice to just bill under one of the family members in order to receive payment. It’s a way around the system…and technically it’s insurance fraud. Do I blame therapists that do accept insurance? Absolutely not! There is a massive need for therapists that do, and that’s unfortunately the nature of the insurance-game. However, it’s a game I am not willing to play anymore. If you’ve found a therapist you think you’d click with, consider ways to make the investment workable. Maybe use it as a really good excuse to stop smoking or one more reason to start making coffee at home. It will be worth it if you’ve found the right fit!

6. Referral boundaries exist on YOUR end too.

We are honored you love us enough to refer your sister to us, but if you have spent 80% of your own session times complaining about what a horrible human ass-hat she is—it will be very difficult to form an unbiased therapeutic relationship with her. Don’t take offense to our rejection of service in that regard. We love your referrals and they mean the world to us. However, we also know our limits. You are the client first and foremost, and that is our primary focus. If you’d like to refer that super sweet friend who you met at a coffee shop who randomly mentioned needs a therapist, or her adorable little daughter who has anxiety? Sold. I have an opening at noon.

7. We want you to love our office!

Just like the shampoo girl at the salon, your therapist wants to know, how’s the temperature? Too hot? Too cold? We work hard to make our space comfortable for you-it’s important to us, so if something bothers you (lighting too low, sound machine too loud, etc), please speak up! We will be happy to make adjustments and ensure a comfortable space for you to relax and fully immerse yourself in the therapeutic process.

8. We worry too…

It might not be within ethical standards to tell you we love you, but we totally do! So, if you decide to take a break from therapy, or if you’re sick for weeks and can’t keep up with the routine of your appointments, just shoot your therapist an email—or we will assume you hate us…or you’re dead.

9. If you aren’t happy with your treatment, we want to know!

New goal? Unhappy with the amount of homework or lack thereof? Wish we discussed your childhood more? Want to tell us about your ex? Need more tips to help with a current issue? Tell us! Let’s work on it together! You will not hurt your therapists feelings by mentioning some redirection—it’s important that we are on the same page!

10. We aren’t the only ones in charge of termination.

If you feel another therapist might suit you better, we will NOT take offense. It’s our job to help you, even if that means a referral to someone other than ourselves. Ultimately your success in therapy is our goal, and we should be more than happy to help you find the perfect fit!

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