1. Consider the top issues and concerns you want to address.
Whether it’s your first time going to therapy or you are a returning client, there is usually a major issue or multiple issues that are motivating you to seek therapy.
You may be experiencing panic attacks, going through a divorce, suffering from severe depression, dealing with challenging family dynamics, having trouble forming lasting relationships, coping with a history of trauma and abuse, or unsure about career goals, navigating issues of identity...
Being clear, or as clear as possible, on what you want to address will help you find the right therapist.
Some concerns are best to work with a specialist such as disordered eating and sexual trauma.
2. Ask trusted friends and colleagues for referrals.
Ask people you trust if they have referrals for you. Ask if they like their therapist and why they like their therapist. The 'why' is important. What someone likes might not work for you.
If you have friends or even acquaintances in the counseling field, ask them if they can provide referrals. Therapists usually have an extensive network of other therapists who they trust.
Tell them what issues you are working on and what's important for you in the therapist.
The more information you provide, the better the referral.
3. Research online.
Check for the following:
4. Have an understanding of the identity of the therapist.
The identity of the therapist - their lived experience in the world - is critical to your treatment. Who they are affects your relationship to them, how they see you, and how you feel in the room with them.
While your therapist doesn’t have to be similar to you in their identity to be effective, some similarities in lived experience will help you feel more safe and/or positive towards them and help speed the therapeutic alliance in service of your treatment.
5. Check for fees and insurance.
If you have health insurance, check which therapists are in your insurance network, what fees might be covered by insurance, and what fees you are responsible for.
Some therapists are completely out of network but will provide invoices / statements / superbills that you are able to submit to your insurance company for reimbursement.
Don’t let insurance coverage be the sole determinant of who you choose as your therapist.
Some therapists are able to offer sliding scale depending on your financial circumstances.
Some community clinics and universities also offer therapy services provided by interns at lower rates.
7. Short list 2-5 therapists and schedule phone or in-person consultations.
Most therapists offer a free short phone or in-person consultation to help determine if you are a good fit to work together. Take advantage of this and schedule a time to talk and meet with them. It will be very helpful to determine who you want to work with.
There are various different types of clinicians and licenses in the mental health field so it can be confusing as to what type of clinician to look for and what their licenses mean.
Here is a list of different type of clinicians. All of them can provide counseling and therapy with slight differences on focus. But their licenses only tell you one thing. It's important to find out what they specialize in, is counseling the main part of their practice, what sessions might look like with them.
LPC (Licensed Professional Counselor): Counseling and able to provide vocational / career counseling
LSW or LCSW (Licensed Social Worker or Licensed Clinical Social Worker): Counseling and trained in community mental health issues
LMFT (Licensed Marriage and Family Therapist): Primarily focused on counseling and psychotherapy for individuals, couples, families and groups
Psychologist: Counseling and able to provide psychological testing, assessment and official diagnosis
Psychiatrist: Able to diagnose and prescribe medication but might not provide counseling
PMHNP (Psychiatric and Mental Health Nurse Practitioner): Able to diagnose and prescribe medication but might not provide counseling
Most therapists offer free phone consultation for both of you to assess if you are a good fit to work together. During the call, here are some questions you can ask the therapist:
The therapist / client relationship is unique. While it is a professional relationship, it's intimate and relational. So a few points to consider:
The most important consideration is whether the therapist culturally aware, competent, and informed.
1. If you are a student in college, check out your campus counseling center. You should be able to receive a number of counseling sessions (8-12 sessions) free of charge.
2. If have health insurance, check what mental health benefits you have for both in-network and out of network. With in-network, you only pay your co-pay. With out of network, you might be able to get a percentage of your therapy fees reimbursed depending on your plan.
3. If your employer offers FSA (Flexible Savings Account) or HSA (Health Savings Account), take advantage of this program. By using FSA/HSA, you are paying for therapy with pre-tax dollars.
4. Some employers offer short term counseling via an Employee Assistance Program (EAP). This is paid by your employer.
5. Some therapists offer a limited number of reduced fee sessions. It might be based on your income, background, circumstances, etc.
6. Review your finances. Is therapy “objectively” out of reach? Or, are there other reasons at play? Are there areas where you could make adjustments to make room for therapy? Where and how we spend money is often emotional and tied to values.
7. Consider group therapy and support groups. While a group setting isn’t for everyone and is not the same as individual therapy, groups can be healing and supportive. Support groups such as Alcoholic Anonymous, Al-Anon (for family and friends of addicts), CoDa (Co-Dependents Anonymous) are free of charge.
8. Consider sliding scale clinics. Most cities have sliding scale clinics specially cities with counseling graduate school programs. These clinics are staffed with trainees and interns gaining experience towards licensure. The trainees and interns are supervised by licensed clinicians. The sliding scale can start at $10-$25 a session.
When you use insurance to pay for therapy (either in network or out of network), the therapist is required to provide the insurance company with a diagnosis of your condition. Some insurance companies might also require progress notes, etc. This diagnosis will stay on your medical record.
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