How do I find a therapist?
It’s 2016, and I’ve literally googled “gay therapist 94102', hoping the qualified, gay, handsome-but-not-too-attractive therapist of my dreams would manifest on my screen.
Instead, I find myself clicking through a handful of local therapy centers and support groups, eventually landing on Psychology Today.
A long search and a few emails later, I had my first therapy appointment scheduled.
This guide is a way of sharing what I’ve learned from struggling to find, and eventually finding, mental health support. It’s the advice I’ve shared with friends — simple, totally biased, but carefully considered.
Hopefully it helps you find the support you want. Everyone deserves to have their mental health cared for, and I hope you are able to find the care you need.
1 — Pick the type of support you’re seeking
There are many different forms of therapy. For the sake of this guide, when I talk about therapy I’m referring to talk therapy — where you spend time with another human (a trained professional), talking.
In many case, the human(s) you’ll be spending time talking with, typically come with a range of qualifications. This guide from WebMD gives a nice overview of the most common ones:
Psychologist. A psychologist has a doctoral degree (PhD, PsyD, or EdD) in psychology, which is the study of the mind and behaviors. Licensed psychologists are qualified to do counseling and psychotherapy, perform psychological testing, and provide treatment for mental disorders.
Counselor. A psychological counselor is a mental health professional who has a master’s degree (MA) in psychology, counseling, or a related field. A mental health counselor is qualified to evaluate and treat mental problems by providing counseling or psychotherapy.
Psychiatrist. A psychiatrist is a medical doctor (M.D. or D.O.) who specializes in preventing, diagnosing, and treating mental illness. As a doctor, a psychiatrist is licensed to write prescriptions.
The credentials of your therapist will have some impact on the types of therapies you can access. For instance: if you’re curious about using medication as a tool in your mental health support, you’d need to see a psychiatrist. No matter the direction you go, ensure your human has some training.
I first sought out a psychologist (PsyD) because I didn’t want to include medication with my therapy. After three years, I explored counseling as a lower-cost option, but quickly went back to another PsyD.
2 — Consider your options
Finding a therapist is a lot like dating (sans the fun bit). It takes an investment of money and time, and a desire to build a genuine, vulnerable connection. And, yeah, sometimes like with dating, you end up with a bunch of shitty options. Persistence, and knowing what you’re looking for will help.
A few things to consider when seeking a therapist:
Money. In 2021, for each 50 minute session, therapy costs between $60–120. Some therapists offer sliding scales based on your situation and their caseload. Others charge well above this average rate. Online services like TalkSpace or BetterHelp charge monthly for a varying number of sessions, typically between $60 to $99 per week.
If you have insurance, check your mental health coverage. When searching for a therapist on Psychology Today, you can specify your insurance as a filter. Unfortunately, many therapists are choosing to forgo the headache of insurance and go out-of-pocket. In this case, using a Health Savings Account (HSA) or Flexible Spending Account (FSA) can cut down on some of the costs that insurance won’t cover.
If you don’t have insurance coverage or access to an HSA or FSA, you’ll likely need to pay out-of-pocket. If this isn’t realistic, you could explore what community-based group services or resources exist in your area or online. Mental health advocacy orgs like the National Queer and Trans Therapists of Color Network (NQTTCN) provide financial assistance to QTBIPoC folks. Also, some mental health adjacent orgs are offering free support groups.
In any case, while mental health care is hard to put a price on, going into debt for it may add more stress than relief. Be realistic with what you can afford, and work with your therapist to find the right balance.
My first therapist was $220 per session, covered 100% through insurance. My insurance changed, and I had to switch to $180 out-of-pocket, covered by my HSA and FSA. Once my insurance changed again, I tried a counselor through a work-sponsored program, but eventually switched to my current therapist, out-of-pocket at $100 per session.
Time. Therapy sessions are about an hour (more precisely: 50 minutes in many cases to prevent overlap and awkward waiting room interactions). Sessions can be as frequent as you and your therapist decide. Most tend to happen on a weekly or monthly schedule. The relationship you form, and topics you’re discussing, will have some impact on frequency. If you’re planning to see your therapist during the work day, consider planning for some time before and after your sessions to let the discussion sink in and give your mind a break.
I was seeing my first therapist weekly, for around three years. Currently, I see my therapist whenever I text him for a session (once every several weeks). When I schedule a session, I block 30 minutes before and after, if possible, so I’m not showing up in other meetings or spaces with too much on my mind.
Connection. Back to the dating analogy. A good connection is hard to force. You might have to try out a few therapists or therapy methods before discovering what works for you. Unless you are in need of immediate support, take your time and trust your gut. Your therapist may be one of the more intimate, emotional relationships you create, so make sure you feel cared for.
I ‘broke up’ with my therapist after three years, because I didn’t feel the relationship was growing with my needs. I felt well equipped to use what I learned to manage my own mental health, until a few life changes pushed me to find my current therapist late last year. In both cases, the connection I had with my therapist matched the needs I had at the time.
3 — Do a little ‘dating’
…figuratively speaking. You don’t want to literally date your therapist (boundaries, you know). While you’re figuratively dating, keep these two questions in mind:
Does your therapist have a therapist? Ask this in your first conversation. If the answer is no, move on. Your therapist is a human, regularly holding space for the burdens of other humans as well as their own. The way your therapist takes care of their mental health may well be an indicator for how well they care for yours.
Do you feel a connection? This might take a little more time, but trust your gut. If you don’t feel comfortable being vulnerable or sharing what’s tucked deep away, it might be time to move on.
Once you feel like you have a good match, stick with it! There are times your therapist might push you, let you down, or totally blow your mind. All of these experiences may be helpful as part of your work. As you continue working with your therapist, express your needs, embrace the time and space you have, and continue caring for your mental health.
4 — Is this working?
After some time, check in with yourself. Is this working as you were hoping when you started? Do you feel supported and empowered, or talked-over and ignored?
Maybe you’re tired of texting your therapist and want to see a face? Or perhaps you caught your therapist falling asleep in your last session?
Check in with yourself and make sure this is working for you.
Therapy is an act of self-care. It can be life changing or saving. You are the one who deserves that, and I hope you can find it.
▢ Consider the cost. Check insurance for coverage, consider an HSA or FSA, or budget out-of-pocket costs. If money is a barrier, other options still exist.
▢ Write down some things you want to explore with a therapist. If you don’t know, that’s okay. Part of the process of therapy might start with ‘I want help, but I don’t know why’. However, having specific needs or topics in mind can help you find the perfect fit.
▢ Do a search. I found Psychology Today to be a really helpful resource to contact individual therapists. It’s a bit of manual work, but gives you the most control over your search. If you use a service like BetterHelp or Modern Health, they’ll pair you with someone (and you can always switch). Other services like Violet are curating culturally competent care providers and can be helpful in your search as well.
▢ Pick your therapist (to start). Once you’ve found a promising option, schedule a consultation or introductory session, and ask if they have a therapist of their own. If you’re needing some guidance on how to select someone, here’s a helpful guide for beginners.
▢ Check-in on your progress. After a few sessions, check-in with yourself (and even your therapist) on how things are going. Do you feel supported? Is the time and money you’re investing worth it? If not, go back a few steps and restart your search until you feel this is working for you.
One final note.
It is a privileged position to be able to access culturally competent, affordable mental health care in this country. If you are seeking alternatives to the support I shared above, here is a list of (mostly) free mental health and recovery related resources. This year has been a rough one for many, and I hope you are able to find and benefit from the mental health support you seek.
Did I miss anything? Have a question? Share it below.