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By Michael W. Regier, PhD — Written on Oct 30, 2022
It takes a great deal of contemplation and courage to say, "Yes, I'm ready to find a therapist."
Taking the next step to figure out how to find a good therapist to reach out to, let alone what kind of therapy would be the best type of mental health counseling for you, can feel overwhelming.
There are so many choices, and chances are you're making this choice at a time when you're already feeling vulnerable. It's one thing to trust your physician for help with a particular physical health issue or procedure, but quite another thing to trust an unknown therapist with access to your mind, heart, and soul.
Finding the right therapist is different than finding the right physician.
While experience is important in any profession, medical treatment is much more standardized than psychotherapy. There are many types of psychotherapy that can be applied when working with mental health conditions such as anxiety, depression, or relationship problems.
Knowing which questions to ask yourself and a potential counselor is a critical factor in your ability to make the best, most informed decision for your particular needs.
Here are the most important questions to ask yourself and mental health professionals in order to find the right therapist:
1. What kind of therapy do you need?
The truth is that therapists often disagree about what kind of therapy is best. Therapists have strong feelings about theory because it defines the way they work and how they view human transformation.
Most therapists identify with a particular theory of psychotherapy that informs their overall practice. They pretty much apply this theory to all of the problems they work with. This often leads to great disagreements among therapists about which theory is best.
This can be a problem when researchers try to determine which kind of theory, and therefore the therapy within that theory, works best. When opposing theories are compared with each other, there's often little difference as to which one works better to solve a particular problem, and this can leave consumers confused about how to go about finding the right kind of therapist to meet their specific needs.
If your understanding of psychotherapy theory is fairly sophisticated, you may want to seek out a therapist who works in a way that is consistent with your view of behavioral change. Or maybe you enjoy doing your own research and want to learn for yourself what studies say about the best therapy for the kind of problem you're seeking help for. Maybe a friend or family member is a therapist and can help guide you through this process.
Finding a therapist you trust to help you make a decision about what kind of therapy will best meet your needs is probably a better approach than trusting Google to make a decision for you. If you don't know someone who can give you a name or two, you can call a referral service to help you sort through the options.
2. How much will you/can you pay for therapy?
One of the things people ask first is how much therapy costs. This makes sense because most of us have to work within some kind of budget.
This can also be confusing, as the cost of psychotherapy can range anywhere between $50 to $200 dollars an hour or more depending on your location and the type of therapist you're seeking. The upper end of this range can seem like a lot of money and may be out of your budget. Just remember that in the world of psychotherapy, as with most things, you often get what you pay for.
More expensive therapists often charge more because they have more experience, and deeper training, and are highly sought after. All of these things make a difference in the kind of care you will receive.
If it's important for you to use your insurance to pay for therapy, call your insurance company and find out which therapists they contract with. But keep in mind that insurance companies are in business to make money. They usually pay therapists as little money as they can in order to get the service they are contracting for. This forces therapists to reduce their fees and be okay with receiving a percentage of what the insurance company is willing to allow them to charge.
For this reason, many experienced therapists do not contract with insurance companies and ask clients to pay in full at the time of their session. This doesn't mean you can't use your insurance with these therapists. Most of them will give you a "superbill" with the pertinent information insurance companies require. You then submit the superbill to your insurance company and they reimburse you a percentage of what you paid. This is called out-of-network reimbursement.
So there are no financial surprises, call your insurance company ahead of time and ask what kind of reimbursement you might expect if you see an out-of-network therapist.
3. Where do I find a therapist?
To find a therapist online, you can go to an online therapist directory like Psychology Today. Just pull up their website and go to find a therapist. They will ask you where you live, and in most cases will give you a good list of therapists to consider.
Once you have a good idea of the type of therapy you need and where to find some choices, you're getting close. Now it's time to figure out who will best meet your needs. Who should you call?
In order to determine which therapist you should call, the next five questions will help you rank your options.
4. Are they licensed?
They need to either be licensed or be an intern getting their hours for licensing, but keep in mind that there is often a big difference between licensed therapists and therapists-in-training.
Therapists-in-training generally charges less. This may be important to you and allow you the opportunity to get therapy even if tight finances are an issue.
It usually takes therapists at least two years of working under supervision to receive their license, so picking a licensed therapist is best if you can afford it.
Next, consider how they are licensed. Licensed psychologists have at least two more years of education than Licensed Clinical Social Workers (LCSWs) or Licensed Marriage and Family Therapists (LMFTs). Every once in a while you will see an LCSW or LMFT with a Ph.D., but most of them have master's degrees.
Psychologists often know more about working with more severe mental illnesses, and they are also trained in psychological testing. This doesn't mean that they are necessarily better therapists, but the difficulty and rigorous training involved in obtaining a Ph.D. often means a higher level of talent. Ph. D.s typically charge more than LCSWs and LMFTs.
A Psy.D. is also a psychologist, Theirs is also a doctoral degree, but they've been more focused on practice delivery with fewer research requirements.
5. Where did they receive their education?
Most therapists list where they went to school, both at the undergraduate and graduate levels. They don’t have to have gone to Harvard in order to be a great therapist, but the quality of education is a legitimate differentiator, so paying attention to where a therapist went to graduate school should be part of your thought process in evaluating them.
6. How much training have they had since finishing their education?
I always tell new therapists that where they train after they get their degree is more important than where they received their graduate education. Therapists actually learn to do psychotherapy at the place they get their hours for licensure, whether in an institutional setting or a private practice.
Unfortunately, some therapists in private practice do supervision as a way of getting cheap labor, so the training therapists receive in private practice may be great or it may be poor, depending on who supervised them.
The population (types of people) and problems (types of mental health issues) newly graduated therapists work with during their training period have a direct impact on whether or not they are good at what they do, as well as whether or not what they do matches with what you need. Find out what their training focus was, e.g., eating disorders, depression, major mental illnesses or marriage, and family problems.
One thing to be aware of is that many licensed Marriage and Family Therapists (LMFTs) actually receive little training in marriage and couples counseling. Sounds odd, right? But it's true. Sure, they have book knowledge, but many of them are afraid to deal with the emotions and complexity of marital conflict when first starting out.
Another thing to look for is whether or not they are certified in a particular kind of therapy. Certification can be a big differentiator in quality of care. Some forms of certification, Emotionally Focused Therapy, for instance, require years of training in videotaped sessions which are reviewed by the trainee with highly trained EFT supervisors or trainers. Each therapist's skills then need to be approved by a committee of peers before they can receive the certification status.
7. What is their specialization?
A therapist will define on their website what they specialize in. This is something to pay attention to. No one can do everything well.
Often, inexperienced therapists who are hungry for referrals will check nearly all the boxes indicating they can be seen for most problems and diagnoses. As therapists become more experienced, they specialize more and check fewer boxes, as they want to get really good at working with specific problems.
Look for a therapist who specializes and has many years of experience working with the problem you believe you have. You wouldn't want to visit a gynecologist if what you need is a knee replacement ...
8. Will they talk with you on the phone before you set up an appointment?
Some therapists will take the time to answer your questions and get to know you free of charge via a phone consultation before you set up your first appointment. This is smart for them and for you.
There has to be a fit between what a therapist offers and what you need help with. If a therapist isn't a good fit, they should direct you to other resources. For example, therapists often refer people with addiction problems to addiction treatment programs.
Feeling safe and cared about is imperative. Pay attention to the therapist's tone of voice and their ability to connect with you. The number one predictor of successful therapy is the level of the therapist's empathy and ability to stay connected and aligned with their client.
Finding a good therapist isn't rocket science, but doing your homework up front is imperative.
Don't take shortcuts. Whether you enter into a short-term therapeutic relationship or one that last months or even years, it needs to be a good fit.
Your journey toward personal wholeness is one of the most important paths you'll walk down in this life. Embrace it!
Carefully select those who walk with you.
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Michael W. Regier, Ph.D. is a clinical psychologist, marriage counselor, and executive coach. He is the author of Emotional Connection: The Story & Science of Preventing Conflict & Creating Lifetime Love.