Thinking about therapy? Read this first!
Art: Annya Kai Art (AKA) Foils
Let’s open this can of (gummy) worms.
Full disclosure: I’m biased, because I’m a therapist; I love therapy and I think it can be super duper helpful. I’ve both received and provided a ton of therapy.
A lot of people who read this will NOT want me to be their therapist - and that’s totally fine. Convincing you to work with me is not my agenda here! What I do want is for you to feel equipped to make an informed decision about whether or not to start therapy - and who to work with, if you do.
Even considering therapy can feel daunting - particularly if it is brand new to you or if you’ve had a negative experience with therapy before. You might have a lot of pre-conceived ideas about what therapy is and how you do it. If you have a lot of stuff to work through there may be a part of you that is fearful, resistant or overwhelmed at the prospect of doing so.
It’s hard to be vulnerable. Many people have this idea that when they go to therapy they have to pour out their entire heart and tell every detail of their life story - whether they like it or not! News flash: you don’t have to do anything and a good therapist will never uncomfortably pressure you to talk or do things in therapy that don’t feel ok to you.
Should you seek therapy?
I trust if you made your way here, there is a part of you that wants to start therapy - or is at least curious about it. So ask this “curious” part of you: ”what’s drawing you, curious part, to the idea of therapy?” Make a list of those things, either mentally or even in writing. Let this part of you that is wondering about therapy “speak” freely.
Actually, stop reading this for 1 minute and do this (optional, but recommended!)..
What did you come up with?
What if any single one of things is a perfectly good reason to start therapy?
If you want some more reasons, here are a few…
Struggling in family, romantic, social or work relationships
Feeling stuck
Desire to find a sense of deeper meaning, purpose and motivation in life
Being burnt out
Having lots of anxiety or worry
Grief that feels unresolved and making it difficulty to move forward
Experiencing distress about the environment, human rights, politics and global issues
Feeling depressed, numb, unmotivated or overly negative
Dealing with a distressing or traumatic event(s), past or present
Being generally dissatisfied with life
Wanting growth, healing, relief and joy (yes, even that!)
Here’s the thing: just because you reach out to a therapist…set up an initial consultation…or even have a first session, nowhere along the way are you obligated to continue this process. YOU are in charge. You get to change course if you want or need to - and this includes firing your therapist if it doesn’t feel like a good fit to you.
So let’s say you’ve decided that you do want to start therapy…
Do this BEFORE looking for a therapist.
Plan how you will pay for therapy. If you prefer or need to use your insurance, you’ll need to find someone “in-network” with your insurance. Contact your insurance provider to find out about your plan’s specific mental health care benefits (number of sessions, share-of-cost, deductible, co-pay) - some insurance provides pretty decent mental health coverage, others not so much.
Your insurance can also provide you with a list of in-network therapists - however don’t be surprised if they only provide their names, addresses and phone numbers/emails and not much else (you can always Google them to check them out!). Also, due to the high demand for insurance-covered mental health care, it’s common for many insurance-contracted therapists to have long waiting lists.
With this in mind, there are some good reasons to consider paying out-of-pocket for therapy, if you are able to do so:
No mental health diagnosis will be required to be a part of your medical record. This means that your therapy - or even the fact that you are in therapy - will not be accessed by third parties (except in the case of a judge’s court order, but those cases are rare).
No limit on the number of sessions you can have. This means that your therapy and healing can go at a pace that feels right to YOU. This is especially helpful if you have a variety of issues and challenges that you want to work on in therapy, or want to explore your growth and healing more extensively beyond the number of sessions your insurance might pay for.
You can have more frequent, or longer, therapy sessions to accelerate your growth and healing process. Insurance generally won’t cover this, except in cases of extreme crisis.
The reality is that many therapists opt to not accept insurance for the above reasons - and also because the pay offered by insurance companies is abysmally low, relative to the significant financial investment therapists make in their education and professional development - especially if they choose to pursue highly specialized (and often costly) training.
This isn’t to say that there aren’t outstanding insurance-contracted therapists out there who do good work and who place a high value on their professional development. However, it’s also true that “private pay” (non-insurance) therapists are often able to see a lower number of clients, which translates into more time and energy to devote to each one - as well as to their own training and professional development. This can help insure against the therapist burnout that can occur when therapists burn the candles at both ends to serve a higher number of clients.
“But the therapist I want doesn’t take my insurance!”
Don’t lose hope! Some insurance plans will provide “out-of-network” benefits, meaning they’ll reimburse you a portion of your out-of-pocket expenses for a private pay therapist. Yes, you’ll pay more than an insurance co-pay, but this can be a great option for reducing the cost of therapy - particularly if you’ve found a non-insurance therapist who you really want to work with.
Keep in mind that to provide this coverage, your insurance will require your therapist to assign you a diagnosis and they *technically* can request access to your records to justify payment for services. Still, I wouldn’t let this deter you from using your out-of-network insurance benefits!
If you are considering paying out-of-pocket, it helps to think about therapy as an investment in YOURSELF. At the end of the day, how much is your mental and emotional health and well-being worth to you? What kinds of “dividends” can investing your time, energy and money in your personal therapy result in? Better mood…increased clarity…higher self-worth…more self-confidence…increased calm and groundedness…healthier relationships and decision-making…being able to engage in a more rewarding way with your work/career…and so much more! While it’s hard to quantify the value of these with specific dollar amounts, I invite you to consider this.
That all said, if you need or want mental health support and not using your insurance isn’t an option you want or are able to take - by all means, use it! You will be working with a trained professional and with the right-fit therapist, you’ll gain invaluable healing and growth.
“So…how do I even find a good therapist?”
Whether or not you’re using your insurance, I recommend browsing a few therapy directories. Here you can read therapist bios and visit their websites to get a feel for them. There are lots to choose from and some specialize in particular lived experiences:
Inclusive Therapists
Good Therapy
Psychology Today
Therapy Den
Latinx Therapy
Therapy for Black Girls
National Queer and Trans Therapists of Color Netowrk
Institute for Muslim Mental Health
Postpartum Support International
Please note that while there are therapists listed in these directories who take insurance, expect that many will be private pay only.
Word-of-mouth can also be helpful: friends, health care providers, wellness practitioners or other community organizations can be great recommendation resources.
Social media can also be a good place to check out therapists - Instagram, Facebook, TikTok, Twitter.
Low-cost therapy options
If you’re insurance’s mental health coverage isn’t great (or maybe you have a super high deductible), and you really need to a lower-cost option for therapy, consider:
Community organizations that offer low-cost or free services (some counseling centers/clinics; organizations that serve people of your identity or with your specific needs)
Therapists that offer “sliding scale” (check their directory listings/websites to see if this is an option)
Open Path Collective (pay a membership fee to get access to lower-cost therapists)
Again, always check your insurance’s out-of-network benefits FIRST - you might be surprised at the affordability of this option!
Avoid a “wrong fit” therapist - and find the right one.
First, I want to normalize that sometimes it takes a few tries before you find the therapist who is the best fit for you and your unique needs. Remember, YOU are the client - and you get to decide who to work with, period!
Most therapists offer a free phone or video consultation (anywhere from 15 - 30 minutes) so you can both determine whether or not the therapist would be a good fit for you.
Here are some questions you can ask a potential therapist:
What kind of training and experience do you have in helping people with [your issue]?
Have you done any advanced or specialized training?
What is your experience working with people of my identity [gender, culture, sexual orientation, religious, and/or other lived experiences and identities]?
What kind of therapy modalities do you use, and how would you approach therapy with me and my particular issue(s)?
What is therapy with you like?
Good questions to ask yourself:
What do you like about their website or directory profile bio and/or social media presence?
Do you have good rapport and feel comfortable talking with them?
Do they answer your questions openly and honestly?
Do you feel hopeful…maybe even a little excited?
Are you intrigued by their therapeutic approach?
Do they support your autonomy in choosing a therapist, or do you feel pressured by them to choose them?
Trust your gut in this process! Shop around and talk to as many or as few therapists as you want. Be aware that unfortunately, some therapists may not respond to your initial inquiry, or it may take them several days (or longer) to get back to you! Don’t take it personally - it usually means that the therapist is extremely busy (remember what I was saying earlier about therapists with high caseloads of clients?). Be that as it may, the professional thing would be for you to at least get a call back to let you know that they’re not available. I’ll sheepishly admit that I myself have failed to call potential clients back, which is why I’ve set up way better systems to ensure that this doesn’t happen anymore!
“I’ve made my first appointment…now what?
First…congratulations! And, if you are feeling nervous, hopeful, apprehensive and even a little excited - that’s totally normal!
Remember, even if you start working with a particular therapist, you ALWAYS get to decide whether or not you want to continue. You may at some point decide that the therapist isn’t the best fit for you after all, or there might be another reason that is leading you to re-evaluate your therapist. I encourage you to consider talking these issues over with your therapist prior to leaving - provided you feel emotionally safe in doing so. You deserve to have the care and support that feels right for you, and sometimes that means changing course in your journey.
Keep in mind that just like in life, things can feel “up and down” in therapy. While there is real growth, relief and healing to be had, you won’t necessarily feel on top of the world after leaving a therapy session. The work can be hard sometimes and “growing pains” are a part of it. This is normal! Experiencing a certain level of discomfort from time to time is a sign that there are parts of you coming up that would benefit being attended to - and this can be very fruitful and growth-enhancing to work with in therapy. This is why it’s important to have a therapist you trust who can support you through the challenging times and be a trusted ally as you walk this path. Therapy offers the opportunity for a healing, therapeutic relationship with someone who is specially trained to facilitate your psychological growth - and this can be life-changing.
If you have any questions about finding a therapist, feel free to reach out to me via email, call or text. You can also learn more about me or schedule a free consultation to learn about my particular therapy approach to the kinds of issues and challenges you want support with (beyond the info on my website). If for some reason I’m not the right fit for you, I’m happy to refer you to a therapist who might be!
I wish you well in your journey!
