Finding a Therapist

The new year can feel like a natural opportunity to reflect on how you’re investing your time, energy, and resources. If you’re thinking about getting more support with your mental health in 2023, you may consider enrolling in counseling. Therapy is not limited to individuals who are struggling or going through major life challenges –if you are already functioning well, you can think of therapy as a proactive engagement in your wellness. Working with a therapist who is a good fit for you has the potential to help you to shift patterns that are no longer serving you, learn new skills to support yourself as future challenges arise, and embrace the whole, multifaceted human that you already are. However, the process of looking for a therapist or starting therapy for the very first time may bring up a range of emotions (overwhelm, frustration, and vulnerability, just to name a few). It could take you some time, emotional energy and trial-and-error to connect with the right therapist for you. I hope this blog provides you with some practical considerations to help your therapist selection process go as smoothly as possible.

Getting Started

The easiest way to get started is to use online directories to search for a therapist who matches your needs. My favorite online directory is Therapy Den as it provides clients the option to search by location, presenting concerns, and insurance. Therapy Den is also generally the most inclusive option available. Psychology Today is one of the largest directories and offers many different filter options, such as insurance accepted, geographic location, gender, ethnicity served, language, faith, and therapeautic modality. There are also some sites that focus on specific demographics such as Therapy for Black Girls and South Asian Therapists. If you have financial need and your insurance coverage is not adequate, therapists on Open Path Collective or The Pro Bono Counseling Project provide care at a lower fee. We’ll talk more about fees in the next section.

You may also ask a trusted health care professional if they could refer you to a therapist.

When you find a therapist who seems like they may be a good potential fit, you typically can reach out to them and request a free phone consultation. While the increased availability of telehealth has made it easier for some to access mental healthcare, you still might notice that many therapists are not accepting new clients or have quite a long waitlist. This is even more common with therapists who accept insurance.

While you shouldn’t be afraid to put the feelers out and reach out to multiple therapists, it’s important to remember that it may not be beneficial to send more than a few inquiries at once. It might seem appealing to contact as many fits as possible, however that can leave you feeling overwhelmed with responses later on (kind of like sending out 10 “Hey, WYD?” messages out on Tinder at once). Instead, I recommend looking through the profiles of several therapists and reaching out to your top 2-3 picks. Depending on how busy they are, and their policies for returning inquiries, it could take them a few days to get back to you. This is especially true if you are reaching out during the weekend. I personally aim to respond to all phone and email inquiries within 24 business hours.

Your initial consultation call should provide you with an opportunity to ask the therapist(s) questions to determine if they can meet your needs regarding your concerns, schedule, and financial situation. This call also gives you a first glimpse at their personality and speaking style. While there’s not time to fully evaluate your fit within a 10-15 minute initial conversation, it does allow you to develop a first impression.

Finances & Insurance

Some therapists accept insurance. If you can find a great therapist who both meet your needs and accepts your health insurance, that’s wonderful. Due to the the demand for counseling right now, you might be waiting longer for a spot to open in their schedule. If you choose to see a provider who accepts your insurance, you can call your insurance company to verify what you should expect to owe your provider. Unfortunately, just because a therapist accepts your insurance, does not mean services will be fully covered. Be sure to ask about your co-pay, which is the fee you’d be expected to pay out-of-pocket at each session.

Many therapists opt out of working with insurance for numerous reasons. Insurance companies can present challenges that may limit the quality of care the therapist is able to provide to the client. Additionally, insurance companies may delay paying therapists and often offer lower rates of pay resulting in a higher number of clients seen per week. This heavy caseload can contribute to therapist burnout. Therapists who choose not to work with insurance companies are “out-of-network” providers. Out-of-network therapists tend to have more availability in scheduling. If you decide to see an out-of-network provider, you can ask them to provide you with a document called a “super bill” to request reimbursement from your insurance provider (that’s the “benefit” of out-of-network benefits). 

If you have financial need, you can ask your therapist if they offer a sliding scale - often these slots may be full, but it can be worth asking. Alternatively, you might consider seeking therapy with an intern/trainee as they often have lower rates than fully licensed providers. If you’re seeking to work with an intern, I recomend the following practices:

If you or your spouse have health insurance coverage through an employer, you might have some other avenues for support. If the employer offers a health savings account (HSA), or flexible savings account (FSA), these funds can be a way to help you pay for therapy with pre-tax dollars. You may also want to check if the employer offers an employee assistance program (EAP). Typically, these programs will offer free shorter-term solution-focused therapy and can provide you with referrals if longer term support is needed. 

Place & Time

Consider the location of your therapist and if you want to see them in-person or via telehealth. Even if you are looking for virtual therapy, your therapist usually needs to be licensed in the state that you are living in to work with you. If you choose to see your therapist in person, notice how you feel in their office and whether you feel comfortable and safe to get settled into the space. I currently offer both in-person and telehealth sessions for my clients.

It is also important to consider the hours your therapist is available and if that will consistently align with your schedule. Often, clients will start therapy weekly as the therapeutic relationship is developing. Over time, as you learn new skills, your sessions could become less frequent.

Speciality, Training, & Identity

Once you’ve made sure your potential new therapist can meet your needs based on affordability, location, and availability, it’s also a good idea to consider whether your therapist has training, clinical experience, or personal experience with concerns that are similar to yours. For example, if you’re wanting to focus on concerns related to childhood trauma, you’ll want to ensure your clinician is trauma-informed and competent in helping you unpack these issues. During your consultation call, you may want to be curious by asking:

  • What are your clinical specialties?

  • What trainings have you taken or what experiences have you had that support those specialties?

    • Generally it can be reassuring to know your therapist is invested in continued learning about your specific concerns

  • Have you worked with/helped clients with similar concerns as me before?

    • While your therapist may list several specialties on their website or profile, your concerns may be more specific. While no two clients are the same, it can help to be curious if your therapist has worked with clients who have dealt with similar concerns as you.

  • Do you identify within the ________ community?

    • You can fill in the blank with intersectional elements of your identity. For example: LGBTQIA+, BIPOC, Fat, Poly, etc. Of course, a therapist does not have to share in your identity to necessarily be a good fit, but for some clients it is very important.

  • Would you describe yourself as affirming of and informed about _______?

    • Once again, fill in the blank. If the therapist does not necessarily share important intersectionalities with you, you will want to be sure they are at least affirming of these parts of you.

 
 

Knowing You’ve Found a Good Fit

Rapport

According to Duchan & Kovarsky, “Therapeutic rapport refers to the empathic caring and shared understanding of issues between a therapist and a client. It implies a team approach to the management of these issues in contrast to an adversarial approach.” Essentially, rapport describes the trusting relationship between you and your therapist which facilitates your ability to be vulnerable and work through emotionally difficult concerns. Usually, after a few sessions, you will have a sense of whether you and your therapist connect.

You may be wondering, “Do I really need to like my therapist? After all, I am paying them to help me!” The answer is, Yes. According to Dr. J. Stuart Ablon Ph.D., “study after study has shown that the quality of the relationship between client and therapist is the only reliable and the most powerful predictor of a positive outcome.”

Here are a few guiding questions to ask yourself if you want to gauge your therapeutic rapport:

  • Do I feel safe with my therapist?

  • Do I feel like I can share feedback with my therapist and that it will be received well?

  • Does my therapist make an effort to understand me?

  • Is my identity (race, culture, socioeconomic status, ethnicity, gender identity, sexual orientation, religion, ability, etc.)  acknowledged, considered, incorporated into our work when applicable?

  • Does my therapist generally remember important details about me?

  • Is my therapist providing me with resources that are helpful?

  • Am I gently challenged in a way that supports my growth?

 
 

What to Expect

Can we really talk about anything?

Know that your therapist will not judge or shame you and very few things are “off limits” to discuss. Each therapist will have their own personal and professional boundaries, that they should make you aware of within your initial session. What you share with your therapist is confidential with a few exceptions that they should go over with you. According the APA’s ethical code of conduct for therapists, there are four general situations which are exempt from confidentiality:

  1. The client is an imminent and violent threat towards themselves or others

  2. There is a billing situation which requires a condoned disclosure

  3. Sharing information is necessary to facilitate client care across multiple providers

  4. Sharing information is necessary to treat the client

Social Media

The therapeutic relationship is centered around creating a safe container for you. Because of the nature of this relationship, your therapist can’t be friends with you or follow you on social media, even if you stop working together for therapy. Your therapist should value your privacy as well as their own. Being “friends” on social media can compromise confidentiality and privacy. It may also blur the boundaries of our therapeutic relationship. I let my clients know that they are are welcome to “follow” or “like” content on my professional instagram account @NoelleBenach and/or Business Facebook Page for resources, therapy-related content, practice information, and event offerings. However, because social media sites are public spaces, anyone who can see our social media pages can see your like or comment. Please use your own discretion in choosing whether to follow your therapist’s public social media accounts.

What If I Don’t Like Therapy or My Therapist?

If you feel like you aren’t connecting with your new therapist after a few sessions, it’s okay to talk about it. You can ask for your therapist to adjust their approach or request a referral for another clinician. My goal as a therapist is to help clients find the best therapeutic fit for them, even if that fit isn’t me! Although it may not be the most comfortable thing to do, therapy should be a safe space to confront relational concerns.

Remember, even the most skilled and experienced therapists have the potential to say something you may not like. They might be challenging you to look at things about yourself that are hard to accept. However, it’s possible your therapist could say something that just isn’t helpful (hopefully not too often, but it happens - therapists are human, too). Your relationship with your therapist should allow for space for you to let them know if they’ve missed the mark.

Even when things are going wonderfully with your therapist, you may not always feel like going. You will most likely talk about your history in therapy, and for some people, going there can be uncomfortable. However, this is often where growth happens. Your therapist is there with you on this journey, and they will be focused on helping you safely navigate any discomfort that comes up as you’re doing this work. Think of attending your therapy sessions in a similar way to thinking about physical exercise or meditation practice. You might not always feel like doing it in the short term, but over the longer term, you’ll notice the impact of your consistency on your overall wellness. When you enter therapy, you are learning and sharpening new skills that you will take with you into the future. This is a place in which you can build self-soothing/distress tolerance skills, insight about yourself and others, and communication skills to use in your relationships. Sometimes therapy will feel good, and other times you will notice that you’re doing work and stretching, and that doesn’t always feel comfortable in the moment - that’s all okay.

Getting the Most out of Therapy

Therapy is an important investment in yourself and to get the most out of it, it needs to be an active process. It can be helpful to get clear on what you’re hoping to work on in therapy and how you will know it’s getting better. If you aren’t exactly sure, your therapist can help you work to uncover this.

Hold time and emotional space for counseling. Clearing time in your schedule to get to your appointment on time (and some space after the session to let things settle) will help you to be more fully present. Also, keep your time clear of distractions. You’re doing yourself a disservice if you are distracted by technology in session. If you’re doing therapy virtually, keep your area free of distractions as best you can – remember that this time is especially reserved for you, and you are paying for it.

Your time in session can go by quickly. Before each session, consider taking a few mindful moments to get still with yourself. As you do this, notice which issue feels most important to focus on in your therapy appointment. You can share what you’d like to focus on with your therapist at the beginning of the session. Bringing a notebook and a pen is also a good idea to jot down any good insights from session, suggestions for resources from your therapist, and notes about homework. On the topic of homework: know that if your therapist invites you to work on something outside of session, trying it can support your growth. If the suggested homework activity doesn’t work for you, you can discuss alternatives in your next session. If your therapist does not give you homework or resources, you can always ask for them.

So much of therapy is about showing up and doing the work, including being honest and vulnerable to the extent that you feel safe to do so. Your time in therapy is a space where you can practice skills that you will use outside of session, such as role-playing a conversation, voicing your needs, and pausing to respond rather than react. And another part of showing up is putting into practice what you are working on in therapy. Much of the important work happens outside of therapy. This can look like:

  • Keeping up a self-care practice such as a gratitude journal or daily meditation.

  • Holding boundaries outside of session and noticing the feelings that come up.

  • Replacing impulse-driven coping strategies with more supportive self-soothing skills

  • Having difficult conversations in order to advocate for your wants and needs

I hope this post has been helpful as you seek out therapy now or in the future. If you’re interested in working together, read the next section below for more information.

Meet the Author: Noelle Benach, LCPC, CST

 

Noelle Benach is a licensed clinical professional counselor in the state of Maryland, as well as an AASECT certified sex therapist. Noelle has trained in numerous therapeutic modalities including Stan Tatkin’s Psychobiological Approach to Couples Therapy (PACT) (Levels 1 and 2 Trained), Prepare/Enrich (Certified Facilitator and Trainer), the Gottman method (Levels 1 and 2 trained), and Brainspotting.

Noelle is a lover of counseling as a therapist, client and professional consultant. Noelle recently opened up Noelle Benach Counseling & Consulting, LLC in January of 2023, after 6+ years of working at a group practice, Space Between Counseling Services.

When she’s not working, you’ll find Noelle enjoying time at one of Baltimore’s many coffee shops, restaurants, or farmer’s markets, spending time with her spouse and 2 dogs, or working on a house/craft project, likely while listening to a true crime or psychotherapy related podcast. Noelle also enjoys reading and listening to audiobooks. She recently finished reading Blood Sugar by Sascha Rothchild.

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