What to Expect When You Are Expecting…To Start Therapy

Starting Therapy
Starting Therapy

“Psychotherapy can be one of the greatest and most rewarding adventures, it can bring with it the deepest feelings of personal worth, of purpose and richness in living.” ~ Eda Leshan

In 2018, 56.7% of U.S. adults with a mental illness did not receive treatment. Maybe you are thinking about seeing a therapist…but you have no idea what to expect, or where to start. You may wonder what happens during sessions, how long will you be in therapy, how you will know that you are done in therapy, or a million other questions. These are common and completely valid concerns, and my goal in this post is to cover that basic information so you will know what to expect when you are expecting…to see a therapist.

What to expect before you start. 

Before going to therapy, it is important to identify the areas in your life that need help and healing. Consider whether it is an individual or relational issue. This step is huge because it requires humility and courage to admit that you need help and to be vulnerable. The next step is finding the right therapist for you. Brainstorm what qualities (such as experience or personal characteristics) are important to you in a therapist; not everyone is looking for the same thing when starting therapy. For example, researchers Susan Hardin and Barbara Yanico asked men and women what they looked for in a potential therapist and found differences in genders: Men tended to want an efficient counseling process, for the therapist to be directive and self-disclosing; while women have higher expectations for the therapist to be open, accepting, genuine, attractive, and trustworthy. Regardless of gender, these researchers found that prospective clients expect empathy, expertness, and concreteness from an experienced therapist, and a positive outcome. What are you looking for?

What to expect when choosing a therapist.

Once you have found a potential therapist, you may experience trepidation about meeting and disclosing your private struggles to this stranger. To help the matter, I urge you to familiarize yourself with the therapist(s) you are considering. Here are three helpful suggestions:

  1. Look at their google listing and familiarize yourself with their website. For example, on Cluff Counseling’s page, I have a section entitled “About Me” where you will find information about me like my hobbies, interests, educational experience and training. I also have a “Frequently Asked Questions” section that will give you insight to my structure and style as a therapist. 
  2. Do not be afraid to ask for a phone consultation before setting your first appointment.
  3. Ask your questions! Create 3-4 questions you would like to ask each of the potential therapists that you are considering. Common questions I hear are: Do I take insurance? How much is each session? Does it cost more for couple sessions? Do I have experience treating ______? Do I have a sliding fee scale? What is my cancellation policy? Do I do couple therapy if that is needed down the road? How long is each session? What do you need to bring to the first session? 

Remember, you are the client and so it is important that the therapist is a good fit for you. If the first one you talk to, or meet with, does not feel right, reach out to the next one on your list. 

What to expect when you start.

Many people are curious about the frequency of sessions, as well as what typically happens during a session. I schedule one 50-minute session a week–unless a client requests to meet more or less frequently, or needs longer sessions.  In the initial session, I always ask why the person decided to start therapy now, rather than a few weeks ago, or months down the road. The response to this question helps shed some light on the process the process went through to get to my office.  

Next, I begin to gather some history on the problem. If I am seeing a couple, I may ask how they met, what attracted them to each other, the highlights and lowlights of their relationship history. If I am meeting with an individual, I may ask how long the problem has been present, what they have tried, what has given them some relief, and who is in their support system. I spend the first several sessions gathering more information and helping the person feel comfortable with me. 

Lastly, I ask how they would know that therapy can help them. Their response helps me understand what they specifically want to address during our sessions together, and orients me to establish measurable goals for the client. I do not want a client to feel they are committing the rest of their life to therapy; setting goals ascertains that there will be an end to therapy!

What to expect during regular sessions.

Once the initial phase of information gathering is complete, we will get to work on meeting the goals. Often, I will give homework assignments to be completed between sessions that will support the work we are doing in session. We will work on coping skills and tools that can be practiced and applied to any unhealthy patterns in the client’s life. Areas where trauma work is needed are identified and a plan is created to do that work. Goals are continually assessed to  make sure they still fit the needs of the client. I remind my clients that the time spent with me is theirs and I invite their feedback; I do not want my clients to ever feel they have wasted their time in a session. Please do not hesitate to speak up to your therapist if your needs are not getting met!

What to expect when therapy is nearing an end.

One of the ways I know a client is close to graduating therapy is when a client or I suggest less frequent sessions. This speaks volumes about the progress and signifies they are feeling more grounded, are reaching their therapy goals, have established a support system outside of therapy, and are ready to put what they have learned into practice on their own. I find great joy when my clients no longer need my help…my goal is to work myself out of the job! My door is and will forever be open to my clients should they need a tune-up. My final question for clients, during their last session, is how they will know if/when they need to come back to see me. The message I want them to hear is that I believe in them and that coming back to me is always an option. 

If you have been considering getting into therapy, I highly recommend you to do so now.  If you are ready to schedule a session but feel nervous, remember that it is completely normal to feel a little anxious about starting something new! It is the therapist’s job to create a safe, comfortable counseling environment where you can begin to address your individual or relational worries. If you think you may need medication, a therapist can refer you to a psychiatrist, and together the therapist and psychiatrist can address your concerns. 

I love my job. You will find the best version of yourself as you shed the weight of trauma or addiction and work through any relational issues you are facing. I am here for you! Please contact me today to get started!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

References:

Q&A: Why Did I Become A Therapist?

“We all have worth; sometimes we just need to be reminded of our worth!” -Melissa Cluff 


Many of us evaluate the previous year to decide what we want to continue to do in the new year and what we want to do differently. One of the new things I want to do is spend time answering some of the  common questions that clients and potential clients ask me. I thought I would start by answering one of my most frequently asked questions–one that is a little more personal: Why did I become a therapist?

First, let me introduce myself. Although I was not born in Texas, I consider myself a Texan.  The fact that Texans had a lot of pride did not hit me until I went to Brigham Young University and saw many Texas flags proudly displayed in dorm rooms. In case you were wondering, I have never used a Texas flag as a decoration, and I also do not own a cowboy hat! I grew up in a large family and it has continued to grow with the addition of in-laws and nieces and nephews. Texas is where I was raised and it is where I returned after receiving my Masters degree from Oklahoma State University. When I am not working in my private practice, I enjoy traveling, hiking, working out, family time, and attending concerts and musicals. 

Growing up I thought I would become a teacher since I liked to boss around my younger brothers and enjoyed helping my mother with her pre-k lesson plans. In high school, someone close to me shared that they had a positive experience in therapy and that I reminded them of their therapist. That comment was the catalyst for me to seriously think about counseling as a career option and I enrolled in AP Psychology. Around that same time, I noticed that I felt drawn to the people who I knew were experiencing pain. For example, I yearned to reach out to the siblings of a student who had committed suicide, and to a football player who had been involved in a car accident where the other driver, a fellow student, had died. I wanted to go up to them and say something, but I did not know what to say or if what I had to say would be received since I did not know them.

In college, I decided to pursue becoming a therapist; I felt the “call” to be a resource for those that carry seen and unseen pain. I majored in Psychology and was on the path to getting a PhD, since I thought that was the only route to provide counseling. During my Sophomore/Junior year, I discovered MFT (Marriage and Family Therapy), which was a newer field, and learned that I would be able to see clients after earning a Master’s degree. I was thrilled with this information! Relationships were something that I wanted to focus on in therapy and becoming a LMFT (Licensed Marriage and Family Therapist) would prepare me well and support my desired direction. 

Graduate school was difficult and I had to put more effort into it than I have ever had to put into anything previously. Luckily, I knew that grad school was the means to my desired end of becoming a marriage and family therapist; I pushed forward and graduated in 2007 with boxes of well-worn, 3-inch binders stuffed with annotated articles, and textbooks. I knew everything I needed to know…or so I thought! 

It quickly became evident, in my first counseling job, that I needed further training–namely in the areas of sex addiction and the related trauma. When I had saved enough money, I pursued my certification to become a CSAT (Certified Sexual Addiction Therapist) and EMDR (Eye Movement Desensitization & Reprocessing). Those certifications increased my confidence that I could be a reliable resource for people in pain. I have continued to seek out training in areas that would help me better serve my clients, and that are of interest to me. Although I never loved school, I have loved pursuing higher education through additional certifications and training opportunities.

I have been in the field of marriage and family therapy since 2005 and my passion for it continues to grow! One of my most cherished roles, as a therapist, is helping the people in my office see that they are lovable and have worth. A paycheck, job promotion, or waist size does not give a person more worth; an addiction, a struggle with mental health, or strained relationship does not take away from a person’s worth. We all have worth; sometimes we just need to be reminded of our worth! 

Thank you for giving me the opportunity to share why I became a therapist. If you have a question for me, email me at melissa@cluffcounseling.com.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

The Leading Cause of Addiction Is Not What You Think

Addiction Counseling | Anxiety

Addiction Counseling, Dallas, TXWhat causes addiction? Many would guess it is the substance or behavior itself and that one gets hooked to something by doing/using it repetitively.  For years, science agreed with this response, but current research has shown that almost everything we think we know about addiction is false.  I invite you to look at the bigger picture, with me, to understand why our society is reaching for these substances and turning to these behaviors in the first place. It is not because we truly want to play meaningless videogames or become a slave to drugs or porn, by rather it is because we lack connection. We turn to addictive behaviors because we need to bond. As I mentioned in my previous post about relationships, humans have an innate need to be close to others; when that need is not met, we inevitably look elsewhere. My purpose in this blog post is to expose the true cause of addiction: the absence of connection.

In this short yet highly informative YouTube video, we are given an overview of a science experiment from the 70’s called “Rat Park.” Initially, rats were placed in a cage with two water bottles–one normal and the other laced with cocaine. As you might guess, the rats became obsessed with the drugged water and eventually died from continual consumption. While Bruce Alexander–a professor of Psychology from Simon Fraser University–was working on this project, he quickly realized that the rats were practically in solitary confinement with nothing to do but do drugs! He built Rat Park, which was basically rat heaven–a lush cage with colored balls, tunnels to scamper down, plenty of rat friends, loads of interaction, as well as the two water bottles, one of which had cocaine. Surprisingly enough, the rats hardly used the drugged water, and none of them overdosed. These researchers made a striking conclusion about how addictions are formed–it is not the chemicals themselves…it is our environment that ultimately influences whether or not we participate in addictive behavior.

Humans have an inherent need to bond and connect (think amae). When we are happy and healthy in our environment, we bond with those around us and form meaningful relationships. But when we cannot (because of trauma, isolation, etc), we will start bonding with anything that will give us a sense of relief–it could be constant use of our smart-phone, video games, gambling, pornography, or harmful substances. We are driven to bond with something because that is part of our human nature!

The opposite of addiction is not sobriety; the opposite of addiction is connection. The cure for addiction is not simply to stop the behavior or substance, such as pornography or cocaine. The path out of addiction is to form healthy bonds, to connect with people you want to be present with and want in your life. If you or someone you love is turning to addiction because of a lack of meaningful connection, contact me today to schedule your first session. The way out of addiction is steep and hard, but I can assure you that it will be worth it!

Stay tuned for my upcoming post about how we can change our outlook on addiction as a society!

Seven Questions Your Therapist Doesn’t Want You to Ask

7 Questions Your Therapist Doesn’t Want You to Ask

...but that the well-informed client will want to know7 Questions Your Therapist Doesn’t Want You to Ask

Have you ever been asked an awkward question that you are unsure how to answer? Well, therapists get those all the time! So often, in fact, that I have spent time to compile my typical responses for when people are brave enough to ask.  I completely understand where you are coming from–you are anxious, coming into therapy trusting me with something vulnerable. So when you ask difficult questions, such as the ones below,  I am impressed–it shows me that you are invested in your therapy and the progress in our sessions. Because I know these questions can take courage to ask, I am devoting my blog today to answering them all at once.

Q:  How can you help me if you have not been married/don’t have children/are not an addict, etc?

A: Fantastic question! This is one I understandably get a lot, as I’m not yet married or may not have experienced exactly what you’re going through. Here’s an analogy I love to use: A doctor does not need to have had a broken leg to know how to fix it.  In last week’s post, I talked about my extensive education, research, certifications, and training I have received in order to be an experienced therapist. I have been in the middle of hundreds of marriages totalling thousands of hours of counseling; I know what works! My job is not to share personal biases or experiences from my own life (like what I have done to achieve the perfect marriage), but to be an unbiased, third party observer and use my education, research, experiences, and skills gained through counseling others to help you reach your goals.

Q: Will you respect my values and/or spiritual beliefs when they are different from your own?

A: Yes, absolutely. As a religious woman, this is something I feel very strongly about. When you come into my office, I leave my beliefs at the door and adopt your values. For example, based on personal values, I have chosen not to smoke. But if you choose to smoke marijuana on a daily basis, I am not going to tell you that’s a bad decision or that you are a terrible person! My job will be to point out if your choices are steering you away from what you are ultimately wanting. If smoking marijuana is affecting you from keeping your job, for example, then I may point out that the drug is interfering with your ability to think clearly.  While I will never expect you to live according to my beliefs and quit smoking, I may advise that you be smart about when you smoke (ie. during the weekend or other times that will not interfere with your work performance). My job is to help you make the most of your life.  I’m not going to project my values on you; instead, I am going to meet you where you are and we will work together to get where you want to be!

Q: Have you seen a therapist for your own issues?

A: I see a lot of therapists as clients, and many of them ask if i have “done my own work.” Without going into details about what specifically I have had to work through, yes, I have certainly invested time in self-betterment. In many of the trainings I have been through, it was required that all attendees bring a piece of personal work to process during the training. If I felt like I did not completely work through that piece by the end of the training, I sought additional resources to help me fully resolve it. In order to be the best therapist I can be, I have to do my own work. I’ve been on the other side of the couch and I can honestly say that I understand where you are coming from.

Q: Do you practice what you preach?

A: You bet I do! Well, I try. I give my clients homework–things like practicing mindfulness or self-care, watching their diet and sleeping patterns, reaching out to their social network for connection, processing/identifying their emotions, etc. And yes, I do all the same things I ask my clients to do. I am not perfect…some days I fail miserably!  But I will redouble my efforts the next day–which is what I will expect of you when you fall short.

Q: Why do I feel worse than I did before I started therapy?

A: Although this is actually quite common, I can see why it would be frustrating for a new client to feel this way. In therapy, I’m going to help you work through issues you have ignored or numbed to protect yourself. Reliving difficult experiences or using coping mechanisms instead of resorting to an addiction can be uncomfortable and/or overwhelming at first. But this is good! It means there is movement where you used to be stuck. It’s a positive thing. I don’t expect it to last forever. A good analogy for this is the first time you took a new medication–did you feel some side effects before it kicked in and did its job? As you continued to take the pill, you likely began to feel more of the positive and less of the negative side effects.  Therapy can be hard, but these painful “side effects” will only be temporary; the “medication” (aka the work you have put into therapy) will kick in and you will experience the satisfaction that comes from your hard work.

Q: Will you let me know when I’m done with therapy or will you prolong my sessions so I keep paying you?

A: I am sure you can think of a million things to spend your money on other than therapy, so I admire you for even considering to come see me.  I always tell clients that my job is to work myself out of the job. As I said in this post, I experience such joy seeing clients progress, get healthier, and move closer towards their goals. (It is important to note that the amount of sessions required for each person and/or situation varies. There is no set time frame, but we will go at your pace until we both feel that you have fully worked through your issue.) So no, I absolutely will not “hold on” to you for monetary gain. I want you to move onto the next stage of life healthier, happier, and independently. Plus, as you “graduate” and leave counseling, that makes room for someone new. (Not to mention that I would probably get bored if I saw you forever…haha!)

Q: Why did you specialize in sex addiction and why do you like being a therapist?

A: Such a valid question. Let me just preface by explaining how I got interested in it: I was working at an agency where I saw numerous clients with signs of sex addictions. I did not have the needed skills to appropriately address or assess this piece of their treatment. I was led to seek additional training in sex addiction, and to working at an inpatient treatment center to further my knowledge, before moving into the private practice sector. I continue to see many sex addicts, male and female, in my office. Why? Because I have found that these dear people have the most tender hearts! And I find deep satisfaction helping them find their worth–they make mistakes (don’t we all?), but that does not make them bad people. I love reminding them of that!

On a more general note, I chose to be a therapist and work with couples and families because I deeply value those relationships. I absolutely love that my life’s work is helping others improve relationships I esteem so highly.

Do you have a question you would like me to answer? Click here to contact me today!

Choosing the Right Therapist for You

Melissa Cluff, Cluff Counseling

Melissa Cluff, Marriage & Family Therapist, Cluff CounselingIn last week’s post, I talked about 5 things I want my future clients to know. This week, I’d like to address how to choose the right therapist for you–an essential element in having a successful experience in therapy.

The first two steps to choosing the right therapist for you are 1) being aware of which personality traits you connect well with, and 2) knowing what concerns you would like to work through with your therapist. First, take a moment to think about what characteristics you are looking for in a therapist, remembering that these characteristics can help make therapy a safe place for you. To give you an example, here are a few adjectives I use to describe myself as a counselor: cheerful, compassionate, nurturing, knowledgeable, available, humble, and direct.

The second part of finding the right therapist for you will depend on your needs and goals–why are you seeking therapy in the first place? What are you hoping to accomplish? Some of the more common reasons individuals seek counseling are for anxiety, depression, codependency, divorce support, family conflict resolution, and help during periods of transition or adjustment. In addition to these topics, I specialize in relationships, addictions (especially sex addiction), and trauma. I have sought years of supplementary certifications so I can be an experienced, knowledgeable, and qualified therapist in these three areas.

Below I will break down some of my “letters” (or the abbreviated qualifications) you see behind my name, my additional certifications, and where each one fits into my specializations. If, after reading this, you have further questions, please do not hesitate to contact me!

Melissa Cluff, MS, LMFT, CSAT, EMDR-II

  • MS: Master of Science

RELATIONSHIPS

  • LMFT: Licensed Marriage and Family Therapist
    Marriage and family therapists are trained in Family Systems Theory. The idea here is that individuals cannot be understood in isolation from one another; I must look at all of the relationships a client is involved in, not just at the individual(s) that come into my office. Because I am a firm believer in the centrality of family and committed romantic relationships to and in one’s health, I devote time in focusing on my client’s relationships, and how each plays a role in shaping who they are.
    PREPARE/ENRICH certified: I am trained to administer PREPARE/ENRICH, the leading relationship inventory and skill-building program. These assessments help couples identify and strengthen growth areas in the relationship and I have found them to be extremely helpful with my pre- and post- marital couples. (Click here for more information on the assessment itself.)

ADDICTIONS

  • CSAT: Certified Sexual Addiction Therapist I trained with Patrick Carnes through the International Institute for Trauma and Addiction Professionals (IITAP). Being a CSAT allows me to better assess, diagnose, and treat sex addicts and their partners compassionately and effectively. I worked with addicts in both in- and outpatient environments before I began my private practice. Using the knowledge I have gained as a CSAT, I have led therapeutic groups for female addicts, male addicts, and female partners of sex addicts, as well as, facilitated recovery intensives for couples. (Click here for more information on IITAP.)

TRAUMA

  • EMDR-II: Eye Movement Desensitization and Reprocessing (Level 1 & 2 trained) EMDR is a model of treatment that works to decrease the intensity of emotions connected to a traumatic memory. I became interested in EMDR after witnessing the positive outcomes it had on my clients at an inpatient treatment center. I recognized that many clients, not just those with addictions, come into my office with trauma, and I wanted to find a way to decrease the power that the trauma had on the clients. (Click here for additional information on EMDR.)”
  • I acquired additional training in trauma, and inner child work through Pia Mellody’s Post Induction Therapy (PIT). PIT is a therapeutic treatment approach assuming that childhood trauma, including child abuse and neglect, is the origin of developmental immaturity. It is often used in inpatient and intensive outpatient settings. I have found that using this model with my clients, in the later stages of treatment, has been extremely effective in fostering ongoing sobriety, reduction of trauma symptoms, and relational healing.

I share this information not to overwhelm or impress you, but to inform you. I have spent the last decade of my life acquiring the education and certifications needed to be the qualified, supportive therapist you deserve. I am warm, compassionate, attentive, and honest. I specialize in relationships, addictions, and trauma. If you are seeking professional help in one of those areas and think I have the attributes you would like to see in a therapist, give me a call.

Welcome

Hello, there! I’m thrilled you stopped by for the launch of my new blog! I’m Melissa Cluff, a Licensed Marriage and Family Therapist as well as a Certified Sexual Addiction Therapist. Cluff Counseling is my therapy private practice. This introductory post will give you a little look into who I am and why I love what I do.

Welcome to Cluff Counseling | DFW Family & Addiction Therapist

I would describe myself as cheerful, dependable, and witty. When I am not in the office, I enjoy decorating, discovering local restaurants with friends,  meal-prepping, further exploring my newfound interest in traveling, and being active in my nieces’ and nephews’ lives. I love to be busy and struggle to stay still. I am a people person; I thrive off of meaningful relationships and am grateful for those relationships in my life. When I was little, I dreamed of being a teacher, like my mother, and I remember using a large chalkboard in our garage to instruct my imaginary students, and sometimes my younger siblings. In high school, somebody close to me confided in me about his positive experience with his therapist, and told me I reminded him of that influential therapist. I then decided to explore psychology, and developed a passion studying human behavior within the realms of relationships and addiction, and sought out higher education that would allow me to make my passion a career.

I received a Bachelor’s degree in Psychology at Brigham Young University and a Master’s degree in Human Development and Family Science, with a specialization in Marriage and Family Therapy from Oklahoma State University. I am involved in several professional associations and have received additional training and certifications that have enabled me to focus on those suffering from addiction and/or trauma (in an upcoming post I will further discuss the meaning of said certifications and how it can help you in our sessions). As a therapist, I would describe myself as 1) compassionate; 2) responsive; and 3) curious, yet non-judgmental. My goal is to provide a welcoming, safe place–a judgment-free zone–where you can bring the things that weigh you down and feel empowered to work towards becoming the person you want to be! As your therapist, I am your confidant, your cheerleader, your advocate.

My life mantra comes from the simple words of Dorothy Satten, “Real is better than perfect.” I have this displayed throughout my office as a reminder that connection, with ourselves and with others, happens when we are authentic instead of trying to be what we perceive others want us to be. I am a client-centered therapist, which means I allow you, my clients, to identify what isn’t working for you and the direction you want change, rather than prescribing goals for you. Through our sessions, you will come to better understand your emotions and needs, and recognize the patterns that have kept you stuck. We will work together to refine your coping skills and equip you with the necessary tools needed to achieve your personal and relational goals. Although it’s difficult to say goodbye to clients, I find immense joy witnessing the personal transformations of my clients as they prepare to move on to the next phase of their life–as healthier and happier people.