The road to starting therapy looks different for everyone:
It may be a recent physical with your doctor where you were sure you had something seriously wrong that led to them gently recommending a therapist. It might be a phone call from the school guidance counselor recommending support for your child. Maybe you keep reaching out to a friend for help, and they find the courage to ask, “have you thought about talking to a therapist?”
As a therapist with my own social presence, I often have DM’s or Facebook messages from those in my network asking me to assist them in finding a therapist. Figuring out the first steps to take when you finally feel ready can be daunting.
So, what are the avenues to take once you’re ready to “talk to someone?”
- The first step when considering therapy is to consider your financial situation. Do you have health insurance? A quick phone call to the number on the back of your card, or a search on your provider’s website will give you information about coverage for mental health.
- If you are considering couple’s counseling, it is important to call your insurance and ask if “Family Therapy ” is a covered service under your plan.
- Be ready with questions about what costs you will incur out of pocket for the services provided. Many individual plans will have a copay for a set number of sessions per year while others (high deductible plans) will expect you to pay all of the costs out of pocket until your deductible is met. Copays typically range from $10-$50. In a high deductible plan, a typical session may cost around $85 for an individual session and around $75 for a family or couple’s session. Consider how often you might like to attend therapy, and figure out what it may end up costing you.
- If you are employed and have an employee manual, now is the time to pull it out! Flip to the benefits section – there may be information about something called an EAP or “Employee Assistance Program.” This is a benefit that many employers offer to their employees that will afford you anywhere from typically 3-6 free counseling sessions per year. Some programs even cover additional members of your family!
- If you don’t have a manual, you can ask your direct supervisor or human resources person about it as well. There is usually a phone number or website listed with a listing of participating EAP providers. Many clinicians will continue to see you beyond your free sessions for a reduced rate as well!
- What if you don’t have insurance? Are you out of luck? No. Many communities have funding set aside to assist those without coverage or the ability to even pay all of their copay. Where I work in Lancaster, PA the Lancaster Osteopathic Health Foundation has a fund set up to assist families with paying their co-pays. During the pandemic, the local mental health network also set up a community supported assistance program to provide free therapy to those impacted by COVID-19. Many therapists are also willing to do “sliding scale” fees where you agree upon a reasonable rate for therapy with a signed document based on your income. Some practices even maintain funding for clients who are unable to pay for services. Please don’t ever let money stop you from making some phone calls! A quick email or phone call to your local chapter of Mental Health America will be the fastest way to find support for paying for services.
- After managing the finances, I would encourage you to do a quick search of Psychology Today. This is a website with a well respected and utilized “therapist locator.” You can search for providers in your area who participate with your insurance. This should help you to narrow things down to get started.
- Once you have a few people on their website, begin reading their information to see if it seems like a good fit for you. You can narrow the search down by areas to focus on in therapy, male or female clinicians, and those with special areas of focus such as LGBTQ+, cultural competencies, adolescents, children, and geriatric specialization. They may also have a their own websites listed to find additional information about their practice.
- If you have found a few clinicians who might be a good fit, you can call them to request a consultation, discuss their availability, and see if they might be a good fit for you to begin your therapy journey. Many clinicians will offer an initial consultation or short phone call free of charge! You can also contact them through their email address, but not all clinicians communicate with their clients in that way so don’t be deterred.
- Once you have found someone whom you feel like you might like to work with, set up an initial appointment. At the first appointment, you can expect to do a lot of paperwork and for the therapist to ask you quite a few questions. Some therapists will request for you to do a lot of this paperwork prior to your appointment, and will have you fill out questionnaires ahead of time.
- After you first appointment it can be difficult to know if it’s a “fit” or not. All therapists practice very differently! I would recommend giving it at least three sessions to assess if the relationship feels comfortable and safe enough for therapy to be an effective form of support for you. Most therapists will proactively ask you about “fit” after a few sessions.
- Knowing if it “feels right” can be difficult to assess. It’s likely however, that you had some idea of what therapy would be like prior to getting started. If you were looking for guidance and your therapist is more laid back, you may need someone who is more solutions oriented or active. If your therapist provides too much guidance, and you feel like you don’t get to talk about what’s on your mind, you may need someone who is more process oriented. Both the terms “solution focused” or “process oriented” would be typical ways for a therapist to describe their approach to therapy so look out for those terms!
- If you feel like your initial therapist may not be a “good fit” please speak up to your therapist! All therapists are ethically mandated to provide referrals for clients to a new therapist when a transition needs to be made. It is highly likely that they have a large professional network and may be able to offer you a great referral. The single most important factor in therapy being helpful is having a good relationship with your therapist, so finding the right fit once you get started is very important!
- Not all therapists, myself included, use Psychology Today. Therapists you follow on social media or therapist friends, are great people to ask! Recognize however, that if you are already friends or close acquaintances with them on social media or in “real life,” that they cannot be your therapist. All therapists must follow a code of ethics that prohibit us from having a relationship with clients in some way outside of therapy. We will give you a referral however as we are ethically required to so!
- If you follow any mental health Instagram or Facebook pages, I suggest thinking over which of their posts resonated with you and eventually led you to “follow” them. It’s likely that you’d find a lot of benefit from working with a therapist who ascribes to the same theory of therapy.
- A quick perusing of their bio or even their website might give you some hints or key terms to use in your search for a therapist. You might even be bold enough to send them a DM, and simply ask what theory of therapy they use.
- If they are a practicing therapist with a website, it will be listed on their website in their “about me” section or under their approach to therapy explanation.
- Some modalities of therapy also require specialized training and certifications such as Dialectical Behavioral Therapy (DBT), Play Therapy, Trauma Focused Cognitive Behavioral Therapy (TF-CBT), or specialized approach to couple’s counseling like Gottman Therapy. Many of these certifications have their own websites with a therapist locator on them so that you can find someone who is certified in these methods.
Once you’ve decided that you’d like to start therapy, taking the first steps can be a little bit overwhelming; I hope that these guidelines help to alleviate some of the burden.
Taking these steps and writing down names of therapists might be something that you do several times before you make the initial phone call! That’s okay. Finding the motivation to go through this process and narrow things down is a great first step. On a day when you’re feeling particularly motivated or strong, all you will have to do is pull out the list and make the phone call. The hardest part will already be done. Good luck!