Teen Mental Health Advice with Therapist Katey Nicolai, PhD

Mental Health Questions Answered: Finding Care and Supporting Others

Hi! I'm Dr. Katey Nicolai and I'm back to answer more of your questions about mental health. If you have questions or want to learn more, reach out to me at Joon Care!

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How do you find the right therapist? 

That's a great question. First of all, I'm excited that you want to try counseling for your mental health, or to just to talk about what's on your mind. Thinking that you might be interested in trying counseling is an awesome first step and you should be proud of yourself. Finding the right therapist is a lot like finding the right friend or partner or any person that you’d want to spend time with. Here are the three steps to take:

  1. Rank the things you want to talk to your therapist about. Try to write down three topics that you'd like to focus on in therapy. This will help guide your search and allow you to find someone who might specialize in one of those areas. If you're unsure what you want to discuss, or maybe you are feeling a more general sense of unhappiness with your life, that's okay. It's still a goal and a worthy topic to seek help for.
  2. Think about the qualities of the people in your life that are easy to talk to. Are you the kind of person who opens up more when the person around you is funny or more serious? Are you the kind of person who needs someone to structure the session for you? Or do you prefer someone who's a little bit more gentle and open-ended? Try to write down three things and when you're setting up initial meetings with therapists, you'll have a guiding sense of what you think is going to be the best fit for you.
  3. Just try it! Most therapists are nice people, that's why we became therapists in the first place! So if you're feeling a lot of barriers or you're feeling really nervous about it, just start making those first phone calls. You'll start to feel in your heart when it's right and when you found someone that you can really talk to. If the first couple meetings don't go well that's okay, there are other people out there, just keep searching and just take that first step. Before you know it you'll be matched with someone who really fits with you.

What is the best way to support someone who has mental health issues?

Maybe it's not you who is looking for mental health support. Maybe it's a loved one or someone in your life who's struggling with mental health. I think the first step is to try as best as you can to have empathy for that person. Know that what they're struggling with is not their fault but something that may be outside of their control.

Once you've really dug into that empathy and built compassion for that person, the second thing to think about is good boundaries with that person. Just because someone has a mental health concern in your life doesn't mean that you have to be the only solution available to them. You can certainly be a support. You can certainly be someone to confide in. But, if you find that you're the only person in their life that they're coming to for support with their mental health concern, that may be overwhelming. Likely you aren't equipped to cope with everything that they're bringing to the table, even if you struggled with mental health concerns yourself, or even if you have a lot of experience talking to people who are struggling. It's not the same as being a licensed counselor who has lots of training on how to keep boundaries and also lots of training to know what to do–especially when we get into deep unknown territory. 

My recommendation is to have a lot of empathy and compassion but also to hold your boundary on what you're able to provide and when. I think as a subset to that, it can be really helpful for people who are struggling with mental health concerns to be their ally. For example, they may need help searching for the right therapeutic support for themselves. Maybe they need help setting up appointments and keeping those appointments with a mental health provider. Maybe they need someone to actually help them take those first steps of making the phone call for them or connecting them to medical care. So I think being an ally in that sense–being someone to partner with them and help seek out professional services–can be a really good way to help hold your boundary while continuing to be loving and compassionate towards that person. 

How do you cope with being diagnosed? 

This question has to do with someone who may be going to therapy for the first time or going to the doctor and getting a big label placed on them by a provider. Maybe they've received a mental health diagnosis for the first time and that diagnosis can feel like a heavy burden. It can feel like something really strong, influential and heavy that they now have to carry with them for the rest of their life. Or maybe the diagnosis was something that they weren't expecting. Maybe you thought you were struggling with one thing and now a provider has assessed you and told you it's actually another kind of concern that surprised and overwhelmed you. The first thing to do is to ask your provider for more clarity around what helped them decide that you were eligible for this diagnosis. Ask them, “what about my symptoms made you feel that this was the most appropriate diagnosis?” Approach it with curiosity and maybe they can help illuminate more about what that diagnosis means. If you're struggling with a diagnosis and not sure what to do next, it may be that there was no follow-up direction. Rest assured that there is a therapist out there who is qualified and an expert in treating whatever diagnosis you have. That diagnosis can actually provide you with the power to seek somebody who specializes in the type of struggle you are facing and you can use that diagnosis as power to be your own advocate. Reach out to find specialized care for your diagnosis. The more you seek that out the better equipped that person will be to treat specifically what you have going on and hopefully find a good connection in therapy. 

Do you treat sexual trauma, assault, anxiety, depression? 

We can really put any item on that list and the answer will be yes–there's a counselor out there equipped to handle whatever heavy thing you're carrying. That might be trauma from your childhood, that might be a recent horrible event that you've had to go through, that might be something mild like anxiety about taking tests, that might be something really consuming like anxiety about leaving your house. No matter how big or how small, there is a counselor qualified to treat you and in most cases there's a counselor at Joon who's qualified to treat you. I would not let the label of a diagnosis or fear about what you might be bringing to counseling get in the way of you reaching out or taking that first step. Even if the first person you talk to tells you that they're not qualified to treat what you're presenting with, that doesn't mean that there's not somebody else who's better suited to you. Again, make a list of what's most important to you, then reach out and try to connect with someone. Keep trying and I promise that you'll find the right counselor to support you.

Those are all of the questions that I have on the agenda. If you have more questions feel free to reach out to me at Joon Care and I look forward to talking with you guys again!

April 28, 2022
Katey Nicolai, PhD | VP of Clinical Services

Katey Nicolai, PhD | VP of Clinical Services

Katey Nicolai, PhD, is a licensed clinical psychologist who received her PhD in Clinical Psychology from Seattle Pacific University. Dr. Nicolai provides services to adolescents and adults using evidence-based treatment rooted in cognitive-behavioral and psychodynamic therapies, including Dialectical Behavior Therapy, interpersonal therapy, and family systems. Dr. Nicolai has specialized training in treating trauma and PTSD, personality disorders, self-harm and suicidailty, family problems, emotion dysregulation, and mood and anxiety disorders.

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