What to expect when trying to find a new therAPIST

These guidelines are for finding ongoing, therapeutic support on an out-patient basis, not emergency care.

If you're in crisis and need immediate support, dial 911 for emergency services. Call or text 988 for suicide & crisis lifeline, or go to your nearest emergency room.

Trying to find a new therapist can feel overwhelming (even for therapists)! It's tempting to just go by photo (yeah, we know you do it 😉) but in all seriousness, that probably won't help you find the best support. Here are a few guidelines that can make it easier to find the mental health professional that will best meet your needs:

1. Know yourself:

• What identities are most important to you, and how do you identify people who honor those identities? Are there buzz words or styles that you look for? Many therapists specialize in working with specific communities (LGBTQ+, BIPOC, specific cultural backgrounds) or issues (eating disorders, addiction, grief). Don't hesitate to ask about their experience and training.

• Is exploring your intersectional identities one of your goals for therapy, or do you already have language to name them?

• Do you have any lived experiences that might need special care or inform your choice?

• Is there a specific therapeutic modality you want to explore i.e. people who have lived through trauma often find EMDR supportive, while DBT is particularly helpful for people who feel like they don’t have great self regulation skills, or who have developed bad habits? Knowing this ahead of time helps narrow your search.

• What setting appeals to you? Telehealth or in-person? One-on-one or group? Indoors or outdoors? Talk therapy, art, movement, or a mix?

• What level of time and financial commitment are you able to make?

2. How are you planning to pay?

• In-Network with insurance

  This is the method most people know about. It works the same as your medical or dental benefits - your care providers get paneled (a fancy way of saying vetted and approved) by certain insurance companies. You pay a co-pay until you meet your deductible. Your therapist gets paid part of their stated rate by your insurance company. This is a good option for many, and makes the process fairly straightforward.

  Why don’t all therapists get paneled? Many therapists do not get paneled because the paneling process can be expensive, a hassle, and at the end of the day providers receive substantially less than their standard hourly rate from insurance companies. They are also forced to diagnose (whether it is necessary for care or not) and have to submit to oversight from a body that is not directly involved in client care.

• Out-of Network with insurance

  A therapist does not need to be “in-network” with your insurance in order to work with your insurance. Some insurance providers offer out-of-network benefits that will reimburse you for part of the cost of therapy which can help make things more affordable. When meeting with providers be sure to ask what they suggest, and ask if they work with a service like Thrizer or are willing to provide clients with superbills that clients can submit for reimbursement. This option does require a diagnosis and will include oversight regarding care decisions made by the provider.

• Private Pay

  If you can afford it, so called private pay (when you pay your therapist directly) offers the most anonymity and freedom. This option allows clients and providers to make their own decisions about diagnosis (or not), care, etc.

• Sliding Scale

  If you find a therapist or agency that works on a sliding scale basis, that can be less expensive than a co-pay and gives all the freedoms that private pay offers.

• Community Mental Health Centers

  Community mental health and training clinics often have foundational support that makes therapy much less expensive. People sometimes assume that providers in private practice are the best, but this isn’t necessarily true. While there are certainly talented providers in private practice (ahem, like the therapists with Light Work Counseling, ahem), providers who work in community mental health have broad experience. They also are often the most plugged into community resources, so while a provider in private practice has their own knowledge base on which to draw, a provider in community mental health has their own knowledge base as well as the knowledge base and resources of the entire organization behind them.

3. Define your goals:

• What made you start looking for a therapist?

• What are your goals for therapy?

• Are you looking for a diagnosis or testing?

• Are you looking for medicine?

• Have you received a diagnosis and need ongoing support for symptoms?

• Do you want someone to help you practice specific skills, or do you just want someone to talk to?

• Have you spent a lot of time in therapy and now just want someone to check in with?

4. Know the difference between what mental health professionals provide:

Quick: Which mental health profession is the most expert in client care? PsyNP, Psychiatrist, Psychologist, LCSW, or LPC? It's a trick question - they're peers! Each offers a slightly different focus.

• Psychiatrists and Psychiatric Nurse Practitioners can prescribe medication and some do therapy, though time is often limited by insurance. These professionals tend to be the most costly (psychiatrists more than PNPs). They're trained in the medical model of mental health.

• Psychologists are able to do therapy but often focus on research or diagnostic testing. They receive training in different therapeutic modalities and are trained in the medical model of mental health.

• Social workers (LCSW) typically focus on direct client care providing therapy or system navigation. Social workers can diagnose and some do research, but their focus is providing direct care to clients. While they do receive medical model training, they specialize in understanding mental health from a systemic perspective focusing on how people interact with their environment and how environments interact with people. They're trained to navigate systems and connect you with resources. Social workers do learn about therapeutic modalities but they choose what to focus on and specialize in rather than receiving a broad overview.

• LPCs have a strong focus on the application of different therapeutic modalities. They are trained in the medical model of mental health.

I recommend starting with a social worker or LPC. These professionals can help you name your needs and either help you themselves or point you toward other professionals. They're also typically the least expensive and least stigmatizing entry to mental health care.

After meeting with one of the professionals listed above, you might choose to also work with a:

• Life Coaches: Life coaches focus on skill building.

• Certified Peer Specialists (CPS): CPS is a relatively new professional addition to mental health care but one that offers client facing, front line and sometimes life saving support. CPS professionals are people who have specialized mental health training that allows them to use their lived experience of successfully navigating mental health challenges that they or a loved one experience to help people who are just learning to live with symptoms navigate daily challenges.

Years ago I went straight to a psychiatrist (fanciest degree, right?). He said, "I can see you're having a hard time, but if you don't need medicine, I'm probably not the best person to help you." I'm grateful he was honest - I ultimately found an LPC who helped me navigate the challenges I was facing successfully.

If you are still uncertain and would like more information about how all of these care options fit together, click HERE.

5. Listen to your gut (but make sure it's your gut):

• A good therapist will let you meet with them to see if you're a good fit BEFORE you commit. When you call, be ready to talk about what's happening in your life right now that is causing you to seek therapy.

• Good therapy doesn't always feel good - sometimes it's uncomfortable or even painful. That's often a sign of growth. The moment you want to fire your therapist might be when the most important work is happening. Bring these feelings up in session - therapists want to explore these feelings with you.

• If your therapist is reactive, dismissive, or unwilling to explore these feelings, that might be a sign this isn't a good fit.

6. It's a journey, NOT a destination!

• Expect to interview at least three therapists before you find your match.

• You might not stay with the same therapist forever.

• You might have more than one therapist at the same time (MAKE SURE they know about each other). Some are amazing talk therapists but don't offer EMDR, somatic therapy, or EFT. You might see another practitioner periodically for a specific modality. That's totally fine as long as you're transparent. Ideally, you'd sign an ROI so your care providers can collaborate to give you the best possible support!

7. Where do I look for therapists?

You can always just Google "therapist near me," but for a more organized approach try:

• Regional Facebook groups (aka the best modern Yellow Pages) - search for recommendations on the group page or post your query. Use the questions above to help you be as specific as possible!

• Your insurance company's website - they often have directories of in-network therapists. Not always the least expensive option, but helpful.

• Websites including Psychology Today, Alma, Thrizer, Grow