So, you’ve decided to finally take the plunge and find a therapist. Good for you! Your mental health is super freaking important and you deserve to get it taken care of! I’ve gone through the process several times myself, and I know it’s not always easy. Having had good therapists and bad therapists, I certainly know all therapists are not created equal. Indeed, bad experiences in therapy can even make people feel worse, not better.
To be clear, I am not a mental health professional. Lucky for me, my mother is a clinical social worker who ruthlessly screens providers for the people she loves. After observing her, I adopted a similar process once I moved away from home. In sharing these tips with you, hopefully I can make the task of getting help run a little more smoothly for you.
First off, “therapist” is an umbrella term encompassing a variety of mental health professions. To help you out, I made you a chart:
You can find more in-depth explanations of the individual mental health professions here.
Once you’ve figured out what type of therapist you’re looking for, you can start to screen potential candidates. When you have an initial conversation with a therapist, there are three main things you want to look for:
- Treatment Modality
You can determine most of this from an initial phone call, but screening is a continuous process. If and when you go in for your first appointments, continue to assess whether the fit is right. Let’s break these down.
This should always be your first and last consideration when choosing a therapist. A few things go into accessibility.
- Special considerations. A good therapist will be honest about their experience with and sensitivity to patients who are LGBT, kinky, non-monogamous, or experiencing particularly difficult issues like physical/emotional/sexual trauma or eating disorders. If they aren’t able to provide the support you need, they’re not the therapist for you. On the bright side, you may find someone who specializes in these topics. Psychology Today’s Find-A-Therapist tool is a fantastic way to find those specialists in your area. Another great resource is the Kink Aware Professionals Directory from the National Coalition for Sexual Freedom.
- Payment. If you have insurance, do they accept it? Do you have out-of-network benefits if they don’t? If you don’t have insurance, do they offer a sliding scale?
- Available Hours. If their only available slot is 8am and you’re not a morning person, this isn’t going to work for either of you.
- Location. Can you get there easily? Can you reliably get there on time?
- Physical Accessibility. If you use a wheelchair or a walking aid, you certainly know best what your specific needs are in terms of physical accessibility. However, it is important to note that many therapists use home offices or spaces that aren’t wheelchair-friendly. Often, this won’t be readily apparent from the address, so it’s good to ask upfront.
- Office. This one is entirely subjective. Is the couch/chair comfortable? Does it smell like mothballs? Is there horrible, kitschy art all over the place? Is it really dark/uncomfortably bright? If you feel uncomfortable in the office, it’s not going to be very productive.
Treatment modality is a fancy term for a therapist’s approach(es) to treatment. Some therapists have an eclectic style, while others will stick to a very specific school of thought. There are many different types of therapy out there. For example: a cognitive behavioral therapist might work with you on how your thoughts and behaviors influence one another while a psychoanalytic therapist will focus on how your unconscious mind and childhood experiences influence your current state. Some therapists will focus on family systems while still others will use the arts, meditation, or special technologies like biofeedback and eye movement desensitization and reprocessing (EMDR) to address issues.
Some therapies have more evidence behind them than others. Additionally, some types of therapy are particularly effective for specific conditions, while others are not. There is no “one size fits all” solution. The National Alliance on Mental Illness (NAMI) and the UK-based Counselling Directory give some great in-depth explanations of types of therapy. Check them out and see which one works best for you.
I know your parents/teachers/everyone EVER told you not to judge a book by it’s cover. However, when it comes to a therapist, you can and should judge that book by its cover. Therapy is first and foremost a relationship. In your initial conversation:
- do they sound friendly? Detached? Business-like? Syrup-y sweet?
- do they give you patronizing therapist voice?
When you have your first few appointments, reassess. A few things to think about when you’re face-to-face:
- What is their communication style like? Are they conversational or do they mostly listen quietly? Do they ask guiding questions? Let you jabber on forever and ever? Interject with commentary? Smother you with platitudes?
- Do they smile? Make serious faces the whole time? Do you hate smilers/serious face people?
- Do they have a good poker face? Do they cast judgmental glances in your direction? Nobody likes judge-y glances in their direction.
- Do they ignore what you say about your boundaries or therapeutic goals? This should be a massive deal breaker.
- Remember, your boundaries are okay no matter what they are. You have every right to establish your boundaries with your therapist and expect them to be respected. A good therapist will appreciate when you clearly communicate your goals and boundaries, because it will help them treat you better.
Keep in mind, your first appointment with a therapist will most likely be pretty standard: intake (ie., why are you here?), family history, billing information, etc. It may take a few sessions to fully get a sense of how your personalities mesh. That’s completely normal. Moving forward, even a therapist you love might push your buttons occasionally. Sometimes, this can be productive. However, if any red flags go off, that deserves your immediate attention. If one therapist doesn’t work for you after a few sessions, move on to the next person on your list. Don’t waste months with a bad therapist when you could be finding the right one for you.
Need help getting started? The National Alliance on Mental Illness has some fantastic tips on starting your search. I’ve included them here for easy reference:
- NAMI State Organizations and NAMI Affiliates – Speaking with NAMI members (individuals living with mental illness and family members) can be a good way to exchange information about mental health professionals in your local community. You can find your state or local NAMI organization at www.nami.org.
- Primary Care Physician (PCP) – Your primary physician or pediatrician is an excellent resource for making recommendations and referrals to a mental health specialist or therapist in your area.
- Your Insurance Provider – Contact your insurance company for a list of mental health care providers included in your insurance plan.
- American Psychiatric Association (APA) – The APA can give you names of APA members in your area. Find your state branch online, consult your local phone book or call (703) 907-7300.
- Psychiatry department at local teaching hospital or medical school.
- National Association of Social Workers (NASW) – NASW has an online directory of clinical social workers. Visitwww.socialworkers.org and click on Resources or call (202) 408-8600.
- American Psychological Association (APA) – The APA can refer to local psychologists by calling 1 (800) 374-2721.
- The Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Mental Health Services –SAMHSA has an online database of mental health and substance abuse services and facilities in each state. Visit www.samhsa.gov/treatment and click on Mental Health Services Locator.
I know the process might seem daunting, but I hope it ultimately helps to get you where you want to be.
Do you know of any tips or resources I missed? Share them in the comments below!