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Updated: Apr 27, 2021

Photo by Rogério Martins

1. So, what do I do first? First off, congratulations! I’m so proud of you. Seriously, even considering that “Hey, I might need some help with something” is a big deal! The best thing to do is to check in with yourself and think about what you want to get out of therapy. Is there something in particular you want to work on? Do you want a consistent safe place to talk about and understand your daily challenges? Is this about and for me or would it be a good idea to do with my partner or my family? Are there certain qualities that I want in a therapist? Write out your answers to these questions. Did more questions come to mind? Write those down too; surely one of the following steps will help you get your answers. 2. What’s your budget? There are plenty of options to access therapy but not all will be a good fit depending on insurance and/or program funding requirements. If you would like to use your health insurance, you should contact your insurance company and ask if mental health or behavioral health benefits are included. If they are, ask about:

  • Limit to number of sessions

  • Out of network coverage

    • If you go with this option, be sure to ask for the department and address to send your receipts to and for any necessary forms

  • Co-pay cost, if any

  • List of providers in your area that address your concern.

If you plan to pay out of pocket, take a look at your budget and calculate how much you can afford to pay. I recommend that you assume that you will need to meet at least 1 time weekly for at least 6 months to a year. This might be more than you actually need, but it would be difficult to stop therapy in the middle of it. You’ll get a better of frequency of sessions and length of therapy during your consultation or once your treatment plan is created. 3. How to Find a Therapist? This might be the most overwhelming part for some, but in the world of Google and the World Wide Web there is an abundance of resources. Yes, you can totally Google therapist in my city, but you might find a ton of therapists that are not mental health therapists. One of the best options, especially if you’re using insurance is to ask your insurance for covered providers. However, this doesn’t guarantee that those therapists will be the best fit for you. That’s where therapist directories come in. What’s cool about them is that many of them target a certain affinity such as ethnic identity, LGBT and social justice based as well as treatment need such as maternal mental health. You can even sort for therapists by distance from your home or work, areas of specialty, language, and in person and online sessions. Here are some of my favorite directories (please check back, I will be adding more to this list):

4. Who Do I Pick? First, take a look at therapist profiles, check out their websites and reflect on who resonates with you. Ask yourself does it look like they might be able to help me with my need and do they accept my form of payment or can I afford them and if I can’t do they slide? Pick three therapists to call or email to schedule a consultation (usually they’re FREE). Why three? Because your schedules may not fit, they may not have openings or when you talk to them you see that you’re not clicking the way you thought you would. Also, make a note that most therapists consult only by phone, but some may be able to meet in person. 5. What Do I Say? Typically, a consultation lasts about 15 to 20 minutes. I have some set questions I will ask a potential client, but I usually start with “How can I help you?” This helps me understand the reason they’re looking for therapy and if I can be of help to them. So that’s what I would say first as a client: “this is what I need help with _____________.” I also ask if the potential client has questions for me. Examples of good questions to ask are:

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

  • Who often will we meet and how long with treatment last?

  • Do you have experience working with clients with similar concerns?

  • What is your fee? Do you have a sliding scale?

  • Do you guide or direct your clients more?

  • Do you have any special training that would help you help me?

  • Do you give homework?

  • What do I need to do before the first session?

It’s important to pay attention to how you felt during the phone consultation to see if you want to move forward and schedule that appointment. For the most part, I think you’ll know during the consultation. Here are some questions to ask yourself:

  • Do you think you can trust this person?

  • Do they seem knowledgeable and competent?

  • Do you feel understood?

  • How do you like the questions you’re being asked?

  • Do you feel safe?

6. Reflect on Your First Session How was it? Did it meet the expectations set for the first session? Even though the first session is usually information heavy it’s important that you feel safe, seen and heard. Does this therapist get you and does it feel like they can help. That first session can make all the difference! If you feel that it’s a match, awesome! If it’s not a good fit, it’s okay. Maybe give it a try a few more sessions and bring up your concerns. Sometimes we see things that happen in our lives play out in our relationships with our therapists. A therapeutic relationship can provide a corrective experience and break some of our old and unhelpful patterns. And if it’s just not a fit, then maybe that therapist has referrals for you or you can look back at your original list. 7. Ongoing Reflection It’s important to continue reflecting throughout the therapy process on your own and with your therapist. Check in about progress, feeling stuck, things you found to be helpful and things you flat out did not like. Therapists are open to feedback and sometimes we miss some things. Having an open and honest relationship with your therapist helps to build trust and promotes growth and progress.

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