You’ve struggled for long enough with the stress and constant worry and decided it’s time to work with a therapist. But what’s the next step?
It’s not like you’ve done this 100 times before like meeting with your family physician. How do you know who’s good? How can you trust someone you don’t even know?
Searching for a therapist can be just as scary as the thought of going on with the issues that have you thinking of getting help in the first place!
Here are some tips that will hopefully make the process a little less stressful for you, and help you to find the therapist that fits with your personality and needs.
There are two steps when looking for a therapist. Finding potential counselors, and then deciding which to actually work with.
Finding potential counselors
At this stage you are casting a wide net just to see who is a possibility for you to work with. To do that, you first need to consider what criteria is important to you.
Is it important to find someone who is in-network with your insurance, or are you willing to consider a private pay therapist who will help you get reimbursed through out-of-network benefits? If you want to stay in-network, then you’ll just want to double check with any potential therapist that they accept your specific insurance.
Insurance companies are making it increasingly difficult for therapists to join their networks, or they regularly lower their reimbursement rates or make it difficult to obtain reimbursement, so many therapists are choosing to go “out-of-network.” Disclaimer: I am an out-of-network provider.
What that means for you is that you pay the therapist’s fee at the time of your appointment, and they provide you with a “superbill” that you submit to your insurance company. Many insurance companies will reimburse at least some of the cost. To know for sure how your insurance company handles out-of-network reimbursement, follow these steps:
A) Contact your Insurance Carrier
1) Ask the insurance provider if you have coverage for outpatient mental health psychotherapy and related mental health benefits. For individual psychotherapy, the code is CPT code 90837.
2) Ask: Does a deductible need to be met, and has it been met?
3) Ask: Is Pre-authorization required? If so, try to obtain this phone number before meeting with your therapist.
4) Ask: Is approval or a referral required by a medical provider?
5) Ask: What is the amount of coverage for an out-of-network provider? This will likely be a percentage number.
6) Ask: Is there a time limit for submission of claims?
7) Ask: Where should my claims be mailed?
Also regarding financing, you want to ensure that you can afford weekly session for 1-2 months before moving to every other week. That frequency is necessary at the outset of treatment to ensure progress is made.
Specialist vs generalist
Is it important to work with someone who is a specialist in your area of concern, or would you be okay working with a generalist? I’m going to be honest here, research shows that a trusting relationship with a therapist where you can be open, honest, and feel supported is the most important aspect for feeling better. That being said, a strong relationship with someone who is an expert at your specific concern is optimal.
Certain issues truly do benefit from working with a specialist. Addiction, eating disorders, obsessive-compulsive disorder, and personality disorders (e.g., borderline personality disorder, narcissistic personality disorder) are among the conditions that have unique qualities that a generalist will likely not handle as well as a specialist. A good therapist should communicate with you from the very beginning whether they are qualified to help you, or if it would be better to refer you to a different provider.
Please understand that a referral is intended to connect you with the therapist that can best help you improve, and NOT an indication of you being broken or undesirable. I want you to feel better and if I can help, I will, but if I can’t, I will provide you the names of people I think can help!
How far are you willing to travel to meet with the perfect counselor? Are you okay with meeting a therapist virtually? If you’re in a rural area, or seeking a specialist for a certain condition, it may be difficult to find someone that’s only a short drive away. For some people it’s important to be able to meet with their therapist face to face, and then you’ll need to decide if your schedule can accommodate the extra driving to meet with your best fit.
Online therapy has been shown to be just as effective as in-person therapy for most mental health concerns. What this means is that you have options across your entire state! While some online therapists practice over e-mail or text message, most use video technology similar to Skype or Facetime. I’ve found that the technology has not caused any problems with developing a strong relationship, and can be far more convenient for patients with busy schedules.
Making a list of counselors
Now that you have your basic criteria, you need to actually get some names!
- Friends who have had positive experiences with their counselor
- Ask your primary care provider who they recommend
- Contact your insurance company
- Online directories
- A benefit of online directories is you can input some of the criteria discusses earlier to narrow down your search (e.g., online therapy available, specific insurance, location, etc.)
- www.openpathcollective.org (providers agree to see patients for between $30-$50/session)
Once you have a few names to consider, you want to spend some time seeing what you can find about them. Most therapists these days have an online presence either on social media or a website. Take a look at what you can find and get an idea of the counselor’s personality and whether it seems like it may be a good fit for you. While you might not be able to tell if someone is “the one,” you may be able to cross some people off your list if their online material rubs you the wrong way.
Now that you’ve narrowed down your list even further, you’ll want to take advantage of free consultations. Most therapists offer between 15-30 minute free consultations. What you can expect on these phone or video chats is for the counselor to ask questions to try and understand what your concerns are.
It’s also a chance to ask any specific questions you have about the therapist or therapy in general, as well as insurance, fees, etc. During the meeting, you should get an idea of whether the therapist’s style is a fit, and if they have the experience to help you.
Good therapists don’t just accept anybody who calls, he or she should also be evaluating whether they are the best person to help you, or if you would most benefit from a referral to a colleague.
At the end of this session, you and the counselor decide whether to schedule an intake session, or if you should pursue other options. It’s okay to tell the therapist you’re still looking, and you’ll schedule at a later date if you choose! There are no obligations at this point to schedule.
The Intake Session
Once you’ve called around, had several free consultations, and decided who you feel is the best fit therapist, it’s time for the intake session. This session will be similar to the consultation in that it’s primarily geared towards gathering information about you, your background, and your primary concerns. It’s also still a chance for you and the therapist to evaluate “goodness of fit” in personality and experience.
I encourage you to be honest with yourself about whether or not you feel a connection. As I said earlier, a strong relationship is the best predictor of success in therapy. If you just don’t click, it’s okay not to schedule again. In that case you may want to ask for a copy of the written intake evaluation so you can provide it to your next option counselor (this is not necessary, but can make it quicker and easier to get into actual therapeutic work).
As a psychologist, I want everybody to get the optimal treatment for them. I never take offense if they choose to change providers after our first session, and I am more than happy to provide options if requested!
Deciding to start therapy is a difficult decision. It requires you to admit that you need help. It means you have to become vulnerable and open up to a “stranger.” Any therapist you communicate with should demonstrate that they recognize this difficulty, and that they respect you for it.
You are choosing to make an investment in yourself. It’s no different from meeting with a personal trainer to improve physical health. Even just taking the step of researching counselors and reaching out to ask for help is moving yourself in the right direction. You deserve to feel mentally strong, and working with a therapist can help you reach that goal!
If you have any questions for me, please either call 727-469-3008, or e-mail firstname.lastname@example.org. I also offer free 30 minute consultations if you’re ready to take that step. Here’s to wishing you the best on your journey of finding the right therapist!