anxiety

How to Get Mental Health Help

You’re wondering - is it worth the anxiety to get help?

If you are too anxious to click a button, send an email, or make a call to get help, this one is for you. Even when you don’t think of yourself as an anxious person it can be highly anxiety-provoking to reach out for help. Maybe you’re worried you’ll sound dumb. Or you think you’ll feel worse after making contact. Perhaps you just aren’t sure if you are ready to reach out.

I’ve helped many friends and clients with getting started. I’ve researched places to get help, helped people make the call, gone to intake screening appointments with friends, taken people to the hospital, and encouraged many people to get help. I know how it can take weeks, months, even years for some people to get help. I get it - It took me multiple searches over months and then even more weeks after to reach out to a counselor when I thought I needed one.

You can calm your nerves enough to do it, even if you are still anxious. It is totally normal to feels this way. In fact, I’ve met very few people who haven’t expressed at least some nervousness about reaching out. In my own practice I try to make it as easy for you as I can, you click a button, provide some very basic contact information, and schedule a call at a time that works for you. I work hard to keep this schedule up to date, so I never have to reschedule your initial call. Then, I call you at our scheduled time. If for some reason I don’t reach you I leave you a voicemail and send an email, just in case you really still need a call. If not just ignore me 😊

The good news is once you make the call or click the button you usually feel a little relieved afterwards. And it is definitely a weight off your shoulders when you find the right person. The bad news is you have that anxiety now. Here are my suggestions on how to get yourself to reach out based on my personal and professional experience.

1.      Break everything into small chunks or goals

You are already thinking about all the pieces of finding the right person and getting the help you need so break it down into each little piece. Deciding if you really need help , getting an idea of what you need , searching for that person, making a list of people to contact, actually contacting as many people at a time as you are comfortable with (even if it is just 1). Make sure your goals are reasonable. How much time do you need to decide if you need help? Who (if anyone) do you need to talk to, to help you make that decision? How much time do you have or want to dedicate to searching for someone? How “perfect” does this person need to seem for you to take the next step? How much time do you need to work yourself up to click the button or make the call? How much time do you need to calm down afterwards? How many times can you realistically reach out in a day, week, or month?

2.      Ask a friend or loved one

I’ve already hinted at this one in the first step but, reaching out to someone you know first can make it easier to reach out to a stranger. You can do this at any step in the process. Maybe you need help breaking things into small chunks. Maybe you want some help for deciding what you need or who would be a good fit for you. Or you want some moral support beside you when you make that first click or call.

3.      Do your research

Figure out what you think you want or need. Then, think about who would be a good fit for you – what do you NEED in a counselor, psychologist, or psychiatrist? Maybe you care about their gender, religious affiliation, race, ethnicity, language, sexual orientation, acceptance or understanding of certain pieces of your identity. Maybe you are more concerned about their approach, availability, or insurance. When you are ready to search, consider multiple options – suggestions from friends, family, or doctors; google searches, and directories such as psychology today and therapy den. As you are searching make your list of people you think could be a good fit for you. It is okay if this takes time, especially if you live in an area with tons of mental health services.

4.      Rehearse your call or draft your email if necessary

You probably write and re-write your emails or texts and say what you want to say in your head before you make a call. (I promise, I am not in your head, it really is that common!) You can do this before making your call or email for mental health services too if it is not as simple as a click. You might practice it on your own or pretend you are making the call with a trusted person.

5.      Try some calming strategies

You might want to think about some calming strategies. My go-to is deep breathing for at least 2-3 minutes. You should do what works for you. You can use apps such as Calm or Headspace to help guide your breathing or meditation. You can also look on youtube for things like “guided meditation” “guided imagery” “progressive muscle relaxation” and “calming music.” There are other strategies too, but these tend to be the easiest for people to use quickly.

6.      Make contact

Immediately after using your calming strategy, make the contact. You can do it! The worst that will happen is you rule someone out on your list. Even if you panic on the phone, the person will either 1) be able to manage it and you know they are probably a good match or 2) can’t handle it and you take them off your list of people. If your contact is me, you can schedule your call here otherwise, head over to that list you were making!

7.      Relax again if needed and reward yourself for taking such a big step!

You did it, hooray! If you are still really amped up, go back to those calming strategies that worked for you. Then, do something to celebrate because you already are on your way to feeling better. Every step big and small matters.

What happens in a psychological evaluation?

If you are thinking about psychological testing you probably want to know what an evaluation will look like.

You are nervous about making an appointment. What will happen? What will we talk about? Will it even make sense to me? What if they don’t answer the questions I have? How long will it last?

I’ve done enough evaluations to lose count so I know what method works for me and the people who like to work with me. I’ll break down what I usually do so by the end you’ll feel less scared about making that appointment (everyone has at least a little worry about these things!)

Most psychological evaluations involve talking to the psychologist about yourself and symptoms such as anxiety and trouble sleeping in an interview, doing some questionnaires about yourself, and possibly some activities that look at how your brain is working. By the end, you should be given feedback. Professionals sometimes have different workflows, but I can tell you how I do it here in Boise. (P.S. This starts after the process of seeing if I’m the right person for you and making an appointment.)

Sun setting at Canyonlands National Park

Sun setting at Canyonlands National Park

Psychological Interview

First, you come in to talk with me about your concerns and share important background information. Depending on the questions we have, this interview will take between one and two hours. If you have trouble talking about yourself (maybe speech or memory is one of your concerns), I will ask your permission to talk to someone who knows you well to make sure we are getting good information and not missing anything important. Honestly, I like to do this even when you can talk about yourself all day - it always helps to get another perspective! If you are still worried about exactly what we’ll talk about, here is a list of things I ask about and a short explanation for why I ask them.

Your current concerns

I hope it is obvious that I care about what is bothering you, and there might also be concerns that others have for you – these could be things like worrying too much, never feeling happy, always being on-edge, trouble sleeping, feeling distant from others, having trouble with relationships, struggling to cope with stress or other problems.

Medical

There are a lot of reasons this is important; so many medicines and hormones can impact how you are feeling, head injuries can change us, and there are a surprising amount of medical concerns that can cause psychological symptoms. It is also helpful to know what medications you’ve tried (if any) and how they have worked (or not).

Education and Work

This gives me information about how concerns might be impacting these areas of your life

Substance Use

I know this is scary but some of this information can tell me things like how you cope and if using a substance or withdrawal might be impacting how you are doing. It is super common for people with mental health concerns, especially trauma, to also use substances so I always ask. Which leads me to…

Trauma

You can see my last post for an explanation of trauma. I find that people don’t talk about it unless asked; which means it gets overlooked. Trauma leads to a lot of things in different people – anger problems, relationship issues, depression, anxiety, the list goes on. I can’t make the best recommendations for you if I don’t know whether or not trauma happened and how it might impact you.

Current Potential Symptoms

These are things like how you are feeling, what you are doing/not doing, sleep concerns, eating and appetite problems, thoughts of hurting yourself or others, and unusual experiences like seeing or hearing things that other people don’t see or hear. I always ask about everything because people sometimes don’t share unless asked directly.

Current Life

This is basics like who you live with, who you talk to, how you spend your free time, and who you are in a relationship with. I also ask about what parts of your identity are important to you (and how much detail you want me to know), such as sexual orientation, gender identity, religious beliefs, race, ethnicity, language preferences, immigration status – context can be really important to understanding the big picture!

This list is not exhaustive, but hits some of the big points. Each interview I do is a little bit different based on you and your concerns 😊 You might hope after talking about all that, we don’t just jump right into testing. I think it makes for a very draining day for some folks, so lucky for you - I don’t.

Canyonlands National Park arch with blue sky

Canyonlands National Park arch with blue sky

Psychological Testing

After the interview, I will plan what questionnaires and activities we should do to answer our questions. You’ll know the general things I want to look at more closely before you leave my office after the first interview. If there are any questionnaires that you or people you give permission for to answer online, I will send those out shortly after your interview. The rest of the questionnaires and activities we’ll complete at my office 1 week after your interview. In between these meetings I’ll be trying to contact anyone you gave me permission to talk to (such as a counselor, doctor, lawyer, or someone else who we think needs some input into your evaluation).

The assessments (and how much time they take) will be different depending on your questions . If you are worried about how your brain is working (like memory, attention, or concerns about your brain working too slow) I’ll likely do an intelligence (IQ) test with you and maybe one for executive functioning (this is basically your ability to plan, organize, and monitor your thoughts and behavior). I would also have you or someone who knows you well to do some questionnaires about your ability to function in the world and take care of yourself (also called adaptive skills) and your executive functioning (it is better to have more than 1 source of information when I can get it!).

If you have questions about why you are sad, worried, fearful, have intense up and down emotions, or keep getting into bad relationships then we’ll probably just do some questionnaires; some of those have to be done in my office. The questionnaires will ask a lot of questions and look at your personality and symptoms to make sure we aren’t missing anything. Common questionnaires I use are the MMPI-2-rf, PAI, and TSI-2. For people who speak Spanish many of the scales I use also are available in Spanish (hooray!) and when they are not available I try to find a good alternative.

Understanding your Results

Within 1-2 weeks after completing the assessments and questionnaires I’ll have your report completed and you’ll come to my office for 1 hour so you will feel clear about the results and confident in your next steps.

I do my best to answer all your questions during our feedback session. If I think counseling will be helpful I will give you specific recommendations for the type of treatments that are likely to work and if I know of anyone will include specific people. I also give you strategies that you can use at home, work, or school. If you find books or apps helpful I can usually recommend a few of those as well. You’ll get an electronic copy of the report (pdf) so you can share it with whomever you think makes sense (like your doctor or psychiatrist if you see one) and so you don’t have to remember everything we talk about in the feedback session.

Occasionally, the problem you have is something I have specialty in treating (anxiety or trauma) AND you really want to use me as your counselor. If I have any openings and we all agree it is a good fit, I am happy to do that.

Whew! I know that was a lot of information. But you’ve made it this far; you’ve got answers about the process.

Are you ready to get some answers about yourself?

Click to schedule a free 15 minute call with me to figure out if I’m the right person to help you and book your appointment. If I’m not your person, I’m happy to help point you in the right direction!




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