Everything ELSE You Ever Wanted To Know About Starting Therapy In College

Hi. I’m a college student. And I’m in therapy. 

If you’re reading this post, you might be considering starting therapy yourself.

Whether you’re just feeling sort of ‘blah’ or you have a diagnosed mental health condition, ALL college students can benefit from therapy.

You might have a lot of feelings about therapy. You might be: 

  • Not sure whether or not you need therapy
  • Worried that you won’t like your therapist
  • Nervous about how much it will cost
  • Concerned you might be crazy for needing therapy
  • Scared your family or friends might judge you

From one college student to another, I want you to know that you are not alone.

I was worried about all of these things at one point or another. So many students have these worries.

This blog post is exactly what I needed when I was a college sophomore, sobbing in my dorm room, finally ready to admit that I needed help, but had no idea where to start.

In part one of this blog post, I discussed: 

  1. Different types of therapists and counselors
  2. On campus versus off campus therapy
  3. Your first appointment: what to expect

I would highly recommend starting with that blog post, if you have not read it already!

In part two of this blog post, I’m going to talk about:

  1. What if you don’t like your therapist?
  2. What do you actually do in therapy?
  3. How do I afford therapy?

So buckle up! Here we go!

What if you don’t like your therapist? 

In part one of this blog post, I talk all about what to expect at a first therapy or counseling appointment, and give examples of questions to ask to get to know your provider as they get to know you. 

Towards the end of your first appointment, you and your provider may choose to discuss how often your provider prefers to see their clients, and what time might work best for future appointments. 

Some clients and therapists hit it off immediately, while other pairs may take some time to get comfortable and get to know each other. 

If you feel comfortable making another appointment, then do it! If you’re feeling unsure about it, I’d encourage you to make a second appointment anyway. 

Is This Provider Right For Me?

Ultimately, the goal with any client-provider relationship is trust. It takes a lot of trust to be able to open up about your fear and shame. 

In some cases, you might need to be able to trust your therapist enough to open up about past or current trauma, or admit to things you’ve done that you’re ashamed of, such as engaging in destructive behaviors or illegal activities. 

It will be much harder for you to start the journey of working on yourself if you don’t feel like you can trust your provider with these things.

In your first few sessions with your provider, ask yourself the following questions: 

  • Do you feel like you can talk to this provider and be honest, truly honest?
  • When you speak to your provider, does it feel like they’re listening? Like really, listening? 
  • Do you feel like you can be YOU, without censoring your personality or your thoughts? 
  • Even if you’re not ready to open up about past trauma or deeply personal things right now, can you see yourself becoming comfortable enough with this provider to do so in the future?

If the answer is YES, then this provider might be a keeper!

If, after one or more appointments, you’re pretty sure that you and this provider are not going to be a good match, it’s totally okay to say that you’d like some time to think about it before making another appointment. 

This happens more often than you might think, and it’s totally okay. 

Your provider wants you to feel comfortable and safe, even if that means you’ll be more comfortable and safe seeing someone else. 

No hard feelings, promise!

So…What do you actually do in therapy? 

I’ve never been to anyone’s therapy appointments besides my own, so I can only speak to my own experience. 

In any given therapy appointment, I might: 

  • Make small talk about the weather, politics, school, or other light conversation
  • Talk about how my week is going, my high points and low points
  • Rant about something that really frustrated or upset me, or spill about something exciting
  • Share about a specific challenge I faced, how I worked through it, and how I feel about it now
  • Reflect on my Big Emotions™ and anything I experienced this week that triggered them
  • Share that I’ve had a tough moment and chose to turn back towards previous negative habits that I’ve been trying to change
  • Admit that I’ve been struggling and start to deep dive into the big thoughts, feelings, and previous life experiences that shape my current struggles.

In some of my therapy appointments, we get into vulnerable, intimate topics, and deeply personal thoughts and feelings. 

Some of my therapy appointments feel more like catching up, getting a chance to get stuff off my chest, to complain about my week or be giddy about an exciting life event. 

Sometimes I want to talk about what’s bothering me, because I want to work through it and understand myself better. 

Sometimes I don’t want to talk about what’s bothering me, because I don’t feel ready yet.

Sometimes I cry in therapy. Sometimes I laugh. Sometimes I don’t know what to talk about. 

In general, I leave most therapy sessions feeling better than when I came in. Sometimes I leave with a lot on my mind, while other times I leave feeling like a weight has been lifted off of my chest. 

Bottom line: your therapy experience will be unique to YOU. The dynamic that you and your provider have will help to shape your conversations and your personal growth. 

How do I afford therapy? 

Most on-campus counseling centers are free for students! This is a great choice for students who are nervous about being able to afford counseling. 

For students choosing to go off campus, there are several options, both for those with health insurance, and those without. 

If you have health insurance!

Great! It is such a privilege to have health insurance as a college student, whether it is through your parents or guardians, through an employer, or through your school’s insurance plan.

First thing to check on is whether or not your potential provider accepts your insurance. Typically, this information will be listed on their website. Many providers, especially those in private practice, accept multiple types of insurance. 

Some providers, like those who are associated with larger healthcare systems, may only accept a few types of insurance.

If you’re not sure or can’t find this information online, it is 100% acceptable to ASK your potential provider about this. You have a right to know how much your appointments will cost before you start. 

If you don’t have insurance

Again, most on-campus counseling centers are free for students, with or without insurance. This is a good option for many students!

There are many off-campus providers who also accept “private pay” clients, meaning they do not bill insurance, but rather, charge you directly for sessions.

Providers who accept private pay clients may also have a “sliding scale” for their fees, meaning the amount they charge per session is based on the income of the client. This can be good for college students, who may not make a lot of money. 

More recently, virtual therapy providers like BetterHelp* can also help connect you with affordable counseling or therapy services.

Virtual services often accept insurance, but may also charge a flat rate per session or per week. These fees can be less expensive than going the traditional route, but I encourage you to DO YOUR RESEARCH!

*This post is not sponsored, nor am I personally endorsing or recommending BetterHelp or any other service like it. This information is for educational purposes only!

If you’re struggling financially

Again, many different options. Providers who accept private pay are often willing to work with clients to find a reasonable payment schedule, especially for clients who are seeing them longer-term.

Depending on the types of issues that you’d like to work on, there may also be support groups or group therapy options that your provider or campus counseling center can refer to you. 

Your campus counseling center may also be able to point you towards organizations that provide free counseling services, or towards other programs that can help you afford to get the help you need. 

(American healthcare is absolutely outrageous, btw. I’m so upset by the fact that I have to even have a section of this blog post that discusses what you can do if you can’t afford essential mental health care…)

Final Thoughts!

While following mental health social media accounts, reading blog posts like this one, journaling and practicing mindfulness, and talking to trusted friends about your problems can feel good and be a critical part of your self-care, none of these can replace individualized mental health services. 

Ultimately, if you’re feeling like you are struggling, seeking out therapy or counseling is absolutely worth it. Your health and safety are IMPORTANT. 

And remember, if you or a friend are in crisis or there is immediate danger to your safety or someone else’s, reach out to the National Suicide Prevention Lifeline, call 911, or contact your local emergency services immediately.

See THIS episode of Feed That Nation, where I talk all about my experience of starting therapy as a college student!

Minnesota-based grad student, future RD, educator, content creator, and mac and cheese expert! Natalie is currently a Masters of Public Health student and dietetic intern at the University of Minnesota, and is on-track to becoming a registered dietitian-nutritionist. She earned her bachelor's degree in Dietetics in 2019 from St. Catherine University.

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