How to find a therapist

Summer time is a good time to try to find a therapist because less people are going to therapy so more therapists have openings.

When I used to try and find a therapist, I was afraid of talking on the phone so even though people had told me it was ok to interview therapists, I would just go with the first therapist who I could find. Now that I’m a therapist, I really do encourage people to do a 15 min phone call to see if we seem right for each other. It gives me a chance to talk about how I like to do therapy, and to find out what they’re looking for in therapy, and see if it matches.

I love this flow chart my friend James made, although it might be kind of hard to read, especially on your phone. It gets into how to figure out what you’re looking for, things that people tend to have preferences about, making a catch phrase to say when you talk to a potential new therapist, figuring out what to ask. I’m going to also go over some of that in case you can’t read this, and also talk about the bureaucracy of it all.

Coming at it from a place of empowerment

Try and brainstorm and write down what are you looking for:

You might want a therapist with a particular identity (or not), someone who can meet in person (or you might prefer online), someone who can meet weekly (or however often works for you).

Then there’s the personality piece, which is one of the reasons it’s helpful to have a phone call to get a vibe for them. It can be hard to tell from a brief phone call what someone’s personality is like, but if it feels totally off, trust your gut on that.

Consider if you want a particular type of therapy. Do you want to learn skills, like how to be more assertive? Do you want to talk about and process your childhood? Do you want someone who will hold space for you to talk about and experience your emotions? Do you want to process trauma? Do you want someone to help you figure out why you keep repeating patterns? Do you want simply a safe space to be you, however that is, whatever comes up? Do you want something short-term (like you were in a car accident and are having sudden symptoms)? Or are you looking for more extended support (like you want to change the patterns in your life and build a therapeutic relationship that can support you in making these fundamental changes)?

Developing a catch phrase to say when you talk to a potential new therapist can help. Like “I’m looking for a somatic therapist who takes Medicaid and understands disability stuff. I want to process some long-term stuff.” or “I’m looking for someone who can help me with my intrusive thoughts, and has openings weekly on Mondays.”

Then when you schedule a talk with the therapist, try and ask them about their approach, and whatever other open ended questions you can come up with so you can get a sense for them.

Try to stay present enough with yourself to feel them out. The phone call isn’t a time to tell them everything that’s going on for you, or for you to convince them to see you, it’s for you to get a sense of them and if they seem like someone you’d be able to build trust with. Open ended questions like “How would you describe your approach to therapy?” “How do you work with trauma?” “What’s your experience working with trans people?” “How do you approach family estrangement?” I like these questions, even when these aren’t the topics you personally are looking for, because not only can they elicit really interesting information, but they can really quickly weed out crappy therapists.

Boring stuff you can stop reading here if you know about navigating insurance and stuff like that already.

What are all the letters after therapists names?

There are so many letters! Mostly it doesn’t matter. To become a therapist you can go a number of routes, you can become a social worker with a therapist focus, a counselor, a psychologist, or a marriage and family therapist (which doesn’t mean you then see people who are married!). It’s all mostly the same. I used to get really stressed out about it when I was looking for a therapist, but now I know that most of what matters in the making of a good therapist has very little to do with what grad school program they went to and what initials that gave them after their name.

Deductibles, copays, coinsurance

The bureaucracies of this world are incredibly broken, and it can be intimidating to sort through all the logistics, like what’s covered by your insurance. It’s like the bureaucrats developed a new language and trained their minions to speak it and refuse to understand normal speech. Although these days I call insurance companies all the time, and about 1/2 the time the person on the other end of the line is another human, just trying to make it through their tedious job. Anyway, here’s what you do to find out what your insurance covers. On your insurance card, on the back there should be a phone number you can call and ask coverage questions. You want to ask what your coverage is for mental health - specifically outpatient mental health (or behavioral health). If they want a code, say 90837 (that’s the code for a 60 min session. They don’t usually ask for a code).

Deductible is how much money you have to pay up front before most things get covered. If you have a deductible of 1,000 then you generally have to pay out of pocket for most medical things until you’ve paid 1,000 and then coverage kicks in. HOWEVER; Some things are covered or partially covered by insurance even before you have met your deductible. Copay generally is the word they use for this. So if you have a $25 copay for therapy, that means that even if you haven’t met your deductible, you just owe $25 for therapy.

Coinsurance is a percentage and means that first you have to meet your deductible, and then after that, you’ll owe a percentage of the cost of therapy. So like, if you have a $500 deductible, you’d pay for the first 4-5 session out of pocket and then it would be covered except for the percentage of your copay.

What insurance pays therapists varies widely across the country, but tends to be in the $100 range from what I can tell. So if you have a 20% coinsurance, you’ll probably owe somewhere around $20 per session after you meet your deductible.

ANYWAY, it’s all stupid and therapy should be free for everyone and we should live in a world where we have functional, healing, vibrant communities. End capitalism. End war.