A Practical & Comprehensive Guide to Finding the Right Therapist for You
Let's be honest, trying to find a mental health professional who takes your preferred form of payment/insurance, fits with your schedule, and seems like a good fit sucks--especially in the U.S. It's even worse if we already are experiencing some form of stress that is leading us to trying to find a clinician in the first place.
Here is my practical and comprehensive advice on how to find a therapist who meets your needs as best as possible.
Remind yourself why you're doing this.
First and most importantly, take a moment to express gratitude to yourself for starting this process. It has not been easy getting here and there are so many barriers, yet here you are trying.
I recommend writing down at least one reason of why you are starting the process of finding a therapist. It could be the same reason you'd explain to a potential therapist as to why you are seeking therapy , often referred to as "the presenting problem" but it could also be something more simple or more personal.
Examples: "I want to feel less depressed, I have tried to feel better on my own but I need something more." or "I have hope that someone can help me change my behavior/thoughts/feelings." or "I sincerely believe it's time to do something differently."
This may sound cheesy but it will serve as a helpful reminder if/when this process feels discouraging, stressful, or difficult. This reason will serve as your guide post and why you need to push forward.
Decide how you are going to pay for services.
In an ideal system, this wouldn't be one of the first steps to finding mental health care but it's an unfortunate reality in the U.S.
Insurance:
If you are going to use health insurance plan to cover therapy, it is critical to understand your insurance coverage. This can be done in two ways, 1) go to the provider's website, log in, and search for your mental/behavioral health coverage or 2) call the 1-800 number on the back of your insurance card to talk to a real human about it. You will want to know if you have a deductible (up-front out of pocket threshold to meet prior to more coverage), a co-pay (you pay a fee, while insurance pays the rest), and a limit on the number of sessions. It may be also helpful to understand your coverage for specific types of treatment such as substance abuse or mental health hospitalization in case you may need them at some point.
Next, find out if your insurance provider has a specific list or registry that it uses to you what therapist are "in network" (aka covered by your insurance plan).
Benefits: Cheaper to you since you’re already paying into coverage.
Considerations: Limited options of therapists, less confidentiality since info has to be shared with insurance for coverage, and potential to max out on sessions before you feel ready.
Super Bill:
Some therapists do not directly bill insurance, which means they are not "in network". However, they may offer "super billing" which means they will create a list of services and sessions provided to you that you may submit to your insurance company to request reimbursement for "an out of network provider". Of course, this only makes sense if your insurance has any type of coverage for out of network providers, usually this would mean you have a PPO insurance.
If this is a route you think you will go, or need to deviate to in order to find the right therapist. I do recommend following the above instructions for insurance coverage to confirm this will actually work for you. See my tips on out of network billing here.
You will then need to understand the process for submitting the super bill to your insurance as well as their process for reimbursement (method, length of time, etc.)
Benefits: Expands your options of therapist, utilizes insurance coverage you already have, usually more confidential than in-network coverage.
Considerations: More time consuming for you, and initial stress about how your sessions will be covered.
Private Pay
If you are paying out of pocket for therapy, you can expect to pay anywhere between $100 - $300 per session depending on your location and therapist preferences. This is definitely a chunk of money so I can understand if someone would be hesitant. If this is your only option, I am here to remind you that you and your well-being are the best thing you can possibly invest in.
Sliding Scale - some therapists, clinics, and platforms offer a "sliding scale" pay option, which means that based on you or your household's financial status they offer varying rates to make services for available. Some practitioners will tell you this directly on their websites but others will not. If you find someone you really like who is out of your price range, it may be helpful to just ask whether they offer any type of sliding scale.
Benefits: Wide range of options for therapists, and insurance does not dictate how many sessions are available to you. Highest level of confidentiality since your records are only being kept by your therapist.
Considerations: Cost is higher and may impact your quality of life in other areas.
Decide on your therapist preferences and what is most important to you.
Consider what your non-negotiable characteristics are and others you would be willing to be flexible on depending on availability.
Characteristics to Consider:
Your Geographical Location - Clinicians are licensed by each state and must have a license to practice for the state that you where you live. This is a non-negotiable!
Issues/goal they work with - Not all therapists work on all issues/goal. Think about what your top 1-3 things you would like to work on in therapy are and compare them to with what therapists say they do.
Examples: anxiety, depression, stress, burnout, family boundaries, childhood trauma, etc.Type of Degrees - there are so many different types of mental health professionals, this might not make a big difference to everyone but for some it may be more important depending on the type of therapy or issues they are looking to discuss. For example, if you are interested in being prescribed medication for your mental health, you would need to see a psychiatrist in some capacity (whether as your sole provider or in tangent with another provider) as the other degrees cannot prescribe medicine.
Examples from California: License in Clinical Social Work (LCSW), License in Marriage and Family Therapy (LMFT), License in Professional Clinical Counseling (LPCC), Doctorate in Psychology (PsyD), PHD in Psychology, Psychiatrist MD or DO, etc.Gender - consider who you would be most comfortable speaking with and building a relationship with. Would it be best for you to be seen as someone the same gender as you or maybe not? Would it be best to see someone who is not the same gender as a problematic family member?
Race/Ethnicity/Culture/Language - Our multi-faceted identities are one of the things we should be addressing and diving into in therapy, it's best to make sure you're with a therapist whom you feel can appropriately address this with you. This is especially important if you would like to work on issues surrounding your background or historical trauma. If you're multi-lingual, consider what language you can express yourself the best in.
This factor does not necessarily mean you need to see someone with the exact background as you, it could also mean finding someone who is open to learning about your culture (practices "cultural humility") or has experience working with people from your culture.Modalities - These are the different styles of therapy the clinician will use in a session. It is common for most modern therapists to use "an eclectic approach" (a combo of multiple modalities) which will mean something different for each therapist. If you've been to therapy before or have experience with mental health and know specific styles that have worked or not worked for you this might be something to consider.
Common modalities include: Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Motivational Interviewing (MI), Somatic Psychology, Narrative Therapy, Humanistic/Client-Centered/Person-Center, Psychodynamic/Psychoanalytic, etc.
If you feel overwhelmed by all this jargon, don't worry! You can ask the therapists to explain their modalities and how it looks in practice. Just skip this consideration for now.
Start your search process.
This can depend on your priorities as well as how you plan to pay.
For Insurance:
I recommend starting with their registry of mental health providers. An important note though, insurance companies do not seem to update these as often as they should and you will often need to confirm directly with the therapist whether they actually accept your insurance.
Use a platform where they accept your insurance coverage. There are multiple websites who do the legwork of insurance paperwork for providers and have a list of therapists they can refer you to. The benefits of this method is that you usually submit a form and/or work with a care navigator who will connect you to a therapist who most closely meets your preferences and availability.
Benefits: This means you may only need to contact a couple people in order to find a therapist.
Considerations: you are sharing your personal info with a larger company instead of only individual providers, so be mindful of what you would like to share on your intake forms.
Use general therapy search registries which allow you to create search specifications to narrow down your specifics. Keep in mind usually therapists must pay to list themselves on each registry. Just because you don’t find someone listed there, doesn’t mean they aren’t taking new clients, available, or share the values of the registry.
Make a list of providers who you think are a good fit for you according to your criteria.
Remember to be flexible if you cannot find someone who meets all your ideal characteristics. I would recommend starting with a list of no more than 10 therapists. Save this in a document or on a physical paper where you can return to it, make notes, and track your process.
Look up their website to get an idea of their personality and expertise.
Cross anyone off your list that you know right away 100% would not be a good fit. You can take this one therapist at a time, doing one a day, or a couple a week, work at your own pace.
Contact your narrowed list either by website, email, or even phone.
Make a goal for yourself of how many you will do each week and make note on your list of who you have attempted to contact.
Here is a sample email:
"Good Morning,
My name is ___(Your Name)____. I am looking for a therapist who is licensed in ____(your state)___ and accepts ____(form of pay)___ . I am generally available for sessions on _____these days and times_____. I am hoping to address ____(1-3 primary issues in minimal detail)____. I would like to connect with you further, I can be best reached at ___(email, phone, etc.)__.
Thank you!
(Your Name)"
Set up 15 minute consultation interviews with prospective therapists.
This will be a chance to ask questions, get to know them, and get a general feel for their energy and communication style. Be ready to provide some brief info about why you are seeking therapy at this time.
Questions to consider asking:
Tell me about yourself.
Tell me what a typical therapeutic process would look like with you.
How would you approach (my primary reasons for seeking therapy)?
Do you seek consultation from other clinicians on cases? How does that work?
Confirm availability with your schedule
Confirm ability to accept preferred form of payment
Consider taking brief notes from your interviews on your document. No need to commit to someone right after during the interview, tell them you're considering other therapists and want to make sure you find the best fit. Give them a timeline in which they can expect to each back from you.
Be mindful of how you may feel about discussing your reasons for seeking therapy and whether you will need time for emotional support built in after your interviews. It can be difficult to open up to strangers, especially ones who you may not speak with again. I recommend not doing these interviews all back to back but giving yourself some time in between to take care of yourself and do something relaxing.
Decide on the best fit for you.
There are many factors to consider when deciding on a therapist, beyond the logistics. It may be helpful to consider the following when making your choice. (Also remember, you don't have to stay with a therapist forever, you can switch and find someone who is a better match for you!)
How did this therapist make you feel?
Indications of a good fit:
Comfortable
Relaxed (acknowledge what nervousness might just come from meeting with someone new and talking about yourself)
Safe
Free to be honest and authentic
Seen, heard, understood
Like you had space to guide the conversation and ask your questions
Like an individual, who has a unique experience with specific needs
Indications of a off fit:
Judged
Triggered or activated
Energy was not a good match - too energetic, or not energetic enough
On edge
Like you needed to pretend to be anything else besides yourself
Like they talked too much about themselves and were rigid in the direction of the conversation
Like you were lumped into a category, or they were overly identifying with you.
How qualified is this therapist to be your therapist?
Did they meet your expectations for their educational, licensing, and experience backgrounds?
Have they worked with people similar to you before?
Have they worked on similar problems before?
Keep in mind there's no such thing as a perfect therapist. It is very hard to find someone who meets your criteria 100% and it might surprise you how someone slightly unexpected can teach you to grow and learn in new ways. Just try to decipher what characteristics you are willing or not willing to compromise. Consider if you can be more flexible with your preferences.
If you found a therapist who can meets your needs, congratulations! Let them know and set up your first session.
If it didn't work out, that's okay too and it can sometimes take time. If there was a therapist whom you really liked but had schedule conflicts see if they can put you on a waitlist or suggest a therapist with a similar approach.
You might need to go back to your list or search to find more therapists to reach out to for interviews. Stick with it, revisit your reason from step 1 to remind yourself why you are making this commitment to yourself and your well-being. Although therapy may not be for everyone, the fact that you are reading this and even consider therapy means that it could likely benefit you. I encourage you to keep trying and remain diligent in your search. If you're still feeling discouraged consider taking a break or asking a loved one to hold you accountable for the process.
Take care of yourself throughout the process. It can be difficult to not find a therapist right away or be turned away by therapists. It can bring up old pains of rejection, embarrassment and shame. Find a safe place or person to express your hurt and express gratitude to yourself for trying to heal.
You are important, worthy of help, and worthy of healing.