Finding a good therapist shouldn't be like finding an empathic needle in a haystack. We'll walk step-by-step through the process of finding potential therapists, narrowing down your list, evaluating whether someone is a good match, and finding affordable therapy options.
I was commiserating with a friend recently about how hard it can be to find the right therapist. She was spending hours researching therapists near her, and even after their websites and names had begun to all blur in her mind, she was still confused about how insurance coverage worked and whose credentials matched what she needed.
Believe it or not, I had a similar experience with finding a therapist, and I’m a therapist, myself! When I was looking a couple of years ago, I both felt like there were too many choices and no good options.
The last thing you need is more confusion about a process that's supposed to bring hope and change.
It’s such a shame that therapy seems elusive for so many given its many potential benefits. It really shouldn’t be this hard! You’re already busy and stressed and dealing with life drama or psychological symptoms. The last thing you need is more confusion about a process that is supposed to bring hope and change.
In the end, I got lucky by basically throwing a dart at the board and landing with a fantastic therapist. But I want to help you use a smarter strategy, so today’s episode is going to walk you step-by-step through the therapist finding process. Buckle up!
What’s the difference between a psychiatrist, psychologist, social worker, and therapist?
Therapists are a diverse bunch. We have different types of educational backgrounds, experience, specializations, and letters after our names. I won’t go into all the details of who’s who. For your goal of finding a good match, the most important things to know are:
- If you need medication, you need to see a psychiatrist (or another advanced practitioner who can prescribe and has a specialization in psychiatry). People with schizophrenia, bipolar disorder, severe depression, or other severe psychiatric symptoms should definitely have a psychiatrist on their team. If you’re not sure whether you need medication, you can do an evaluation with a psychiatrist or psychologist to get their treatment recommendations.
- If you want some form of “talk therapy,” you’ll most likely want to see a clinical psychologist (Ph.D. or PsyD), a licensed clinical social worker, or licensed professional (or mental health) counselor.
- Not everybody is trained in every type of therapy, so if you specifically want CBT, psychodynamic therapy, or mindfulness, make sure to ask about their training and experience with this therapy.
Where do I start the search?
OK, you know what you're looking for and you're ready to start the search. How exciting! Get a spreadsheet or notepad ready, because you’ll want to take notes on potential therapists as you do your search. Here’s where to start.
Start with your insurance company’s website
To spare yourself the disappointment of finding The One, only to realize that they don’t take your insurance, start with your insurance company’s “find a provider” tool. These tools are usually well-designed to filter by geographic location, therapist credentials, specialization, and the therapist's gender.
Ask your primary care doctor for a referral
Sometimes, your family doctor is your best resource because they already know, and they may have connections with, great therapists in your area. If they’ve gotten good feedback on a therapist from other patients, they can make a confident referral for you.
If you’re looking for a specific type of therapist, try PsychologyToday or GoodTherapy
You may be looking for a therapist who is a person of color, or speaks Spanish, or has a particular sexual orientation or gender identity. You may be looking for someone who offers evening sessions or telehealth options. Psychology Today and Good Therapy are great tools for filtering your search by these details. The therapist profiles also give you better insight into a therapist’s style than an insurance company’s website.
If you want to hone in on a specific disorder or highly specialized treatment, search for a non-profit organization with a member directory
For example, if you’re looking for help with PTSD, Trauma-Focused Cognitive Behavioral Therapy (tfcbt.org) has a directory for trauma-focused therapists. For help with insomnia, the Society of Behavioral Sleep Medicine (my home organization!) has a directory at behavioralsleep.org. Those with misophonia can check out misophoniaproviders.com. For postpartum depression, postpartumhealthalliance.org has a directory too.
How do I narrow down my list?
You’ve got a few names jotted down. How do you narrow down your list? Here are a few things to consider.
Logistics and cost
Ideally, the therapists you have on your shortlist have websites or directory profiles that give you the basics: Do they take insurance? What are their fees? Where are they located? When are their clinic hours? Are they taking patients/clients?
Your list may naturally get shorter if a therapist does not meet your logistical and financial needs. But if someone seems like a really good match, it’s worth calling in case they offer options, like a sliding fee scale or scheduling flexibility. We'll talk in a lot more detail about cost next.
Do they really specialize in the treatment you need?
You may not need a particularly specialized treatment if you’re just looking for support or some insight. But if you have psychological trauma, OCD, ADHD, an eating disorder, postpartum mood symptoms, sleep problems, or a personality disorder, I highly recommend finding someone who truly specializes in that area, because someone without the right training could do more harm than good.
If a therapist’s bio lists many, many specialization areas, especially lots of disorders that aren’t very related to each other, they may not really be a specialist. Let's say a therapist's bio claims they're a specialist in both borderline personality disorder and sleep disorders. It takes years of training to truly master treatment for borderline personality disorder. The same is true for sleep disorders. It would be unlikely that a therapist is truly a specialist in both.
Someone without the right training could do more harm than good.
But of course, you can always just ask about a therapist’s training and experience. You might ask something like, “I noticed that you listed OCD as a disorder you treat. Could you tell me more about the type of treatment you use for OCD and how you received training in this treatment?” If you've done a little background research, you might know that the treatment for OCD should be CBT or exposure and response prevention (ERP). From there, the therapist's answers will help you get a better understanding of their expertise.
What’s their philosophy?
Even amongst therapists with similar training, there can be a big range in personal philosophy. Is the therapist all about the most cutting-edge science? Focusing on the client’s strengths? Getting people out of their comfort zone?
Don’t worry if you don’t know which philosophy would be the best match for you—there’s always some trial-and-error. At this stage, it’s more important that the therapist can articulate their philosophy. Their website, or their initial phone/email contact with you, should give you an idea of their main values.
If the therapist can't seem to talk about their philosophy beyond "I want to help you feel better," that's probably a sign to keep looking for a therapist who's a better fit.
Will they really understand me and my experiences?
A good therapist is, at their core, an empathy machine. They should be willing and able to put themselves in your shoes, or at least try their best and be open to learning from you.
A good therapist is an empathy machine.
That being said, there is benefit in many cases to having a therapist who looks like you, has a similar identity or cultural background, or has had a similar experience. For example, I’ve had patients who really just needed to be heard by someone who is also an immigrant, or a woman, or an Asian-American. Although another excellent therapist may have been helpful too, my identity at least made these patients feel more at ease to start with. It’s not always possible to find a therapist matching your background, but if that’s available to you, I recommend trying that person first.
I want to give a special shout-out to Therapy For Black Girls, an organization that specifically focuses on mental wellbeing for Black girls and women. They have a provider directory on their website, along with lots of good resources.
What to look for in a therapy assessment session
When all of the background research is through, it's time to dive into a real assessment session. Here’s what you should look for during your first meeting with a potential therapist.
They should explain informed consent
The therapist should give you an easy-to-understand introduction to who they are, what their credentials are, what the purpose of this first meeting is, what the rules are for confidentiality (and exceptions to those rules), what their policy is for cancellation fees, and anything else you need to know before you dive into this professional relationship.
They should ask you lots of questions
After the introductory spiel, almost everything the therapist says during this first meeting should be a question. This shows that they're focused on getting to understand you. If they’re diving into significant advice-giving already—something like “You should definitely break up with her”—consider this a red flag.
They should give you a chance to ask questions
Go to the meeting prepared with what you want to know about your symptoms (“What is your impression of my concerns? Do these symptoms indicate a psychological disorder?”), the treatment (“How long do you think my treatment will last?”), and their approach (“How do you usually track treatment progress? How will we know when I’m ready to graduate from therapy?”).
They should be able to articulate a general assessment and treatment plan
This may not be set in stone or fully fleshed out by the first meeting. Often, assessment continues formally or informally after this. But the therapist’s attitude should not be, “Well, let’s just see how it goes!” They should have some plan for how to begin treating you or what further assessments are needed.
They should make you feel heard, respected, and safe.
No matter what type of treatment you’re getting, your therapist should be an attentive, non-judgmental listener and a respectful partner in your work together. If they discriminate, dismiss, belittle, or threaten, that's an immediate deal-breaker.
The real work begins
If you’re feeling hopeful about a potential therapist’s plan and style, it’s time to dive into therapy and commit to at least a few sessions. I say “commit” because it often takes at least a few sessions to really get into it, and sometimes, you may even feel worse before things get better because you’re leaving your comfort zone.
It often takes at least a few sessions to really get into therapy, and you may even feel worse before things get better because you’re leaving your comfort zone.
So even if you are tempted to jump ship after your first few sessions, hang in there a bit longer to reap the benefits of your hard work. Along the way, just make sure your therapist continues to be a respectful partner and can explain how and why things will improve if you stick it out. They should also keep track of your progress and be open to your feedback about how things are going.
How much will it cost?
There is a huge range of what therapy can cost, depending on where the therapist is located, your health insurance, the therapist’s credentials and specialization, the setting where they see you, and much more. The U.S. national average is between $60 - $120 per session, but for specialists in metropolitan areas, it could be upwards of $250 per session.
Here are some tips for finding affordable therapy:
- Use your health insurance if you can. But make sure to read the fine print (or call your insurance company) about co-pays and limits on the number of sessions covered. Also, ask your therapist which billing codes they use so you can ask your insurance provider if those are covered.
- If you don’t have insurance or your preferred therapist is out of network, you may still get partial coverage. Ask your therapist for a “superbill” that you can give to your insurance company to ask for reimbursement.
- Generally, psychiatrists are more expensive than psychologists, who are more expensive than social workers and counselors. If your needs will be met by a counselor (such as supportive therapy), start there.
- Your employer may offer free mental health benefits to you and even your family members with an Employee Assistance Program or something similar. Talk to an HR representative to explore this option.
- Training clinics can also be a great place to get high-quality care for less cost. For example, the clinic where I trained offered a sliding scale for sessions starting at $5, and my patients were getting care from me and my highly qualified, world-class professors. To see if there’s a training clinic near you, look up clinical psychology, social work, or counseling graduate programs at universities close to you.
- Research studies are also great opportunities to get therapy for free. You will likely even be compensated a small amount of money for your time. If you live near a university or academic medical center, this institution likely has a website specifically for finding active research studies.
Now you know all about finding a good therapist for you. Hopefully, this advice comes just in time for your New Year’s health and wellness goals! If you’ve had particularly good or bad experiences in your therapist search, let me know so I can collect more tips to help others. Together, let’s democratize mental healthcare and make it as accessible as possible.