How to Begin Therapy

Deciding to begin therapy is a brave and courageous step. Asking for help creates a vulnerability that is unlike anything else in the human condition. However, knowing where to begin, or even how, can be confusing, overwhelming and complicated. Where do you go to find the help you need?

I’m hoping to offer a few pieces of advice that can help answers some basic questions and get you started in the right direction.

Where Do I Start?

The first place to start with therapy is to make sure you know what you’re wanting to work on. Start with answering a few basic questions: What are the main issues you are wanting to address (trauma, anxiety, OCD, depression, etc.)? Do you prefer a male or female therapist? Location- online or in person? How far are you wanting to drive- remember you’ll most likely be attending weekly sessions, so if you’re not up for a 2 hour drive, narrowing your distance is going to be helpful. Are you planning on using insurance? Do you even know if you have mental health insurance (most plans do include this, by the way, but always important to check)? Do you know of certain types of treatments that you would like to try (Cognitive Behavioral Therapy-CBT, Eye-Movement Desensitization and Reprocessing- EMDR, Couples Therapy)? Are there certain commonalities that are important for your therapist to have, similar spiritual beliefs for example?

Now It’s Time to Search

Once you’ve answered those basic questions, it’s time to go searching to find a good match. Now, it’s important to keep in mind there is no such thing as a perfect therapist or a perfect match, because therapists are HUMAN! But the important thing is, that you find a good enough match to help you in the season you’re in and what you’re struggling with. I recommend going to a few different sources to help find that good enough therapist. This list of course is not all inclusive and there are other options too, these are just what I have experience with and believe are the most helpful.

• Therapist Directories (PsychologyToday, TherapyDen, Therapist.com). These are a few of the online directories of therapists around the country. You can put in filters: gender, location, insurance, issues to be addressed, and style. You can read profiles, compare prices, find their website, and even reach out directly to the therapist. Check out my Psychology Today profile here!
• Yelp.com- Just like looking for a place to eat, fix your car, or a new dentist, therapists are also on Yelp!
• Word of Mouth- Your friends, your friends’ friends, your uncle’s third cousin twice removed’s boss might know of a therapist they liked or heard of that might be a good fit for you. Ask them! Ask about their experiences. Ask other therapists if they have referrals. We all tend to like to work with each other so we’re happy to offer referrals in anyway we can.
• Insurance- If you have mental health coverage as a part of your insurance plan (which most plans do these days), you can call your insurance representative and ask for referrals. Usually they send you an extensive list of in-network providers, which could be overwhelming, but also could be a starting point.
• Search Engines- You can also just Google (or whatever search engine you like to use) “Therapists who treat anxiety near me” and see if you get any leads.

What Do All Those Letters After Someone’s Name Mean?

So maybe you’ve found a few that have potential, you like their Psychology Today profile picture, they’re website looks pretty modern, and their Instagram is filled with all those inspirational therapy memes. But how do you know if their education and training will help you? And why do they have all those letters at the end of their names?

Great questions! Each state has their own licensing qualifications for someone to become a mental health professional, as well as what they’re called. Here’s a break down taken from nami.org of the different types of professionals you can find (including what all the letters mean).

Psychologists

Psychologists hold a doctoral degree in clinical psychology or another specialty such as counseling or education. They are trained to evaluate a person’s mental health using clinical interviews, psychological evaluations and testing. They can make diagnoses and provide individual and group therapy. Some may have training in specific forms of therapy like cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT) and other behavioral therapy interventions. If you’re wanting to be evaluated for ADHD or Autism, you would want to go to a Psychologist.

Degree requirements: Doctor of Philosophy (Ph.D.) in a field of psychology or Doctor of Psychology (Psy.D.).

Licensure & credentials: Psychologists are licensed by licensure boards in each state.

Counselors, Clinicians, Therapists

These masters-level health care professionals are trained to evaluate a person’s mental health and use therapeutic techniques based on specific training programs. They operate under a variety of job titles—including counselor, clinician, therapist or something else—based on the treatment setting. Working with one of these mental health professionals can lead not only to symptom reduction but to better ways of thinking, feeling and living. I’m a Licensed Professional Clinical Counselor in California (LPCC) and I treat individuals who have experienced trauma, anxiety, and depression. Contact me for more info!

Degree requirements: master’s degree (M.S. or M.A.) in a mental health-related field such as psychology, counseling psychology, marriage or family therapy, among others.

Licensure & Certification: Varies by specialty and state. Examples of licensure include:

• LPC, Licensed Professional Counselor
• LMFT, Licensed Marriage and Family Therapist
• LCADAC, Licensed Clinical Alcohol & Drug Abuse Counselor

Clinical Social Workers

Clinical social workers are trained to evaluate a person’s mental health and use therapeutic techniques based on specific training programs. They are also trained in case management and advocacy services.

Degree requirements: master’s degree in social work (MSW).

Licensure & credentials: Examples of licensure include:

• LICSW, Licensed Independent Social Workers
• LCSW, Licensed Clinical Social Worker
• ACSW, Academy of Certified Social Worker

Side note- if you see the words “Associate” or “Intern” in relation to these titles, it means someone has graduated from Graduate School, however, are earning their required hours to obtain licensure so they’re under the supervision of another licensed therapist. Someone at this level is required to disclose this to you, usually their profile, website, or email signature will say “Under the supervision of Jane Doe, LPCC 123456.” It doesn’t mean they’re not competent and can’t offer good therapy. It just means they are quite as experienced as a licensed person.

Let’s Talk About the MONEY!!!!

So now that you’ve got that figured out, it’s time to figure out how to pay for it. Therapy is expensive. There’s no getting around it. Depending on location and experience of the therapist, sessions can cost $60-300+. A lot of time insurance pays for some part, if not all, of treatment. But not always. And if that’s the case, what do you do?

First thing- remember this is an investment into your overall well-being. Maybe it means sacrificing something else (like Starbucks trips, that 3rd margarita at dinner, or weekly nail appointments) in order to move you closer to a state of healing. What you’ve been doing hasn’t been working, otherwise you wouldn’t be seeking out therapy, so taking a hard look at what you can give up to invest in yourself could be worth it in the long run.

Second, therapists want to help you! And the majority of us, the good ones at least, aren’t in it just for the money. Yeah, we need to make a living, pay rent, and all the things (we’re human, remember), but we are helpers. Having an open and honest conversation about what you can afford before you start is essential and a lot of therapists will be willing to work with you. Some therapists offer a sliding scale, which means that if you ask for a reduced fee that’s based on your income.

Other ideas to make it more affordable is to try and go every other week (unless you’re in crisis, or needing more acute care), or once a month. The idea that you need to go in weekly isn’t always a necessity. This is something to discuss with your therapist.

Final Thoughts

At the end of the day, the most important thing about going to therapy and finding a therapist, is the relationship. You want to be able to find someone you can be vulnerable with, explore with, and open up to. You want to be able to connect with their personality, they’re style. They will not be perfect. And there might be times you need to speak up and say, “Hey, I didn’t like what you said,” or “that thing you told me to try didn’t work for me.” And that’s okay!

I recommend finding around 4 or 5 potential therapists that seem to meet most of your criteria and then reaching out and having a 15 minute phone call with them and see how you connect. Ask about fees, scheduling, style, and even background and training. We can get a good sense about someone pretty quickly. So try it out. And if you schedule with someone, attend a session or two, and feel it’s not a good fit, it’s okay to try someone new. The most important thing is that this works for you!

I offer free 15-minute phone consultation for anyone seeking treatment. Reach out to find out more and how to begin therapy!