Getting Started With Therapy

One of the greatest barriers to getting help from a mental health professional is feeling overwhelmed about where and how to find someone. My hope in writing this guide is to help alleviate some of the stress and fear of the unknown. Having previously worked at a mental health resource and referral helpline, I gained a wealth of knowledge that I am happy to pass along!

Step 1: Figuring out what you need help with.

This is the main reason you are looking for a therapist. Sometimes we have experienced anxiety or depression for awhile and were managing it just fine on our own and then something happened and it became harder and harder to deal with on our own. Other times, something major or life changing happens and you are looking for support to cope with something you’ve never had to deal with before. Either way, you made the tough and scary decision to start looking for a therapist. This is so important to know what you are needing help with so you can find someone with that area of expertise. You don’t need to know the name or diagnosis of your problem as long as you can describe your symptoms. If you know you need help and support, but are not able to pinpoint the exact area, your therapist should be able to guide you in this process.

Step 2: Figuring out your financial situation/insurance.

We hope that finances never become a barrier for those seeking mental health treatment, but let’s face it, everyone has bills to pay. Sometimes we face financial hardships and paying out of pocket is not in the cards. Luckily, there are a few options to consider for how to pay for your mental health treatment:

1)   Private pay/out-of-pocket: If you have the financial means to pay out of pocket, this is a great option since you have the freedom to see any mental health professional you want. You don’t have to worry about your mental health information being shared with your insurance company or worry about number of session limits.

2)   Insurance: While insurance is open the most cost effective way to seek services, it can be quite difficult to find a provider in-network with your insurance provider. Depending on your insurer and plan, you may have out-of-network behavioral health benefits, which means they will reimburse you for part of your sessions. This is a great option since you can pick any provider you want to and all you have to do is ask your provider for a “superbill.” The superbill includes the type of service offered and how much you paid. I will be writing a future post about working with your insurance company for out-of-network services.

3)   Low rate:

a.     Open Path Psychotherapy Collective: I am a member of Open Path. This is a non-profit organization committed to accessible mental health. They have a database of mental health providers committed to offering low fee services for those in financial need. You can become a lifetime member for a one-time fee as long as your income qualifies you for low cost services. You will then have access to their database of providers offering low cost services.

b.     Sliding Scale: Many providers reserve a few spots in their schedule for sliding scale clients. This includes reduced session rates for those in financial need. All you have to do is ask if they offer sliding scale services. 

Step 3: How to find a therapist & who to choose. 

This step can be extremely overwhelming, especially if you just get a list from your insurance company or go on the website for a large mental health directory (i.e. Psychology Today or Good Therapy):

  • One of the first things to look for is if the provider lists your concern as an area of specialty. You wouldn’t go to a podiatrist for an ear issue. Treat your mental health with the same caution.

  • Does their profile seem up to date? You know I’m talking about those people when you can tell their last picture was taken in the 1980s!

  • Do they offer a free phone consultation? If not, how are you supposed to get a feel if they are going to be a good fit. More on the importance of this below.

  • Be cautious using on sites with ratings and reviews to pick your provider (i.e. Yelp, Vitals). There are many organizations that will write a bad review and then contact you to pay them to have your negative review removed. I’ve also seen many mental health providers with reviews from friends and family.

Step 4: What to ask in your initial phone consultation? What to look out for? What to ask therapist?

At this point, you’ve researched and maybe reached out to a couple of potential therapists. You finally hear back from one to schedule a phone consultation. You can tell so much about a person from a 15 minute phone call. Use this as an opportunity to evaluate the therapist and be aware of your gut reaction. Here are some ways to prepare for your phone call.

  • Question to ask:

    • What treatment modality do you use (i.e. CBT, DBT)? How might that look in a session? I’ll go into more detail in future blogs spotlighting various treatment modalities.

    • How frequently do you schedule sessions?

    • What are your rates? Do you take insurance? Do you provide superbills to submit to my insurance company for reimbursement?

    • What is your experience with my presenting problem (i.e. anxiety, depression)?

    • How do you involve the family in your work with children and teens?

  • What to observe:

    • Does this person guide the conversation? The therapist is the expert and most likely has more experience with this sort of thing than you do so do they frame the call or do they let you start talking?

    • How is this person’s tone? Matter of fact? Business-like? Compassionate? Warm? Friendly?

    • Are they able to answer your questions in a confident way?

    • Is this person easy to talk to? Do you feel heard?

    • Does this person seem rushed?

    • Do you feel pressured to book an appointment right then and there?

Step 5: Consider your options before booking your appointment.

If you have been trusting your instincts and gut reaction to this point, you may already know by the end of the phone call if you want to meet this therapist in person. If you do, great!  There’s no harm in booking the appointment during your initial consultation.  

If you are still unsure about starting the therapy process or if this person is the best fit for you, then sleep on it. You are under no obligation to book with that therapist. The only downside is that that person may not have many openings and you could risk losing the opportunity to work with them. But it may be worth thinking about it rather than rushing into a commitment.