So you’ve made the courageous decision to start therapy. There is a good chance that you’ve been considering it for some time now, and are already feeling drained even before beginning your search. Figuring out exactly how to find a therapist, let alone a good one, can feel daunting. Dear reader, allow me to offer you the most comprehensive guide to liaise you in the quest of finding your perfect therapist match.

When you are looking for your perfect therapist there are many factors to consider. Research shows the largest indicator of success in therapy, beyond the therapist’s education level or years of experience, is the relationship you have with your therapist. So unlike when seeking other types of professionals, like a doctor or a lawyer, you can’t just pick the first one you find. For the same reasons, there is no “best” therapist. The best therapist for you is the therapist you feel most connected to and understood by. 

So, how exactly do you find a therapist? Let’s get started.

1. CONSIDER HOW YOU ARE GOING TO PAY

One of the initial decisions you'll need to make is whether to use your health insurance or pay for therapy out of pocket. Both options have advantages and disadvantages.

It pains me to admit this, but in general, you're more likely to receive high-quality therapy if you're able to pay for it. As a therapist, it frustrates me to say this, so hear me out as a briefly rant about my hatred for the American healthcare system: 

The system is broken. Insurance companies often reimburse therapists at an unfairly low rate. This means that to make a living in an expensive city like Los Angeles, therapists who accept insurance must work long hours. Providing therapy requires a high level of emotional labor, and working with big emotions all day can be exhausting. To ensure that we can take care of ourselves (yes, therapists are human too!) many of us opt for the private pay route. This allows us to work fewer hours and provide higher quality services that we can feel proud of. There are many caveats to this rule, such as living in cities with lower costs of living, having alternative income streams, etc. But for the most part, if you ask me, when it comes to therapy, you often get what you pay for. This deeply frustrates us therapists as much as it probably frustrates you, but please don't blame us - blame the broken system.

INSURANCE ROUTE: HMO VS PPO

HMO: If you have an HMO plan, the best thing to do is contact your insurance provider directly via phone or through their website to inquire about available providers. Once you have the list of available providers, you can cross reference the information in the blog below to find a therapist that closely matches your needs. It's important to note that you may not be able to find a therapist who meets all of your criteria. I would suggest prioritizing what is most important to you, and being willing to be flexible in order to find someone who is available.

PPO: Having a PPO plan opens up a few more doors under the insurance umbrella. Depending on your policy and out-of-network benefits, you may have the option to see a therapist who does not accept insurance and seek reimbursement from your insurance company. The first step here is to learn more about your specific out-of-network benefits and deductible. Once you have this information, you can follow the steps outlined below for finding a therapist who accepts private pay. When reaching out to potential therapists, be sure to ask if they can provide you with a superbill, which is basically a detailed receipt that you can submit to your insurance company for reimbursement. Keep in mind that you will likely need to meet your deductible for out-of-network providers before your insurance coverage kicks in, and it will be your responsibility to continuously submit superbill claims to your insurance company.

PAYING OUT OF POCKET

Choosing to pay out of pocket for therapy offers you a wider range of options when it comes to finding a therapist. A quick google search can tell you the average cost of therapy in your area. At the time this blog was published, the average cost of therapy in Los Angeles is about $200/session, with the expectation of meeting every week at an ongoing basis. The length of therapy varies from client to client based on what you are working on, but I find that of my clients who seriously commit to working on their stuff and get the most out of the process come every week for about 6-18 months. A lot of prospective clients will ask if they can come every other week to lessen the cost. While you can do that, I find that isn’t really helpful for meeting your goals. There is usually too much space in between sessions that people spend the time focusing on catching up and don’t have enough time to get into the deep or meaningful stuff. If you are conscious of your budget but still want to pay privately to find your perfect match, I would recommend budgeting for a time where you can solidly dedicate at least 3-6 months, and in that time really take the work seriously. 

If the cost of private therapy is unaffordable for you, there are a few options that can make it more accessible. 

Sliding scale. Many therapists offer services on what is called a “sliding scale.” This means that they might be willing to negotiate a reduced rate depending on their availability and the client’s circumstance. For example, if you are a teacher or a first responder, or a queer teenager whose parents are unsupportive of therapy, some therapists may be open to adjusting their fees to work with you. Keep in mind that not all therapists offer sliding scales or have availability at the moment, but it never hurts to ask.

Associate level therapists. An associate therapist (ACSW or AMFT) is a therapist who has completed their graduate education and is working on accruing hours towards being a fully licensed therapist, while receiving supervision from a licensed therapist. Because they are still in training, these folks are typically have lower rates and can be more amenable to offering sliding scale options.

Low fee counseling centers. There are many community organizations that will provide low-cost or even free therapy based on your income level. A simple online search will show you available options in your area. These centers often provide therapist training programs for associate-level therapists and graduate trainees. Although your clinician may have less experience, they are likely receiving excellent and rigorous training. However, the downside is that there may be a waitlist to get started, and if your clinician graduates from the training program, you may no longer be able to continue working with them.

Open Path Collective. Open Path is an online database that connects clients with licensed therapists who offer lower fee therapy. Open Path operates on a membership model where clients pay a one-time fee of $59 to become a member, which gives them access to a network of mental health professionals who offer sessions for as low as $30 to $80 per session.

And of course, those highly advertised online mental health platforms… you know, the ones that are advertised on every podcast and football game. I have reservations about these services, and I don’t feel comfortable recommending them wholeheartedly. Many of these platforms underpay their therapists, just like insurance companies do, and have a reputation for selling client information, which has resulted in lawsuits against them. While I do have a couple friends who found great therapists this way, I’ve mostly heard horror stories.

2. LOCATION, LOCATION, LOCATION.

Both in-person and virtual therapy have advantages and disadvantages, and the choice between the two ultimately depends on your specific needs and preferences. 

In-Person Therapy offers an experience beyond clinical therapy, allowing you to develop rituals around leaving your typical environment and entering a new space solely for the purpose of focusing on yourself. Building a relationship with your therapist face to face allows for a deeper connection, as you can read their body language, energy, and mannerisms. Additionally, in-person therapy may be a good option if you do not have a safe or private place at home. TLDR: while going in person may be less convenient, there is a sacredness to the experience that cannot be replaced.

Virtual Therapy is a great option for those who have a harder time accessing therapy in person. If you are someone with a busy schedule, time saved on commuting can make therapy much more accessible. Also, depending on where you live, virtual therapy opens up options to see someone who specializes in your specific needs or interests but may not be located nearby. However, virtual therapy can be disrupted by technical difficulties, distractions from family members or pets, and may not provide the same sense of ritual or separation from everyday life as in-person therapy. As someone who both offers and receives therapy virtually, I can recognize that while the experience is different from in-person therapy, it is not inherently less effective or valuable. 

If you choose virtual therapy, I suggest finding ways to optimize the experience. I always encourage my clients to minimize their self-view to reduce self-consciousness and focus on being present. I have also found it personally helpful to create a ritual around my own therapy sessions to help signal the transition from everyday life to focusing on yourself, such as journaling or going for a walk, to mimic the ritual you would have had if you were seeing a therapist in person.

3. WHAT ARE YOU LOOKING FOR?

As a starting off point, you should ask yourself what you are hoping to work on in therapy. Perhaps you have a clear idea, such as working through an eating disorder, or anger management. Or perhaps you just want someone to talk to, and help you take your life from good to great. If you can be clear about what it is you are seeking, the process of sorting through the thousands of options will be much simpler.

The process of knowing what to look for in a therapist can be confusing, due to the overwhelming amount of options. As I’ve stated previously, the factor that will make therapy most successful is the connection you have with your therapist. 

Are there any specific qualities that you find vital when connecting to someone? Some factors to consider are age, race, gender, sexual orientation, or religious affiliation.

Ultimately, a good therapist will meet you where you are and seek to understand you, regardless of any differences. However, it's understandable that people may feel more comfortable with certain types of qualities in their therapist. It's important to be mindful of what matters most to you, while also remaining open-minded to the therapeutic experience. Remember that therapy is a collaborative process, and it's okay to have a dialogue with your therapist about what is and isn't working for you! By working together, you can build a strong and effective therapeutic relationship.

PSYCHIATRY VS THERAPY

There are a wide variety of professionals who can provide mental health care, but they differ in terms of their qualifications, training, and scope of practice. 

A psychiatrist is a medical doctor (MD or DO) or nurse practitioner (PMHNP) who has completed training in psychiatry. Their focus is to diagnose and treat mental illnesses primarily through medications. While some psychiatrists also provide psychotherapy, most focus on medication management, as their training is primarily focused on biological aspects of mental health and prescribing appropriate medications. 

A psychotherapist is a more general term and can encompass a range of professionals with varying levels of education and training including including psychologists (PhD or PsyD), licensed clinical social workers (LCSW), licensed professional counselors (LPC), or marriage and family therapists (MFT). Therapists focus on addressing emotional and psychological issues, improving mental well-being, and promoting personal growth.

These roles can overlap to some extent, as there may be psychiatrists who provide therapy and psychologists who have additional training to prescribe medication in some regions. The precise qualifications and scope of practice may vary based on country, state/province, and specific licensing requirements. 

TLDR: if you want meds, see a psychiatrist. If you want to talk things out, see a psychotherapist. If you want both, see both. If you don’t know what you need, just start with one (whoever you feel more called to) and talk about your concerns. They will be able to help you understand and decide what type of additional care you need.

THERAPY ORIENTATION

When seeking out therapy, most people don’t realize that “therapy” isn’t a one size fits all model. Every therapist has their own personality as well as style in the way they work. Depending which orientation your therapist comes from, you are going to have a very different experience in your therapeutic process. Think about why you are seeking therapy in the first place. Do you have a specific goal you are going to be working on? Do you have an idea for how you want the process to feel? Do you have any idea for the type of personality you might gel with? Most therapists practice from some degree of eclectic assortment, depending on you and your needs, but typically have a primary modality they resonate with. Below are the most common types of therapies you will spot in your search. 

Cognitive-Behavioral Therapy (CBT): This type of therapy focuses on changing negative thoughts and beliefs in order to improve your mood and behavior. CBT focuses on identifying practical tools and strategies to manage and cope with the symptoms of a problem, rather than delving into the root causes of the issue. There are many off-shoots of CBT; a couple more popular styles are dialectical behavior therapy (DBT) and acceptance and commitment therapy (ACT). I find these approaches to be really effective for folks who are seeking solutions to manage immediate symptoms.

Psychodynamic Therapy: This approach emphasizes exploring unconscious thoughts and feelings to gain insight into how past experiences may be affecting current thoughts and behaviors. This is the type of therapy you want if you are seeking a more profound understanding of your thoughts, emotions, and behaviors.

A few common off-shoots of psychodynamic therapy include classic psychoanalysis (think: Freud), Jungian therapy (EG: Carl Jung), and relational therapy:

1. Classic psychoanalysis: This is the OG Freudian stuff, where you would meet regularly with your therapist, for an indefinite amount of time, to explore the deep underbelly that is your unconscious mind to understand the hidden conflicts and desires that influence your thoughts and behaviors. 

2. Jungian therapy: Carl Jung was a cool dude. Jungian therapy explores the unconscious aspects of the mind and emphasizes the importance of individuation and self-discovery. It focuses on symbols, dreams, and archetypes to uncover deeper meanings and promote personal growth and integration.

3. Relational psychotherapy: This approach is all about seeing the relationship between therapist and client as a mirror to help you build insight into your own patterns of behavior and relating to all other relationships in your life. You are noticing what is happening here and now to understand how it relates to your life at large. I tend to resonate with this style.

Trauma Therapy

Ahhh, Trauma. Perhaps the biggest buzz word in the current pop-psychology zeitgeist. The field of trauma has made some major breakthroughs over the last few decades. The current understanding is that trauma can be any major event that leaves a lasting impact on our lives. This includes both Big T and Little t traumas, which can have a significant impact on our physical, mental, and emotional well-being.

When we experience a trauma, our bodies go into a fight/flight/freeze response. This response often causes the trauma to become trapped or stored in our bodies. Trauma has a unique way of sticking to us, making it difficult to release without specialized treatment. Simply talking about past events, as is often done in traditional psychotherapy, may not be enough to effectively address trauma. Instead, healing trauma requires engaging both the body and mind. Fortunately, there are a variety of trauma therapies available today that have been shown to provide positive results.

1. Eye Movement Desensitization and Reprocessing (EMDR): EMDR involves a series of sessions with a specially trained therapist, during which the client will be asked to recall the traumatic event while simultaneously engaging in a series of rapid eye movements or other forms of bilateral stimulation, such as tapping or sounds. The theory is that this bilateral stimulation helps the brain to process the traumatic experience and integrate it into the person's memories in a more adaptive way. 

2. Somatic Therapies: Somatic therapy is based on the idea that the body and mind are interconnected, and that emotional experiences can be stored in the body. This type of therapy seeks to build connection between body and mind in order to identify and release trauma that has been stored in the body. Some common somatic therapies are Somatic Experiencing (SE), Sensorimotor Psychotherapy, as well as movement based activities like dance or yoga.

3. Psychedelic Assisted Therapies: Research has long shown promising results for the use of psychedelic-assisted therapy in treating trauma, and is becoming more and more mainstream today. Psilocybin, Ketamine, and MDMA are some of the more common methods used today. If you are seeking out this type of treatment, it is important to find a provider with extensive training in this modality. 

4. ACTUALLY FINIDING A THERAPIST

Online Directories. Once you’ve figured out all of these details, you can go ahead and find some providers. Other than simply searching the internet, there are a few therapist directories that are pretty great and well-established. The two most well-known and vetted are Psychology Today and Therapy Den. These directories have check boxes that allow you to narrow your criteria based on what this article has covered.

Personal Referrals. if you have any friends that are in therapy with a therapist they love, there’s a good chance you are going to click with that therapist too. If the friend is comfortable with sharing, I always suggest asking for the referral.

5. SCHEDULING THE FIRST SESSION

Once you have found some viable options, reach out to a handful (2-5) to schedule a consultation. The consultation is typically free, sometimes over phone or zoom, and is usually about 15 minutes or so. The consultation is kind of like a vibe check and an opportunity to ask questions about their style, orientation, sliding scale, scheduling a time to meet, etc. Here are some questions to ask during the consultation:

• What is your therapeutic approach or orientation?

• What experience and training do you have in treating the specific issue(s) I am seeking help for?

• What does a typical therapy session with you look like?

• What is your availability and what are your scheduling options?

• What are your fees and do you offer a sliding scale or accept insurance?

• How long do you anticipate therapy will last for my specific concerns?

• How do you collaborate with clients in developing treatment goals and plans?

You don’t need to set up appointments with everyone you consult with. Start with the one person you got the best vibe from, and go from there. 

6. FINDING YOUR MATCH

Finding the right therapist is a bit like dating. Sometimes you need to try a couple people out to find the right fit. I suggest starting with one at a time, and if you aren’t feeling a click by the second or third session, on to the next. The way you know you’ve found the right fit is that it should feel pretty easy to have a conversation with them, you feel understood, not judged, like you can show up and open up honestly as your true self. This doesn’t mean therapy is easy. Opening up about the dark and scary parts of ourself is hard work. But with the right therapist you should feel safe and comfortable enough to build a trusting relationship that allows you to open up.

7. KNOWING WHEN IT’S TIME TO WRAP THINGS UP

There will inevitably come a time when you are ready to stop going to therapy. In an ideal situation, you’ve found your dream therapist match, and have completed the goals you set out to work on when seeking therapy in the first place. In this ideal, you and your therapist will discuss your termination, come up with a plan on how that’s going to look, you can process the work you’ve done together, and experience a sense of closure for the beautiful relationship and experience you both shared.

Usually after I terminate with a client, they will still come back to therapy off and on. Like if they go through a break up or some sort of life transition, they might come back for a few sessions here and there. So termination doesn’t need to mean its final. Its just wrapping up the package of what you’ve been working on. Some people are scared of this and just stop coming. Honestly, this sucks. Don’t do that to yourself. Give yourself the opportunity for closure. It’s a really meaningful and beautiful process. 

A NOTE ON STICKING WITH IT WHEN THE GOING GETS TOUGH:

There is a difference between going to therapy and truly working on yourself. Just like you can sign up for a gym membership because you made a new years resolution to do so, or you can commit to a healthy lifestyle including taking care of your body. Inevitably you will reach a point in the therapeutic process where you resist going for one reason or another. Just like when you’re in that yoga pose and you want to get out- this could be you reaching your edge. Check in with yourself and be real. What are the forces driving you wanting to quit? Are you really too busy or have you just faced a difficult part of yourself you don’t want to face? Be honest with yourself and open with your therapist. They are trained to help you work with your resistance. This is when the real work happens. If you can push through your edge instead of avoiding, you will experience the kind of freedom within yourself that made you want to seek out therapy in the first place.

A NOTE ON BREAKING UP WITH YOUR THERAPIST:

It is important to remember that therapy is ultimately about working on yourself and not about pleasing your therapist. Sometimes though, it’s just not the right match, and it’s okay to let go. Here are some ways to know if it’s time to cut ties: 

• Consistently experiencing negative feelings: If you consistently feel uncomfortable, unsafe, misunderstood, or judged by your therapist, it may be time to reconsider your therapeutic relationship.

• Ethical concerns: If you have concerns about your therapist's behavior, such as boundary violations or breaches of confidentiality, it may be time to seek out a new therapist.

• Lack of progress or usefulness: If you feel like you are not making progress in therapy or you simply do not find the sessions helpful, it may be time to reevaluate your therapeutic approach.

• Feeling stuck or stagnant: If you have been seeing your therapist for a long time and feel like the relationship has become stale or unproductive, it may be time to consider moving on.

If you feel unsure about your progress or have concerns about your therapeutic relationship, it is always encouraged to bring up your concerns with your therapist. Maybe it's something you can work through together, or maybe it's time to move on. Ultimately, your therapeutic relationship should serve your needs, and it is okay to end it when it no longer feels helpful or productive. Remember that therapy is a journey, and sometimes that journey includes finding the right therapist.

IN CONCLUSION…

At the end of the day, even though finding a therapist can seem like a daunting task, it's important to remember that it's a process that can lead to life-changing benefits. The key is to prioritize your needs and preferences, and to take the time to research and explore your options. Remember that therapy is a collaborative process, and it's okay to try out different therapists until you find one who feels like the right fit. With patience, persistence, and an open mind, you can find the support you need to work through life's challenges and thrive.