FAQs for Those Feeling Anxious About Their First Therapy Session in the U.S.
Nari Yoo | Ph.D. Candidate at New York University
Navigating therapy in the U.S. can be challenging, but you’re not alone.
Here are the answers to some of the most frequently asked questions regarding therapy.
Are you an international student or first-generation immigrant in the U.S. thinking about seeking therapy/psychological counseling? Navigating mental health services in a foreign country can be challenging, but you're not alone. In this post, we'll answer common questions Korean international students or first-generation immigrants in the U.S. have about accessing therapy for the first time.
Q. Can international students use therapy services at US universities? How can they access these services?
A. Yes, most US universities offer tailored therapy programs for international students. You can find information on your school's website under the 'therapy support' page. If you need to talk to someone immediately, you can use the crisis support service. For a formal, longer session with a therapist, you can book an individual session. After an initial session with a school therapist, you can decide together if long-term therapy is needed or if a referral to an external agency is necessary.
Q. When is a good time to start therapy?
A. You can start therapy anytime you feel there's a significant issue with your mental health. However, you don't need to wait until you have a serious problem. If you're often stressed or experiencing mood swings, it's recommended to seek therapy. You can start with a personality assessment and start unpacking the things you've been struggling with.
Q. I'm uncomfortable with therapy in English. Can I receive therapy in Korean?
A. Yes, it's possible. You can find bilingual Korean-English therapists on therapist directories such as PsychologyToday or Zocdoc. You can ask in the first session if you can mix Korean and English. You might be able to receive therapy using a comfortable mix of both languages.
Thanks to a recent policy change called PSYPACT (Psychology Interjurisdictional Compact), clinical psychologists who are qualified in states that have enacted this legislation (such as Arizona, Washington DC, New Jersey, you can see the map here) can provide online therapy sessions in other participating states. This means that even if you currently reside in Ohio, you can receive therapy from a Korean psychologist located in Texas. If you specifically want to receive therapy in Korean but there are no Korean-speaking counselors in your state, you can check if your state participates in PSYPACT and inquire whether you can receive online therapy through PSYPACT from a psychologist in another state.
Q. I'm worried about effectively communicating in therapy since English isn't my first language.
A. Language barriers are a common challenge for many first-generation immigrants and international students in therapy. Don't worry. Be honest with your therapist about your language limitations and ask for clarification without any shame when you don't understand something. It's also okay to express words or sentences in Korean and then explain the meaning of them. For example, some words like Hwabyung, Hyo, and Nunchi don't translate 1:1 to English, so if you want to use them, you might want to say them in Korean first and then explain them.
Q. I'm concerned about therapy records. Will this negatively affect my future education or employment opportunities?
A. In the US, the use of mental health services is relatively less stigmatized compared to South Korea. Psychological counseling/Therapy itself doesn't result in medication prescriptions or create psychiatric treatment records. Receiving therapy won't disadvantage you. In fact, it might be seen as a sign of good self-management and self-awareness!
Q. I want to receive therapy, but I'm concerned about the cost. Are there affordable options?
A. Using your university's therapy center is often free or low-cost if you are a student. It's also good to ask therapists if they offer a sliding scale, which is a system where therapy fees are discounted based on income level. As students often have no income, therapists who use a sliding scale are likely to offer lower fees.
Q. How can I check if therapy is covered by my insurance?
A. You can get detailed guidance by directly contacting your therapist or insurance company. Be sure to check the coverage of your insurance network and reimbursement conditions. Please check out this article for more information on insurance coverage.
Q. I don't want my family or friends to know I'm receiving therapy. Is confidentiality guaranteed?
A. In the US, confidentiality between therapist and client is strictly protected by law. You can rest assured that therapy content won't be disclosed without your consent except for the cases such as court order or suspected child abuse.
Q. Which is more effective, online therapy or in-person therapy?
A. The effectiveness of therapy depends more on the rapport with the therapist and the content of the sessions. Choose the method that you're more comfortable with and can participate in the sessions in the long term. You could start with an online session and then visit the therapist's office for in-person sessions if you prefer. If school, childcare, work, or other commitments make it difficult to set aside time for in-person therapy, I encourage you to consider starting online. Since the COVID-19 pandemic, most therapists are offering online therapy options.
Q. I've heard there are different types of therapy. What are they?
A. There are various modes of therapy including individual therapy, couple therapy, family therapy, and group therapy. You can choose the appropriate type based on your situation and needs. Individual therapy helps increase self-understanding and personal growth, while couple and family therapy are effective in addressing interpersonal issues. Group therapy provides opportunities to share experiences and gain insights with people who have similar concerns.
Q. I've heard that therapists have different areas of expertise. How can I find this information?
A. Therapists have expertise in various topics such as substance addiction, relationships, trauma, sexual identity, racial discrimination, etc. It can be helpful to find a therapist specialized in the area you want to address. You can filter by desired specialties or focus populations on therapist search sites. Reading the introduction on therapists' websites can also help you understand their approach, values, and areas of expertise.
Q. How long does therapy usually take?
A. The duration of therapy varies depending on the type and severity of the issue, and individual circumstances. Trauma therapy might take relatively longer, while developing coping mechanisms or cognitive behavioral therapy might be completed in a shorter period. If the situation isn't urgent, scheduling sessions once a month might be less burdensome. It's important to discuss with your therapist to find a pace that suits you.
Q. I'm not sure what topics to discuss in each session.
A. Deciding on the topic for each session is something you and your therapist do together. As you freely discuss your daily concerns, stresses, or emotional changes, important topics will naturally emerge. It's okay not to have a special agenda. Your therapist will guide the conversation and help you find meaningful topics together.
Q. How can I tell if I'm a good match with my therapist?
A. Your first impression, comfort level, trust, the therapist's language, and cultural background can all affect the therapeutic relationship. Try attending 2-3 sessions to gauge the therapist’s expertise and primary therapeutic approaches (such as cognitive behavioral therapy, mindfulness and meditation, or music therapy.). If you feel it's not a good fit, it's okay to look for another therapist.
Q. I don't think I'm a good match with my therapist. What should I do?
A. Feeling that you don't match well with your therapist is very common. Usually, in the first session, you both assess each other to gauge the match. If you decide it's not a good fit after the first meeting, you can simply say you don't want to continue. It's good to honestly discuss your needs, such as language preference, identity match, religion, or preferred therapy techniques, and close the case. Therapists also consider the fit with clients important and it's very common to discontinue after an initial interview, so they won't be uncomfortable.
Q. How long should I continue receiving therapy?
A. The therapy process involves setting goals with your therapist and working together to achieve them. Your case will be closed when your situation improves and you feel confident in managing on your own. Afterwards, you can continue to receive support through group therapy or support groups.
ABOUT THE AUTHOR
Nari Yoo is a PhD candidate at NYU's Silver School of Social Work. Her research has a dual focus: understanding community-level dynamics and harnessing technological advancements to enhance the well-being of racial/ethnic minorities and immigrants in both the U.S. and East Asia. Her long-term objective is to create technology-assisted and/or community-based interventions that provide culturally and linguistically relevant services. Outside of her research, she immerses herself in cross-cultural experiences through travel, books, and thought-provoking documentaries.
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