Once you have decided that you might benefit from seeking counseling, you are faced with what can feel like an overwhelming task: finding the right therapist. There are many providers out there, so how can you feel confident you have made the best choice? Read on to learn what considerations will help you find the right therapist for you!
Area of Specialization
Virtually all therapists are comfortable and experienced in working with common mental health concerns such as mild to moderate depression, anxiety, stress, or life changes, so if you are seeking counseling for those types of issues, you may not need to seek out someone who specializes in those areas (that’s totally up to you though, as you may still find comfort in working with a therapist who primarily works with those concerns).
Beyond those common areas, most therapists identify a few key areas in which they have particular interest or expertise, and possibly advanced training or certifications– these are called specializations. Some examples of specializations are: relationship issues/couples/marriage counseling, neurodivergence (e.g., ADHD, Autism Spectrum), trauma, eating disorders, and substance use concerns. For many clients, it feels like the best choice to select a therapist who has a special interest and/or additional training in working with the particular issue that the client is experiencing.
Do They Take Your Insurance?
An important factor that will determine the cost of therapy is whether the therapist participates in your insurance network. If you are going through your health insurance to pay for therapy, working with in-network providers will cost less than out-of-network providers. How much less will be dependent upon the rates of the therapist, and the specific terms of your insurance plan, so it is important to make sure you understand how your insurance coverage works.
If you decide to see an out-of-network provider, you can try to submit paperwork to your insurance company for partial reimbursement of what you paid for those services. If the out-of-network therapist who provided the services meets relevant license criteria, your insurance company may help cover some of the costs, though it will still cost you more out of pocket than if you worked with an in-network provider. Also, those costs may or may not count toward your deductible– this is dependent on your insurance plan, so make sure to find out this information from your insurance company in advance of working with an out-of-network provider. Alternatively, if financially feasible for you, you can choose to pay the therapist’s full rate out of pocket and not involve your insurance company at all. Those costs would not count toward your deductible.
Why would I see an out-of-network provider if it will almost always cost me more money than seeing someone in-network? Typically, someone would make this decision if they felt the therapist who best fit their needs was the right choice despite being out-of-network, and it is worth paying more to work with that particular therapist, or if there are no in-network providers who are accessible, whether due to geographical restrictions or lack of availability of appointments.
Level of Fit
One of the key predictors of successful outcomes in therapy is what’s called “therapeutic alliance,” which is the authentic connection between the client and therapist. Research has consistently shown that a client is more likely to engage meaningfully in therapy, and therefore more likely to experience improvement in symptoms, if they have strong therapeutic alliance. If you’re going to be investing your time and money into seeking therapy, you are going to see the best return on investment if you work with a therapist with whom you feel comfortable.
It’s important to feel comfortable in therapy because you are sharing private information about yourself, and it is hard to be vulnerable, so it makes a big difference to feel like you are working with someone who you can trust, and who will make you feel safe, respected, and not judged.
How can you tell if you’re likely to be comfortable with a therapist? Sometimes it’s just a feeling you have, but you can also take an educated guess by reading the therapist’s website to get a feel for their experience in the areas you are seeking help around, how they work with clients, as well as their personality. How well those things align with what would make you feel comfortable represents the level of fit between you and the therapist. Again, level of fit between client and therapist is a major predictor of therapy being a success, so take the time to find a therapist who you believe you will be comfortable working with.
Tip: some therapists offer or will agree to a brief 15 minute consultation call to help you determine level of fit. This call is not therapy, it is an opportunity for you to ask how they typically work with clients in order to see if you would feel comfortable working with this person. I am happy to offer a 15 minute consultation if you send me a message requesting it.
Accessibility
Sometimes we are restricted in the therapists available to us, either by who is geographically close by, whose services we can afford, or by who has appointments available.
Remote or virtual therapy has been a total game-changer, removing geographic barriers to affordable care in many cases. While some are hesitant to work with a counselor online rather than in-person, there are several benefits to working with a therapist remotely, one of which is that it frees you up to select your therapist based on criteria such as fit and expertise, rather than being restricted only to therapists who are geographically close by.
As for affordability and availability, these two factors often are associated in a supply and demand type of way. Read below to learn more about navigating these decision points.
Experience and Cost: Weighing Upsides and Downsides
There is a high level of demand for mental health services, and it is common to experience wait times of several weeks or more between the time of calling to make an appointment and the first available appointment.
Often you can schedule faster with a less experienced clinician, including interns and residents (this means they are not yet licensed, but have completed relevant coursework and are being supervised by a licensed therapist).
The benefits of working with an experienced therapist are obvious: they are well-versed with practical experience with clients who have come before who have struggled with similar concerns to those which you are facing; experienced therapists can also more expertly navigate the differences between textbook knowledge and what will work practically in a given client’s situation. You will often pay more to work with an experienced therapist because of their expertise.
However, there are also potential benefits to working with someone with less experience. Aside from a shorter wait time to get an appointment, if you choose to work with an intern or resident, you have two sets of eyes and ears on your case– both the individual you are working with and their supervisor will be giving consideration to the issues you are dealing with and how to best support you.
Sometimes, even experienced therapists offer what are called “sliding scale” fees, where those therapists are willing to work with a limited number of clients for less than their usual rate. This can be a great opportunity– the downside is that there is limited availability of these types of arrangements.
Conclusions: Time To Find A Therapist
I am not being compensated in any way for this, but I will share with you my favorite therapist search engine: Monarch. I just think it is so easily searchable, with helpful customization filters (for example, you can select only therapists who take your insurance, or who specialize in a certain issue). Note that the Monarch directory only shows therapists who use the Simple Practice Electronic Health Record service. Another popular therapist search site is is Psychology Today; similarly, it will also only list therapists who have paid for a Psychology Today subscription.
Another option is simply to google therapists in your area. Something to be aware of is that often therapists do not have google reviews, because this is not something someone can leave anonymously, so people are sometimes hesitant to share their impressions because it also means disclosing publicly that they have been in therapy and not everyone is comfortable doing that. For any therapist you find from a search engine or elsewhere, look to their website to learn more about them, in order to help you determine if they would be the best match for you.
At a minimum, here are questions you want to make sure you know the answers to in your search for the right therapist:
Does this therapist take my insurance? If not, what are the out-of-network reimbursement procedures and limitations for my insurance plan?
What is the rate per session, and how much of that do I pay vs. my insurance?
Do they have experience working with the area around which I am seeking help?
What information from their website makes me feel like I would be comfortable or uncomfortable working with them?
Armed with this information to help you make an informed decision, go out and find your therapist!
Michelle Lange, Psy.D., is a Licensed Clinical Psychologist and the owner of Relaction Therapy, providing mental health and wellness consultation services. Visit relaction.us to book a session or consultation appointment.
Image credit: Anthony Tran via Unsplash
