By Cassie Johnston
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The number one question I get when I start talking about mental health is, How do you go about finding a therapist? I get it! It seems incredibly daunting to find a complete stranger who you feel comfortable sharing your deepest and darkest emotions with (although, I’d say that it’s often easier to share those with a complete stranger than someone close to you).
Much like dating, finding the right therapist for you is a bit of a game of trial-and-error. You just don’t know if you’re a good fit until you’re in a room together (either a physical room or a chat room if you’re using an online therapy service). That being said, there are some tips I can share to make finding your “candidates” a bit easier.
Some things to keep in mind through your entire therapist search:
Okay, now let me walk you through the exact steps I took to find a therapist, and hopefully, they’ll help you along your journey!
Do you want a therapist who specializes in LGBTQ+ issues? Do you want a female therapist? Do you want a therapist who has kids? Do want to do therapy in Spanish? Do you want a therapist who is Christian? Do you want a therapist who is older than you? Start by writing this list down. What qualities does a therapist need to have to feel like they “get” you?
Once you have all those qualities down on a piece of paper, rank them in order of most important to least important. The chances that you can find a therapist in your area and in your price range that is accepting new patients that has all your wants? Slim. But you probably can find one that has your top 3-5, so you’ll need to identify those.
The first step was about your wants, now we’re onto your needs—which can sometimes really be hard to figure out. Do you need tough love? Do you need someone to coddle you? Do you need a motherlike figure? Do you need someone who is no-nonsense? Do you need someone to cry to?
A good way to figure this out is to think about the people in your life in the past who have helped push you in a good direction. The people who uplift you and make you be better. What were there qualities? That’s what you’re looking for from the personality and therapy style of your therapist.
Thanks to the Affordable Care Act, the majority of health insurance plans are now required to cover mental health care here in the US—for some plans, that means regular therapy appointments, so make sure to check with your insurer.
That being said, many (many!) independent therapists do not work with health insurance companies for varying reasons and will need to be paid out-of-pocket. Thankfully, many of them also work on a sliding scale to help provide mental health care to everyone.
Either way, you need to decide what you can afford (while keeping in mind that mental health care is just as important as your blood pressure medication). Is it $200 a month? Is it $20 for your copay each month? Your budget limitations will affect which therapists will be in your list of maybes.
Of course, in person, in an office is the most common way to see a therapist, but it’s 2018, kids! You don’t have to have your therapy sessions in a stuffy office if you don’t want to.
There are therapy apps (my first therapy experience was with Talkspace, and I highly recommend it for an affordable, low barrier entry point into therapy—BetterHelp is another one). Some therapists do walking therapy sessions (mine does). Some therapists do house calls (mine does). Some therapists do video chat visits (that’s how I see my therapist almost every week now—it’s so much easier than driving into town). Some therapists do animal therapy (incorporating therapy dogs or horses or other animals). Some therapists do art therapy.
If sitting on a couch and spouting your feelings for an hour doesn’t feel like a good fit for you, then figure out what is a good fit! If you know you want a therapist who does walking sessions, you’ll be able to narrow down your search dramatically.
Pardon my language, but eff the mental health stigma. We need to be talking more about our mental health, not less. Open up the conversation with your friends by just putting a general “Hey, I’m looking for therapist recommendations! DM me if you know someone great.” message out on social media. Not only will you get some recommendations, but you might start up a conversation about mental health with someone new!
Another approach: if someone in your life openly talks about their mental health care (like, ahem, me), send them a message asking for therapist suggestions. Chances are, they’ve seen a few and are happy to help!
These recommendations are the first therapists that go on your list of names to investigate further! You can’t beat a personal referral, so anyone you hear about from a friend is worth your due diligence. I will note that many therapists will not see close friends or family members at the same time due to conflicts-of-interest. So if your best friend is seeing a therapist, you might not be able to get into her counselor—but you might be able to find someone “adjacent” (like someone at the same practice) that has similar qualities. Or get a recommendation from her counselor for someone else with a similar style in your area.
Now that you know the qualities you want/need in a therapist, it’s time to start searching. The Psychology Today website has an excellent Find a Therapist search function (this is how I found my therapist). Once you’ve put in your location, there is a really robust sorting feature so you can filter the therapists by the qualities you decided on earlier. You can also sort by insurance company and what issues they specialize in (ADHD, anxiety, depression, etc.). There are lots of websites that do this (Good Therapy and Therapy Tribe are two others), so make sure to check around.
Collect the names of the therapists that seem like they check off your requirements, and add them to the list with the personal referrals from above.
You can start calling right away after you make your list, but being a digital native whose entire life is on the internet, I did a little more digging before I started on the phone. I found the professional (not personal—that’s a little creepy) social media accounts and websites for each of the therapists on my list. Not only does this tell me a lot about them by what kind of content they share, but I also desperately needed a therapist who understood my heavily digital life.
When I found my current therapist’s practice Facebook page, she had posted just that morning a meme that said, “And if today, all you did was hold yourself together, I am proud of you.” I read it and literally burst into tears. It was exactly what I needed to hear and she wasn’t even my therapist yet! Her social media accounts gave me an insight into her personality that I couldn’t have gotten elsewhere.
You’ve done all the researching you can, it’s time to actually get in a room with your therapist candidates and do a trial run. If you have any questions you need to be answered, you can always ask over phone or email, but I preferred actually getting in a room with the therapists and seeing what they had to say face-to-face.
I recommend booking with at least three different therapists at first. Many therapists require lots (lots!) of paperwork to get started with them, so it can be a little annoying to fill that out for all three candidates, but I think seeing how different practices and therapists work is really valuable.
In my experience, the first appointment with a therapist doesn’t really get down to the nitty-gritty stuff—it’s more of a get-to-know-you session, which is perfect for your purposes right now. When you go into the session, let the therapist know you are seeing a few different therapists in the area over the next few weeks to see who is a good fit (if they scoff at this, you pretty much immediately know this is not the therapist for you).
Some questions to ask yourself during (or immediately after) a therapy session. I recommend writing these on a piece of paper and then filling them out when you get back to your car after your first session with each therapist.
It should be pretty clear, pretty quickly which therapist is a good fit, and if none seem like a good fit—go back to the drawing board! Feel free to “date around” to land on your perfect therapist.
Also a reminder: a therapeutic relationship is always evolving. A therapist that might have been a great fit for you and your mental health care a year ago might not be a good fit for you now, always make sure to check in with your goals and progress along the way to make sure your therapist is still the right person to help you navigate your mental health care.
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This is a lot of wonderful information! I just recently started seeing a therapist a month ago for a combination of childhood PTSD/anxiety/mild depression, and just in that time I’ve been able to feel some relief and some change.
I wanted to add that you are correct that not all insurance plans are required to cover mental health care. I have a plan that I acquired from the federal health care exchange, and it unfortunately covers nothing. :( So I wanted to offer a resource I discovered in my own desperate search for how to afford therapy: the Open Path Collective (openpathcollective.org). It is a nationwide group of licensed therapists who see patients at regular office rates normally, but reserve a certain number of office visits each week for affordable-rate patients. The cost for those visits is $30-$50. You have to fill out an application to join the collective and see if your financial need qualifies you, but they have very in-depth profiles of their counselors and availability that makes it very easy to pick the right one. It was a true godsend to discover this collective!
This is a wonderful post. It’s one thing to say “take care of your mental health” but a whole other to give a detailed step by step on how to get started. I had one of those moments where seeing this post today was timely in my own life so thank you. (also my mom is an LICSW and I’m going to make sure she gets her social media professional pages up to speed!!) Thanks!
Just a quick note to add – Psy.D. is a doctorate in psychology, but psychologists may also have their PhDs. PhDs typically receive more research training (although this isn’t across the board true), but both clinical psychology PhDs and PsyDs receive training in psychological assessment and intervention. The titles you mentioned (PsyD, PhD, LCSW, LMHC, etc.) also don’t typically vary by state. You will see those pretty consistently wherever you are looking for a therapist, although licensure requirements may vary slightly by state (for psychologists at least – I am less familiar with master’s level requirements). But this shouldn’t impact quality of care and is more about knowing the specific laws, etc. in your area of jurisdiction as a therapist
Thank you for the Psy.D. clarification! My experience has been that the titles do vary state-to-state for the master’s level counselors, at least. I live on the Indiana/Kentucky border, and it’s LMHC here in Indiana and LPCC in Kentucky. I was really confused at first until someone explained to me that they are different titles for the same basic licensure. :) Most therapists in our area are both LMHCs and LPCCs so they can practice in both states.
This was a great post! Your advice is great and I’m so glad you found a good fit fairly quickly!
The difference in the accreditations are based on a person’s study path – which leads them toward an orientation for how they approach treatment (MFTs for example approach things from a systems perspective where therapy is rarely done individually but involves how we are connected and the impacts of our relationships; PsyDs are often research oriented , etc). You can choose which accreditation to pursue and each state has legal rules for experience, education and testing. You point is well taken – just make sure they are committed to their profession and the education needed to get and maintain whatever certification fits. To that point, I would add that you do one more step – go to your state’s Department of Regulatory Agencies and look up their name to double check there are not complaints filed against their license.
And, we too wish there weren’t so much paperwork! Usually it is to meet state mandates for disclosure and our licensure requirements – which really is in the client’s benefit but it can be very overwhelming.
For those people who have employer-provided health insurance, there is often an Employee Assistance Program that can help. I was fortunate to find the right fit with my first try through my EAP, and I also was given several free sessions before I had to start paying through insurance.
I agree that it’s best to check if a therapist can make you feel comfortable during your first appointment. This is something that I’ll be sure to do because I have a hunch that I have been suffering from depression. Since my husband died, I have lost the interest to talk to anyone. I want to recover fast because my only child depends on me. I’ll do all your tips to find the best therapist that won’t make me feel uneasy to share my thoughts.
Thank you for stating that any good therapist worth the degrees on their wall knows this and won’t fault you for trying to find a better fit if you aren’t seeing progress. I struggle with really bad depression and have been considering seeing a counselor. I will definitely keep all of your great tips and information in mind when trying to find the perfect therapist for me.
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