With only a couple days of this year left, you might be starting to think about all of the changes you hope to make in the new year. You might even be thinking about talking to someone—a professional, about your relationships, job, work, or school stress, and general mental health, moods, and wellbeing.
If you are, you’re not alone—much like gym memberships, the frequency of consumers accessing mental health services increases at the start of each year. And, as we approach the clean slate that we all need now more than ever (good riddance, 2020!), many of you will soon be on the hunt for a therapist.
Over the past almost decade that I’ve worked in mental health, I’ve heard countless people share their fears and therapist-horror-stories, all of which prevent them from seeking therapy.
“I left messages for over 50 therapists and never heard back.”
“They didn’t understand what I was saying.”
“Isn’t therapy for crazy people?”
“I don’t even know how to find a therapist.”
“I can’t afford therapy.”
“They said it’s not a good fit.”
“How is a stranger going to help me?”
The feedback usually comes in response to sharing what I do for a living, as if I’m responsible for the wrongdoing of therapists everywhere. I listen, smile, and usually joke, “well, on behalf of all therapists, I’m sorry,” before offering a few tips on how to find the RIGHT therapist. Because, the examples listed above each have one major thing in common—they are therapy repellants, preventing people who want therapy from seeking the support they need.
Before we go any further, let’s make an important distinction. Finding a therapist isn’t actually what’s difficult—it’s finding the RIGHT therapist that’s tricky.
In a lot of ways, finding a therapist is like finding a mate. It’s an intimate relationship that needs to meet your needs. You want someone you feel safe with, who gets you; someone who makes you feel heard and cared for, while challenging you enough to help you recognize your strengths, examine areas for improvement, and explore new insights, as they help to facilitate the changes that brought you to therapy in the first place.
Year after year, and study after study, the single most important factor in the efficacy of mental health treatment has remained the same: the therapist-patient relationship. It is more important than the type of therapy, education, experience, or training of the therapist. Of course, these things are important, too, but they are still not as important as the relationship itself.
So, if the weight of outcomes depends heavily on the therapeutic relationship and finding the right therapist, how does one go about finding a therapist that’s right for them?
Well, precious ones, here are 5 tips to take into account when you’re looking for a therapist:
Tip #1: How to Get Started
As a society, we’ve come a long way in terms of mental health, but we still have a lot of work to do because there is still much stigma associated with accessing mental health services. People are often nervous about sharing what they’re going through with a therapist. Will they think I’m beyond help? Will they confirm the negative thoughts I believe about myself? Fears like these are common and normal—it’s anxiety provoking to share intimate details of your life with a professional you’ve just met, and you might even think you’ll scare them away.
Well, my loves, I’m here to tell you otherwise. I assure you, therapists have seen and heard it all, and it’s really hard to scare us. Even newly licensed clinicians have been doing therapy for years, so the chances of truly shocking them are quite rare. Therapists are trained to help people and we anticipate you sharing your challenges with us—that’s why you’re here! Contrary to what some may think, we’re not mind readers. So, the more you share with us, the better we’re able to support you.
Here are some things to think about when you’re getting started, and possibly questioning what needing therapy means about you:
1. Most, if not all therapists, are required to do their own therapy in order to become a therapist. And, many therapists will continue therapy, even long after this requirement has been met—yes, your therapist needs therapy, too (hi, my name is Tracy, and I’m a therapist who has a therapist). Therapists believe in the therapeutic process, not just because it is our job, but because we have also sat on the couch and come face-to-face with our own humanity. We know that we all have room for growth, and we also know how hard it is to do the actual work.
2. Therapists do not think less of you when you cry or share what’s going on—we expect it, and we want to help.
3. We’ve seen a lot of tears, heard a lot of traumas, and we’ve even seen people yell, storm out, curse, and throw things (therapists have seen what?!). What might feel embarrassing to you, is just a normal Tuesday for us. Wherever you are, whatever you’re experiencing—we’re along for the ride with you.
4. Therapists have worked with people from varying, backgrounds and professions, and we’ve learned that even people at the top of their careers CAN and DO need therapy. That’s right—even your most well-respected and put-together family members, friends, colleagues, and providers, need support, too. And, most therapists hold the belief that everyone will benefit from therapy with the right person.
5. Therapy is a safe, non-judgmental space where you get to focus solely on yourself. How many other places award us this opportunity? If you’re living in today’s world, that means you’re likely juggling multiple roles, so the answer? Not many.
6. Therapists are bound by stringent ethics and confidentiality standards. Mental health is stricter than most other professions when it comes to these guidelines, even stricter than the guidelines in medical healthcare. Therapists aren’t even allowed to confirm or deny they are treating someone. Outside of a few exceptions, what you share will remain with only them, unless you give consent, or choose to share on your own.
Tip #2 How to Search for a Therapist
So now that you’ve decided you need a therapist, you have to figure out how to actually find one.
There are several ways to search for a therapist, and here are some ways you can do just that:
1. Online directories: there are many psychology specific directories, where you can peruse potential therapists. You can filter by location, insurance, experience, specialty, etc.
2. Web search: type in “therapy,” “mental health,” or “counseling,” and your search will populate multiple results for therapists in your area. You can then click through different websites to learn more about the results your search has yielded.
3. Ask friends and family: word of mouth referrals are great, because they’re coming from someone you trust!
4. Ask your other providers: your doctor, teacher, massage therapist, nutritionist, acupuncturist, and dentist, all likely have a list of trusted mental health referrals on hand.
5. If you’re using insurance, call the number on the back of your insurance card. A customer service representative will be able to provide you with a list of in-network providers.
Tip #3: What to Look for in a Therapist
You’ve made it this far, but now you’re feeling overwhelmed because many areas are saturated with mental health professionals, and you need to weed out therapists who don’t have what you’re looking for.
I often get inquiries from individuals who are convinced that I’m the therapist for them, but what they’re looking for may be out of my scope of competence. Ethically, therapists have to share their experience, and many times, we get referrals for people we are not equipped to work with. Our licenses are broad, but our experiences, interests, and training, are unique. There are some therapists who work exclusively with couples, while others have never seen a couple. So, if a therapist is referring you out, it’s not personal, and is likely in your best interest. If a therapist tells you that they are not the right fit, they should be providing you with alternate referrals.
When searching for a therapist, most will have a professional website, or some sort of profile you can see. Read about them and their expertise, and make sure they have worked with people who have had similar experiences to yours.
Here are some questions to ask yourself, when you’re vetting a therapist:
1. Are you seeking a therapist with specific demographics?
2. Is it important to you that they have certain lived experience?
3. Do they have specific training, experience, or certifications? Do they provide the type of therapy you’re looking for (individual, family, couples)?
4. What populations do they work with? Have they worked with individuals with similar experiences, challenges, and goals as you?
5. Are you using insurance, or paying out of network? A lot of therapists do not accept insurance, so if you’re wanting to use insurance, make sure to look for a therapist who is in-network. If you’re paying out of pocket, ask your insurance about reimbursement. Some insurance companies/plans will reimburse you for mental health services, even if that provider is not contracted with them. Your therapist can provide you with a superbill, which is essentially a receipt for services rendered, and you might be able to recoup some, if not all money spent on mental health services.
6. Does it matter to you if your therapist is licensed? There are many talented, pre-licensed clinicians (pre-licensed meaning post-graduate school), who are more than equipped to provide quality services, and because they aren’t licensed, they’re usually more affordable. Remember, just because a therapist has their provisional license, doesn’t mean they don’t have experience. Therapists begin doing therapy on their own, while in graduate school, so even a “new, pre-licensed therapist”, has likely been practicing therapy for years.
7. Currently, most therapists are providing virtual services. This means that you might find someone you like, who doesn’t live in your area. If you are fine with continuing with telehealth beyond the pandemic, then location isn’t a big deal, but if you hope to receive services in person, you’ll want to find someone in your area.
Tip #4 What to do When You Like What You See
You’ve found a therapist (or maybe a few), who seems to check all of your boxes—yay! They have the experience you’re looking for, their picture looks nice, and their bio seems legit. So, now what?
Usually, the next step is to contact them. Most therapists will offer a complimentary consultation or screening, before requiring you to book an initial appointment. If this isn’t listed on their site, contact them and ask about it. It’s important for you to have some interaction with them, to make sure the vibe is right, and a consultation is a good chance for you to do just that.
Here are a few things to discuss when you’re having a consultation with a therapist:
1. Share why you’re coming to therapy and be as honest as you can. This will help them to determine whether or not they have the appropriate, clinical experience to help you.
2. Ask about fees, and if you can’t afford their fee, ask if they offer sliding scale. Sliding scale is a reduced rate, and most therapists have a set number of patients they will see at a lower rate. If you can’t afford sliding scale, tell them what you can afford. There are low-fee and free resources available, and they might be able to point you in the right direction of services within your budget. Don’t feel embarrassed, they know therapy is expensive, and you won’t offend them.
3. Ask them about their style and what to expect. What’s their assessment process like? Will they send you forms electronically, prior to your first appointment? If they’re providing telehealth, how will you log on to your session?
4. Ask them their availability, and make sure their schedule aligns with your needs.
5. Ask all of your questions, even if your questions are about them, their education, training, or experience. You have a right to know this information about any healthcare provider you choose to see. This is about YOU, and you’re interviewing them, not the other way around. Even if a therapist has the appropriate experience, YOU still get to decide whether or not to move forward.
6. When you’ve finished speaking to them, ask yourself this question: Is this someone I can see myself opening up to? If the answer is no, move on. If the answer is yes, you may have found a good fit.
7. Don’t feel pressure to book immediately, it’s ok to take time to think about it. In fact, I encourage you to contact a few therapists, to make sure you’re picking the best person for you.
Tip #5 How to Know if Your Therapist is the one
So, you’ve made it through all of these steps and you’re sitting in front of them (or on the other side of the screen)—now what?
Here are some things to remember when starting out:
1. Therapy is not magic and results are not instantaneous. It would be really cool if this was the case, and it would certainly make the job much easier—but it’s just not true.
2. It will take time for you to form a relationship with your therapist (remember, this is the most essential factor!), and you’ll likely feel worse before you feel better. You’re probably going to talk about things that are hard and evoke emotion, so it’s to be expected that you feel this way and have this experience. The good news? Typically, the more we talk about distressing topics, the easier it gets and the better we feel.
3. Check in with yourself and listen to your gut—are you feeling uncomfortable because you’re being challenged in a positive way, or is your therapist missing the mark? There’s a difference between the two. Your therapist is there to guide you and it would be a disservice to nod in silence. It’s also a disservice if your therapist is saying things that don’t quite click, and/or are harmful or offensive.
4. It’s ok to give your therapist feedback! This may come as a surprise, but like you, your therapist is human! They will make mistakes and they might even hurt your feelings. Check in with them about this—a good therapist will not only check in with you, but they will be receptive to your feedback, and will listen. You have a relationship with your therapist, so it’s normal to have challenges, and it’s also possible to repair and recover. If you read my previous post on boundaries (click here to read), you’ll remember that rupture and repair, leads to resilient relationships.
5. Lastly, remember that you’re not committed to this therapist! You can leave at any time, and sometimes, like dating, you might go through a few therapists, before you find the one. And, much like dating, when you finally find the one it won’t be perfect, but you’ll somehow know it’s right.
by: Tracy Gilmour-Nimoy, M.S., LMFT, PMH-C