Why Starting Therapy Feels So Hard - Even When You Know You Need It

Starting therapy can feel overwhelming, even when you know it could help. Here’s why it feels so hard and what you can do about it:

Emotional Barriers: Fear of judgment, stigma, or opening up about painful experiences often holds people back. Many believe they should handle everything alone.
Practical Challenges: Cost, navigating insurance, and finding time in a busy schedule make therapy harder to access.
Uncertainty: Not knowing what to expect from therapy creates anxiety, making that first step feel intimidating.

Quick Tip: Therapy is not a sign of weakness – it’s self-care and a proactive way to improve your mental health. Small steps like researching therapists, journaling, or exploring online options can make the process easier. Virtual platforms like Televero Health also address barriers like cost, scheduling, and privacy.

Taking the first step is hard, but it’s worth it. Therapy offers tools to help you lead a healthier, more balanced life.

Scared of Therapy?

Common Emotional and Mental Barriers

Starting therapy is often more challenging due to emotional barriers than logistical ones. These internal struggles can delay taking that first step, even when someone knows how helpful therapy can be. Understanding these emotional roadblocks is key because they frequently hold the real power over decisions to seek help.

Even with increasing awareness about mental health, stigma remains a significant obstacle. The statistics are sobering: over half of individuals with mental health conditions don’t seek help because of stigma. It’s not just about fearing others’ judgment – it’s also about battling the internalized negative beliefs many have about seeking mental health care.

Stigma shows up in various ways: public discrimination, personal shame about needing help, and institutional barriers like work policies that undervalue mental health care compared to physical health care. For example, a 2022 poll revealed that only 48% of employees felt comfortable discussing mental health with their supervisors. This highlights a persistent fear of professional repercussions, even as mental health conversations become more common.

This issue isn’t confined to one region or culture. A 2016 report found that "there is no country, society or culture where people with mental illness have the same societal value as people without mental illness". This global devaluation can make seeking therapy feel like admitting a personal flaw rather than addressing a health need. However, these ingrained beliefs can be challenged with new perspectives.

"I fight stigma by choosing to live an empowered life. To me, that means owning my life and my story and refusing to allow others to dictate how I view myself or how I feel about myself." – Val Fletcher

Fear of Opening Up and Being Judged

Talking about your struggles with a stranger can feel overwhelming. A common fear is that opening up might lead to judgment, misunderstanding, or being perceived as weak. This fear is one of the most significant emotional hurdles to starting therapy.

Concerns often include thoughts like, "What if the therapist thinks less of me?" or "What if my problems aren’t serious enough for therapy?" Many also worry about being labeled in ways that feel dehumanizing. For those raised to believe that emotional strength means handling everything alone, these fears can feel particularly intense.

What many people don’t realize is that therapists are specifically trained to offer a non-judgmental space. Their focus is on empathy, understanding, and acceptance – not criticism.

"Therapists want to help people, not judge or criticize them. In fact, helping others and making a positive difference is what attracted them to the profession in the first place. They are trained to have a non-judgmental approach and put personal thoughts and feelings aside." – Kindbridge Behavioral Health

Unlike friends or family, therapists avoid offering unsolicited advice or opinions. Instead, they provide a safe space where you can explore your thoughts and feelings freely. Addressing fears of judgment upfront can even help build trust. Sharing these concerns during your first session allows the therapist to reassure you about their approach.

"Starting therapy for the first time is scary and anxiety provoking. Not knowing what to expect heightens anxiety. It is helpful to think about what you are hoping to gain during your time in therapy so that you can convey that to the therapist… The goal of the first session is to help build rapport with you and lessen your anxiety." – Minkyung Chung, MS, LMHC

"True strength comes from facing your emotions, not hiding from them. In therapy, you’ll discover that vulnerability is one of the most powerful tools for growth and healing." – Annapolis Counseling Center

Beyond the fear of judgment, many grapple with the belief that they must handle their challenges on their own.

Denial and the Need to Handle Things Alone

For some, the idea of therapy clashes with deeply held beliefs about self-reliance. This resistance often stems from denial about the severity of their struggles or a conviction that they should solve their problems independently. While this mindset can offer temporary comfort, it often prevents people from getting the help they need.

Denial, as a psychological defense mechanism, helps people manage stress by distorting reality. Common thoughts like "I’m fine", "Everyone deals with this", or "I just need to try harder" can create a false sense of control. But over time, this denial can become a barrier to meaningful support.

"I see it as a protective barrier we have that we might or might not be aware of. It keeps us safe. It also keeps us from looking at ourselves or addressing something around us and making a change." – Jonathan Scholl, therapist and clinical social worker at Harvard-affiliated McLean Hospital

The numbers highlight how widespread this issue is. 60% of people with a diagnosable mental health condition don’t seek treatment, despite evidence that 70-90% of those who do experience fewer symptoms and improved quality of life.

Several factors contribute to this resistance: cultural ideals of self-reliance, fear of judgment, concerns about maintaining a certain image, and uncertainty about what therapy involves. In the United States, in particular, the emphasis on individual responsibility and "pulling yourself up by your bootstraps" can make asking for help feel like a personal failure.

Ironically, seeking therapy takes tremendous strength and self-awareness. Recognizing the need for support and taking steps to get it is an act of courage, not weakness. Around 50% of Americans are diagnosed with a mental health condition at some point in their lives, showing just how common these challenges are.

"It’s hard to look at your own life and take a good inventory of what’s going on. It takes a lot of work." – Jonathan Scholl, therapist and clinical social worker at Harvard-affiliated McLean Hospital

Breaking through denial often requires honest self-reflection and, sometimes, input from trusted friends or family who can offer an external perspective. The key is understanding that asking for help isn’t a sign of failure – it’s a proactive step toward better mental health and a more fulfilling life.

Acknowledging these emotional barriers is the first step toward finding practical ways to overcome hesitation about therapy.

Practical and Logistical Challenges to Starting Therapy

While emotional hurdles like stigma play a major role, practical issues such as cost and scheduling often make accessing therapy even harder.

Money Worries and Insurance Questions

For many, the price of therapy is a significant roadblock. In the U.S., a single session typically costs between $100 and $200, and roughly one-third of private practice therapists don’t accept insurance. Even with insurance, out-of-pocket costs can still add up. For instance, Medicaid reimbursement rates are, on average, 40% lower than cash pay rates, which hover around $143.26 per session.

A staggering 60% of therapy users pay out-of-pocket, spending an average of $178 per month. In 2021, fewer than half of adults with mental health conditions received treatment, and 21% of adults skipped filling prescriptions due to high costs.

As one expert put it:

"Taken together, low insurance acceptance across a broad swath of mental health provider types means that access to care is disproportionately reliant on patients’ ability to afford out-of-pocket payments – even when covered by insurance."

The financial strain has only grown since the COVID-19 pandemic. Amy Morin, editor in chief of Verywell Mind and a licensed psychotherapist, highlighted the ripple effect of rising costs:

"For many people, it’s the increased costs. The gas money to go to therapy is now higher. People have to pay more for babysitters, so they can go see a therapist. And then of course, a lot of therapists are raising their rates given the rise in inflation, too."

If cost feels like a barrier, exploring options such as sliding-scale fees, payment plans, group therapy, or online platforms with subscription models might make therapy more affordable. However, money isn’t the only challenge – scheduling and access also pose significant obstacles.

Scheduling Problems and Access Issues

Juggling therapy with work, family, and other commitments can be tough. Traditional therapy often requires appointments during business hours, which might clash with busy schedules. For those in rural or underserved areas, the problem is even more pronounced. Finding a qualified therapist may involve long-distance travel, turning a one-hour session into a half-day ordeal.

These challenges contribute to missed appointments, which cost U.S. healthcare practices an estimated $150 billion annually. Additionally, limited access to specialized care often restricts treatment options in behavioral health.

Fortunately, solutions like telehealth have made therapy more accessible. Virtual sessions remove geographic barriers, allowing people in remote areas to connect with specialists. They also provide flexibility, making it easier for families to fit therapy into their busy lives.

Technology has also streamlined scheduling. Therapists using AI-driven tools save an average of 13 hours per week, while online platforms let patients book, reschedule, or cancel appointments whenever they need to.

Kapil Nandakumar of blueBriX highlights the importance of these tools:

"Offering 24/7 self-booking isn’t just about cutting down on phone calls; it’s about meeting people in their most vulnerable moments, when they’re ready to take that crucial first step."

Not Knowing What to Expect in Therapy

The uncertainty surrounding therapy can cause anxiety, especially before that first appointment. You might worry about what will happen in the session, how long it will last, or whether it will immediately dive into painful topics . Many people also feel embarrassed or wonder if their problems are "serious enough" to justify seeking help.

It’s helpful to know that the first session, often called an "intake", is typically about getting to know you. The focus is on understanding your background and setting goals, not diving into trauma. As Krista Jordan, a clinical psychologist in Austin, explains:

"Therapists are actually trained not to let you discuss graphic details of trauma in the first session."

Dr. Keziban Salaheddin, an MTA therapist, acknowledges these common fears:

"Taking the first step to starting therapy can be very daunting for many people. Concerns about being judged, feelings of shame and difficulty putting words to your emotional distress, are really common barriers to getting support."

Practical Ways to Overcome Therapy Hesitations

If you’re feeling unsure about starting therapy, you’re not alone. Tackling these hesitations can seem daunting, but there are concrete steps you can take to make the process feel more approachable.

Writing and Self-Reflection Exercises

Taking time to reflect on your feelings and thoughts can help you understand what’s holding you back. Research shows that self-reflection – analyzing, questioning, and reframing experiences – can help manage emotions like anxiety and self-doubt. It’s also a key component of therapies like Cognitive-Behavioral Therapy (CBT), often leading to greater self-awareness and personal growth.

Journaling is a powerful tool to capture your thoughts and spot patterns in your behavior. Start by writing about recent experiences without judgment. This can help you pinpoint the obstacles keeping you from seeking therapy.

Here are some reflection prompts to guide your journaling:

Emotions: What feelings are you most comfortable with? How do you handle intense emotions?
Limiting beliefs: What doubts or negative thoughts might be stopping you?
Authenticity: If you lived today with complete authenticity, what would change?
Core values: What are your core values, and are your daily choices aligned with them?

Another helpful exercise is the "Your Wisest Self" practice. Picture yourself at the end of a fulfilling life, offering advice to your younger self. What would this wiser version of you say about seeking help when needed?

You can also try Socratic questioning to dig deeper. Ask yourself: What made you consider therapy? When did these feelings begin? Why do you feel change is important, and how could therapy help?. These exercises can clarify your thoughts and prepare you for the next steps.

Setting Small, Doable Goals

Starting therapy can feel overwhelming, but breaking it into smaller steps makes it more manageable. Progress often comes from steady, incremental actions.

"Small steps lead to big changes. Starting therapy can seem overwhelming, but it doesn’t have to be. Every step in the right direction has a ripple effect that will bring you more and more positivity until the problem no longer exists." – Therapist To Go

Here’s a simple week-by-week plan to ease into the process:

Weeks 1-2: Reflect on your reasons for considering therapy and list any hesitations.
Week 3: Identify specific issues or themes you want to focus on.
Week 4: Research therapists in your area or explore online options – no need to contact anyone yet; just familiarize yourself with the options.
Week 5: Write down questions for your first session. This can help reduce anxiety about what to say.
Week 6: Reach out to therapists for initial phone consultations. Many offer brief calls to see if you’re a good fit.
Week 7: Explore payment options, like insurance coverage or sliding-scale fees, and decide how you’ll cover therapy costs.

Celebrate each small win. Whether it’s researching therapists or scheduling that first call, every step forward matters. Keep track of your progress in a journal or checklist to see how far you’ve come. Remember, meaningful change takes time, so be patient with yourself.

Viewing Therapy as Self-Care

One of the most empowering ways to approach therapy is to see it as an act of self-care, not a sign of weakness. Self-care means intentionally nurturing your physical, mental, and emotional well-being.

"Self-care is an essential part of therapy and counseling." – MindSol Wellness Center

Therapy can be emotionally demanding, so pairing it with self-care practices is essential to avoid feeling overwhelmed. Think of therapy as a way to prioritize your mental health, much like going to the gym strengthens your body.

Self-care also builds resilience and helps you develop healthy ways to handle stress. It fosters a stronger connection with yourself and deepens self-awareness. By viewing therapy as self-care, you’re not labeling yourself as "broken" – you’re taking proactive steps to improve your well-being.

Research highlights the importance of self-compassion in self-care. Treat yourself with the same kindness you’d offer a close friend.

"When we come from a self-compassionate place, self-care is no longer about these sporadic one-time events that you do when you feel burned out and exhausted. Self-care is something you can do all the time." – Patsiopoulos & Buchanan

Challenge negative self-talk that may be holding you back. If you think, "I should handle this on my own", reframe it as, "Taking care of my mental health is responsible and mature". Gratitude can also shift your mindset – focus on the positive steps you’re taking to improve your life rather than what’s "wrong" with you.

Finally, set boundaries around your decision to seek therapy. You don’t owe anyone an explanation for prioritizing your mental health. Saying no to commitments that drain your energy, including the notion of "toughing it out" alone, is part of healthy self-care.

When you view therapy as self-care, it becomes more than just an hour-long session. It’s about building a lifestyle that supports your emotional and mental health every day. This shift in perspective can help break down stigma and empower you to seek the support you deserve.

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How Televero Health Makes Starting Therapy Easier

Televero Health

Starting therapy can feel like a daunting step, but Televero Health has created a virtual platform aimed at breaking down the barriers that often discourage people from seeking help. By addressing these challenges head-on, they’ve made therapy more accessible and approachable for individuals across the United States.

Flexible Virtual Therapy Options

Traditional therapy often comes with logistical hurdles like taking time off work, arranging childcare, and commuting to appointments. Televero Health simplifies the process with same-day, online appointments that you can access from any device. Whether you’re at home, at work, or even traveling, you can choose the environment that feels most comfortable for your session.

Their technology ensures a high-quality experience that rivals in-person therapy. With high-definition video and audio, therapists can pick up on subtle non-verbal cues, while features like virtual whiteboards allow for interactive exercises and collaborative treatment planning. This makes sessions not only accessible but also engaging and effective. And when it comes to managing costs, Televero Health keeps things simple and transparent.

Clear Pricing and Insurance Coverage

Financial concerns often stop people from seeking therapy, but Televero Health takes the guesswork out of costs. They accept insurance and work with you to clarify what your coverage includes.

Using Change Healthcare Verification Services, Televero Health reviews your benefits upfront and handles claim processing, so you won’t face unexpected billing surprises. They even adjust future charges based on your insurance provider’s Explanation of Benefits (EOB), ensuring a smoother financial experience.

For those who need extra support, payment plans are available to help manage outstanding balances. If you have questions about your bill or need assistance with payment options, their billing team is ready to help you find a solution that fits your budget. Plus, all financial transactions are handled securely through HIPAA-compliant Heartland Payments, giving you peace of mind. With a valid credit card on file, you’ll know exactly what to expect for copays, coinsurance, deductibles, or self-pay fees.

Secure Care

Privacy is often a major concern for those hesitant to start therapy, whether it’s worrying about being seen at a therapist’s office or safeguarding personal information. Televero Health addresses these concerns with a virtual platform that prioritizes security and confidentiality.

Therapy sessions are conducted with end-to-end encryption, ensuring your conversations stay private. Multi-factor authentication adds another layer of security by verifying your identity and preventing unauthorized access. Even document sharing is protected, so your medical records and personal information remain secure.

With Televero Health, you can attend therapy from the comfort of your own space, free from concerns about public exposure. Automated appointment reminders help you stay on top of your schedule, while the secure patient portal provides 24/7 access to scheduling and important documents. Their robust security measures – like encryption, multi-factor authentication, and secure document sharing – ensure that your privacy is always protected.

Tools and Resources to Take the First Step

Getting started with therapy can feel daunting, but the right tools can help ease your way. These resources are designed to guide you through those first steps and make the process more approachable.

Free Writing Prompts

Journaling is a simple yet powerful way to explore your emotions, uncover patterns, and address deeper issues. As Wayne Jonas, M.D., Professor of Medicine at Georgetown University, puts it:

"Journaling provides a safe environment that enables you to face your traumas. When that happens, remarkable healing follows."

If you’re unsure where to begin, organizations like KMA Therapy, Psych Central, and PositivePsychology.com offer free writing prompts to help you reflect and process your thoughts. Here are a few techniques you can try daily:

Stream of consciousness writing: Let your thoughts flow freely for 3–5 minutes.
Reflective journaling: Focus on specific events or experiences.
Gratitude practice: Write about the things that brought you joy or peace.

These exercises can help you better understand your emotions while creating a habit of self-reflection. Beyond journaling, self-assessment tools provide another way to evaluate your mental health.

Self-Assessment Tools

Self-assessment tools offer a structured way to identify mental health symptoms and strengths, giving you a clearer picture of where you stand. With one in five adults experiencing mental illness annually and one in six youth aged 6–17 facing mental health challenges, these tools can be a helpful first step.

Organizations like Mental Health America (MHA) provide free, anonymous screening tools to help you recognize potential warning signs. These assessments are private and can offer insights into symptom levels, making them a great starting point for conversations with a healthcare provider. Google Search also includes clinically validated tools for conditions like PTSD and depression, which mental health professionals often use to evaluate symptoms, make diagnoses, and track progress.

While self-assessments are valuable, remember they’re not meant to replace a professional diagnosis. Instead, use the results as a conversation starter with a healthcare provider and a way to reflect on your mental health.

Once you’ve gained some clarity from these tools, the next step is preparing for your first therapy session.

Getting Ready for Your First Virtual Session

If you’re starting therapy with Televero Health, a little preparation can help you feel more confident and get the most out of your first virtual session.

Technical setup:

Find a quiet, private space where you won’t be interrupted.
Test your device’s camera and microphone to ensure they’re working properly.
Check your internet connection for stability.

Mental preparation:

Write down key questions, goals, and symptoms you want to discuss.
Note important details about your background and current challenges.
Set realistic expectations – it’s normal to feel a bit nervous at first.

Televero Health makes it easy to get started with same-day appointments, so you don’t have to wait weeks to speak with someone. Their secure patient portal, available 24/7, simplifies managing your appointments and accessing important documents. After your session, take some time to decompress – whether that’s through journaling, a walk, or quiet reflection. This time can help you process your experience and take another step forward in your mental health journey.

Conclusion: Taking the First Step Toward Better Mental Health

Starting therapy can feel overwhelming, but recognizing that you need support is a powerful act of courage. As Serene Pathways Counseling wisely states:

"Seeking counseling is a sign of strength, and taking that first step can lead to a more fulfilling and balanced life."

While challenges like social stigma, fears of vulnerability, and practical concerns such as cost and scheduling are very real, they don’t have to stand in the way of getting the help you deserve. Early intervention in mental health can make a world of difference, helping to prevent small issues from becoming larger, more complex problems. Therapy also provides a safe and supportive space where you can build coping skills and gain self-awareness – tools that are essential for meaningful, lasting change.

You’re not alone in this journey. Therapy offers a space to explore your thoughts and feelings while equipping you with strategies to face life’s challenges head-on. Taking that first step, even if it feels daunting, can open the door to a healthier and more balanced life.

For those facing logistical barriers, Televero Health offers a practical solution. With same-day appointments available 7 days a week, including evenings and Sundays, and a fully online format, they eliminate geographical hurdles . Starting therapy doesn’t have to be a big leap – begin with something small, like sending an email, scheduling a brief session, or trying a self-assessment tool. They also address common concerns with upfront insurance verification and flexible scheduling options, making the process more manageable.

Research supports these accessible approaches, showing that virtual therapy can be just as effective as in-person sessions for conditions like anxiety, depression, and panic disorders.

If you feel like something isn’t quite right, trust your instincts. Relief Mental Health reminds us:

"The truth is, seeking support is a huge step toward feeling better, and you’re already braver than you think for even considering it."

Therapy isn’t about having all the answers – it’s about taking that first step toward understanding yourself and improving your mental health.

FAQs

Why does starting therapy feel so overwhelming, and how can I move past it?

Starting therapy can feel like a big step, especially when it means facing intense emotions, dealing with stigma, or figuring out practical issues like scheduling and cost. One way to make it less intimidating is to think of therapy as an investment in your overall well-being – just like exercising or eating healthy. Shifting your mindset this way can help ease any feelings of shame or fear.

There are also simple ways to make the process smoother. Start by writing down your thoughts or concerns about therapy; this can help you sort through your feelings. Mindfulness or breathing exercises can be helpful if you’re feeling anxious. Talking to a trusted friend or family member about your plans can also offer encouragement. Taking small steps – like looking up therapists or trying out virtual therapy – can make the journey feel more manageable and help you build the confidence to move forward.

What can I do if therapy feels too expensive for me?

If you’re worried about the cost of therapy, there are plenty of ways to access more budget-friendly options. Community mental health centers and nonprofit organizations often provide low-cost or even free services, depending on your income. Many therapists also offer sliding-scale fees, which means they adjust their rates based on what you can afford.

Another option to consider is university training clinics. These clinics allow graduate students, who are supervised by licensed professionals, to provide therapy at a reduced cost. Virtual therapy platforms are also worth exploring – they frequently offer sessions at much lower prices than traditional in-person therapy. Getting the support you need doesn’t have to strain your finances – there are affordable solutions out there to suit your needs.

What happens during a first therapy session, and how can I get ready for it?

In your first therapy session, the therapist will likely start by asking about your background, the challenges you’re facing, and what you want to achieve through therapy. It’s more of a conversation than anything else – meant to give them a clear picture of your situation and how they can help.

Before the session, take a moment to think about your feelings, any specific goals you’d like to work on, and the main issues you want to discuss. If the session is virtual, make sure you’re in a quiet, private spot where you can talk freely. Being open and honest will go a long way in helping your therapist understand you and provide support that fits your needs.