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Dr. Hannah Roberts · May 9, 2024 ·

Starting Therapy – How to Prepare

Learning to Thrive: A How-To Guide for Therapy

by Gavin Hannegan, Cal Poly, San Luis Obispo undergraduate intern, supervised by Dr. Hannah Roberts

Hello Thrivers! Welcome to the first installment of a three-part series called, “Learning to Thrive: A How-To Guide for Therapy.” This series will help you understand what to expect as you are starting therapy and continue through the end of your therapy journey. Over the past few months, we’ve explored how therapy can be an effective self-care tool no matter what your needs are. Now, let’s put those discussions into context.

Even if you feel ready, starting therapy can still feel daunting, especially for the first time. If you’re asking yourself, “Where do I even start?”, this guide is for you! Our goal is to alleviate any uncertainties you may have about the initial contact with your chosen therapist. Here are a few recommendations to help make this process feel comfortable and accessible.

Set Aside a Weekly Time for Therapy

It’s helpful if you have an idea of when you would be willing and able to meet with a therapist. Therapy sessions tend to last about 50 minutes, but you may need to factor in additional amounts of time for commuting to and from the therapist’s office, for example. Additionally, to be fully present, give yourself a few minutes before and after the session to center yourself, identify your goals for the session, and reflect on what was discussed. Your sessions should be a consistent part of your schedule, but it shouldn’t become a burden. Unfortunately, a perceived lack of time tends to be one of the largest barriers for mental health treatment among college students, especially those from ethnic or racial minority backgrounds (Miranda et al., 2015). The good news is that the format of therapy can be flexible to meet your needs. You can meet with your therapist virtually, meet with an on-campus professional, or schedule a nature therapy appointment to combine therapy with movement outdoors. Weekend sessions are also an option if you have a full workload during the week. An agreed time between you and your therapist is one of the first steps in starting therapy and crafting the therapeutic relationship.

Select a Therapist That You Will Feel Comfortable Working With

Therapy is a space that allows you to be vulnerable and open about yourself, so it is important that you find someone who is capable of holding space for you. Your therapist does not have to come from the same background as you, but they should have the experience necessary to make you feel affirmed, heard, and supported. One way to gauge if a therapist is right for you is to read their bios. Click the “Meet Us” section to learn more about the team behind Thrive. Psychology Today is a great resource for finding therapists in SLO county, virtually in California, and all across the country. These bios will contain the therapist’s specializations (eating disorders, LGBTQ+ care, etc.), the format of their sessions (in-person or virtual), the cost of each session and how to pay for it, and their contact information. Feel free to reach out to a therapist if you have specific questions about their style and practices. And don’t be afraid to advocate for yourself as you’re starting therapy. Therapy clients see the greatest improvements in their mental health when both the therapist and the client believe in the strength of their relationship (Zilcha-Mano et al., 2017). Choose a therapist that you would be comfortable working with in order to build this strong relationship.

Consider How You Might Pay for Your Sessions

A common challenge in starting therapy is concerns about the cost (Miranda et al., 2015). In a study of over 12,000 adults with a mental illness, over 70% cited financial concerns for their lack of treatment, particularly among those with no health insurance (Walker et al., 2015). In SLO, the cost of a session usually ranges from $150-$250, which is what you can expect with your Thrive therapist as well. While money can be a sensitive subject, remember that therapy can accommodate your needs. Attending therapy sessions from home can reduce transportation costs. When reading the bios of different therapists, identify a price range that would fit well within your budget. Psychology Today lists the different payment methods that therapists accept, such as credit cards, Venmo, and cash. Each bio also lists which insurance each therapist can take. Some therapists may offer a sliding scale depending on your income. Remember, if you have a PPO insurance, you may be able to get some reimbursement for your sessions. And finally, colleges and universities may offer free or reduced-cost therapy sessions with on-campus treatment centers – Cal Poly’s Graduate Students offer low-cost services for all (you do NOT need to be a student) at the SLO Counseling Service at Cal Poly. There are a variety of options to help you afford your therapy sessions. Build your therapy into your budget so it doesn’t feel overwhelming.

Remind Yourself That You’re Deserving of This Care

The stigma against mental health is rampant and pervasive. When we start to internalize these messages, we become less likely to seek help for ourselves (Schnyder et al., 2017). Instead of listening to problematic messaging in society, surround yourself with uplifting voices. Think about the goals you hope to achieve through therapy and let that motivate you. Practice some daily affirmations such as, “I am worthy,” “I feel inspired,” or “I want to grow.” Share your concerns with a friend who would be happy to support you in this journey. Be open about these insecurities with your therapist so that you two can identify and work towards a solution. It may take time to build your self-worth, but that’s part of what therapy is for!

Feeling ready for starting therapy? Next week, we will identify what this initial session may look like, and discuss strategies to help you adjust to this new environment. We’re so excited to see where therapy takes you!

Have more questions or feel ready to start therapy in California today? Schedule a session with one of our therapists! You can schedule online here!

We hope you enjoyed this blog post! Have more topics you’d like us to blog about? Contact us and we’ll be sure to include your topic in a future post.

References

Miranda, R., Soffer, A., Polanco-Roman, L., Wheeler, A., & Moore, A. (2015). Mental health treatment barriers among racial/ethnic minority versus white young adults 6 months after intake at a college counseling center. Journal of American College Health, 63(5), 291-298. https://doi.org/10.1080/07448481.2015.1015024

Schnyder, N., Panczak, R., Groth, N., & Schultze-Lutter, F. (2017). Association between mental health-related stigma and active help-seeking: systematic review and meta-analysis. The British Journal of Psychiatry, 210(4), 261-268. https://doi.org/10.1192/bjp.bp.116.189464

Walker, E. R., Cummings, J. R., Hockenberry, J. M., & Druss, B. G. (2015). Insurance status, use of mental health care in the United States. Psychiatric Services, 66(6), 578-584. https://doi.org/10.1176/appi.ps.201400248

Zilcha-Mano, S., Snyder, J., & Silberschatz, G. (2017). The effect of congruence in patient and therapist alliance on patient’s symptomatic levels. Psychotherapy Research, 27(3), 371-380. http://dx.doi.org/10.1080/10503307.2015.1126682

Dr. Hannah Roberts · March 1, 2024 ·

Queer-Affirming Therapy:

Finding a Safe Space

“It is absolutely imperative that every human being’s

freedom and human rights are respected,

all over the world.”

– Jóhanna Sigurðardóttir

by Gavin Hannegan, Cal Poly, San Luis Obispo undergraduate intern, supervised by Dr. Hannah Roberts

Therapy can be an incredibly rewarding experience, so it is important to find a therapist that you would feel comfortable with. For LGBTQ+ folk, it is even more important to find queer-affirming therapy. The therapist-client relationship can offer a safe space for you to be able to freely express yourself without judgment. The process of finding queer-affirming therapy can feel overwhelming. Some therapists explicitly state that they welcome people of all backgrounds, but other times, the cues can be a bit harder to read.

Here, I will be offering a few signs to look out for to help you determine if you would feel affirmed by your therapist. As you read, keep in mind that the process of building that trust with your therapist may take time. You might also respond differently to different therapists. There is no rush to feel comfortable right away!

Your Therapist Is Open to Learn

A common misconception is that an LGBTQ-affirming therapist has to also identify as LGBTQ, but there are plenty of straight or cisgendered therapists who can empathize with your experiences. One theme that emerged in interviews with SLO County residents who attended therapy is that positive experiences with therapists occurred when the therapist were willing to learn more about LGBTQ identities, regardless of if the therapist identified as LGBTQ or not (Bettergarcia et al., 2021). A therapist might ask you some questions about your identity to better understand your perspective. It is also okay for you to educate your therapist when the opportunity arises. Here are some examples:

“I actually go by this name, and I use these pronouns.”
“No, I haven’t really felt that way. I feel more like this…”
“That term is a little outdated, it’s more appropriate to say this…”

You are well within your right to correct your therapist and explain how that made you feel. However, it is not your job to teach your therapist everything about how to effectively work with the LGBTQ+ population; the therapist may need to do some homework and develop their knowledge outside of the session.

Your Therapist Actively Validates Your Identities

An active effort on the part of the therapist is key. In their research, Anzani et al. (2019)

distinguish between passive forms of affirmation towards trans people (i.e., not using microaggressions) and active forms of affirmation (i.e., encouraging gender exploration). While both forms can be helpful, Anzani et al. (2019) recommend that therapists strive to be actively affirming in order to help their clients navigate the cisnormativity that exists within society. Active validation looks like:

Your therapist connecting you to local groups and resources
Your therapist using the correct name and pronouns before, during, and after transitioning
Your therapist treating your identities as normal and authentic

In other words, an affirming therapist should do more than the bare minimum. When meeting with your therapist, you can ask them directly how they will actively validate your LGBTQ+ identities. If this feels too forward, you can also take note of how your therapist responds to LGBTQ+ issues. Do they simply acknowledge homophobia or transphobia or do they work with you to develop tactics to combat these prejudices?

Your Therapist Treats You As An Individual, Rather Than a Representative of Your Identity

The ways in which you experience your identities might not be the same ways that other queer folk experience their identities. If a therapist generalizes these experiences as representative of the broad LGBTQ+ community (i.e., “All gay people experience…”), then they might be missing some important details. For starters, the label of LGBTQ+ encompasses many different identities. In one survey, mental health clinicians reported that even though they might be affirming of lesbian, gay, and bisexual clients equally, they actually perceive themselves to be more competent when treating lesbian and gay clients compared to bisexual clients (Ebersole et al., 2018). Each of these distinct identities can bring unique experiences–on top of the unique experiences that each individual already has! Again, you are more than welcome to correct your therapist if they make a generalization, but don’t feel responsible for teaching your therapist about the diversity of LGBTQ+ identities. You might also encourage your therapist to adopt a multicultural approach and to consider the interplay of multiple identities. Keefe et al. (2023) found that racial and ethnic minorities who also identified as LGBQ responded best to mental health programs that emphasized the minority stress model, compared to those that did not implement this model. In other words, racial and ethnic minorities may be subject to discrimination based on race and discrimination based on LGBTQ+ status, so your therapist should account for each of these influences.

One last note: your reasons for attending therapy might not even be related to your gender or sexual identity. While affirming therapists should not outright ignore your identities, it may not be necessary for your therapist to always attribute certain topics to your gender identity or sexual orientation. These identities are just a few aspects of who you are. Remember that this is your journey, and you deserve to feel respected and affirmed in the ways that feel most comfortable to you.

Feel like you want your therapist to have more information? Here’s a blog post that features the same tips, but directed specifically towards those in the helping profession.

Have more questions or feel like you need queer-affirming therapy? Schedule a session with one of our therapists today! You can schedule online here!

We hope you enjoyed this blog post! Have more topics you’d like us to blog about? Contact us and we’ll be sure to include your topic in a future post!

References

Anzani, A., Morris, E. R., & Galupo, P. (2019). From absence of microaggressions to seeing authentic gender: Transgender clients’ experiences with microaffirmations in therapy. Journal of LGBT Issues in Counseling, 13(4), 258-275. https://doi.org/10.1080/15538605.2019.1662359

Bettergarcia, J., Wedell, E., Shrewsbury, A. M., & Thomson, B. R. (2021). “There’s a stopgap in the conversation”: LGBTQ+ mental health care and community connection in a semi-rural county. Journal of Gay & Lesbian Mental Health, 26(1), 48-75. https://doi.org/10.1080/19359705.2021.1900973

Ebersole, R. C., Dillon, F. R., & Eklund, A. C. (2018). Mental health clinicians’ perceived competence for affirmative practice with bisexual clients in comparison to lesbian and gay clients. Journal of Bisexuality, 18(2), 127-144. https://doi.org/10.1080/15299716.2018.1428711

Keefe, J. R., Rodriguez-Seijas, C., Jackson, S. D., Bränström R., Harkness, A., Safren, S. A., Hatzenbuehler, M. L., & Pachankis, J. E. (2023). Moderators of LGBQ-affirmative cognitive behavioral therapy: ESTEEM is especially effective among Black and Latino sexual minority men. Journal of Consulting and Clinical Psychology, 91(3), 150-164. https://doi.org/10.1037/ccp0000799

Dr. Hannah Roberts · February 1, 2018 ·

Beginning 2018: Updates from Thrive SLO

Checking In

Wow! It’s already February of 2018! How was your first month of the year? Did you try anything different? Any resolutions or intentions that you started the year with? How did it go? Now is a perfect time to step back and review your work of the past month to see what worked well and what you might want to readjust. We took a one-month media fast while we were hard at work behind the scenes (in both our personal lives, as well as as psychologists at Thrive). And it was the best thing we could have done! We are so excited for 2018 and we’re finally feeling ready to share a few updates with you! Here are a few things happening in 2018:

Our Space

We are loving our little office suite on Monterey and California! We can’t believe that we’ve already been there for 9 months and it is finally feeling like home. We couldn’t have a better neighbor than Juli at Savvi Spa and the space feels fresh and healing. Sometime soon we’ll have an open house so you all can stop by!

Types of Therapy and Coaching

You may not have realized, but we have some pretty unique ways that we support our clients. Not only do we offer traditional, one-on-one counseling in our lovely office (see above), but as psychologists, we also meet with counseling clients from all over California via secure, online video sessions, and we can coach virtually anyone anywhere in the world through that option. We also continue to offer nature therapy sessions throughout SLO County for a select number of clients.

Adding to Our Hours

We now have appointments available weekdays, weeknights, and weekends. Dr. Roberts and Dr. Park have each extended their hours for Thrive clients as the practice has grown and both have openings for a few new clients this month.

Adding to Our Team

We are thrilled to be bringing on Dr. Lisa Slover as a Psychological Assistant. Dr. Slover will be focusing on working with adolescents and their families, as well as with new moms, especially those experiencing postpartum anxiety and depression. You’ll be hearing more from her soon. While Dr. Slover is working toward her license as a psychologist, she will be supervised by Dr. Roberts and Dr. Park and will also be able to see clients at a reduced fee. Feel free to contact us if you would like to schedule now.

Adding to Our Services

All of our providers are now seeing adolescents (14 & up), college students, and adults. We work with men and women from all walks of life. We offer inclusive services with an emphasis on cultural humility and specialize in supporting members of the LGBTQ community and their families. We now offer one free session for trans individuals needing a support letter for gender affirming services, as we feel this is an important way to give back to our community.

Adding Online Scheduling

Ok, we’ll admit it: We’re Millennials (or Xennials…), so we prefer that scheduling be easy and streamlined for your lives and ours! We’ve now added the option for new and current clients to schedule appointments online. No more phone tag, where you call us and leave a message while we are in session, just so we end up calling you back while you are busy with your life! Although, we absolutely can still schedule the old-school way if that works better for you!

What’s Next?

We have all kinds of ideas cooking for online classes and support groups and local collaborations! We love how starting our own practice has allowed us to get as creative as we can to better support you! And we want to hear from you: How can we help you thrive in your own life? Is there something you’ve been looking for? Is there something we can offer? We’ll be doing some polling on our Instagram Stories over the next few weeks, but feel free to comment on this post or drop us a line and share your thoughts anytime!

Let’s make 2018 our year to thrive!!

Love,

Dr. Hannah & Dr. Sarah

Dr. Hannah Roberts · March 15, 2017 ·

Join us for a Community Hike at Montana de Oro State Park

At Thrive SLO, we try to be intentional about our own self care and we love fostering community with like minded individuals! We’re hoping to create quarterly community events, always free of charge, that allow you to better get to know us and deepen our sense of community in the San Luis Obispo area.

Let’s get together this Saturday for a gentle community hike at Point Buchon in Montaña de Oro! Open to all – no hiking experience necessary. Meet the founders of Thrive San Luis Obispo, psychologists Dr. Sarah Park and Dr. Hannah Roberts, and join our growing community of like-minded Thriving individuals. In celebration of the spring equinox, we’ll be informally chatting about starting fresh and, as always, we’ll be discussing other ways we hope to bring more holistic wellness and thriving to our daily lives.

When: This Saturday, March 18th at 10am.

Where: Point Buchon Trail, Montaña de Oro State Park. To get to the Point Buchon Trail: Take the road into Montaña de Oro State Park ( 3550 Pecho Valley Rd, Los Osos, CA 93402) as far as you can go – the road ends in a parking lot. Park there and meet us at the gate! For more info about the trail, visit: Diablo Canyon Trails

Can’t wait to see you!