So you think you need a therapist? (Hint: Even if you don’t think so, you probably do). Given the content of this blog, being asked about how to find a good therapist is a frequent inquiry. Usually, it’s either how do I find a good Black mental health professional? Or, I get questions about what my own process was like in finding the person for me. The short answer: it’s both art and science.
Finding the best fit entails a lot that doesn’t just have to do with the therapist. As a mental health professional in training, learning about what goes into eligibility for insurance reimbursement is quite a doozy. As an example, the American Counseling Association is appealing to our government to allow licensed professional counselors reimbursed for providing care to individuals on Medicare. This includes persons over 65 and/or with disabilities. Don’t forget that there are mental illnesses that can have a person receiving disability benefits. The American Counseling Association has more information on their priority to remove this barrier. It should be no surprise that our government has such a heavy hand in hindering wellness.
Unfortunately, it can feel like a heavy round of speed dating to find a good therapist. It’s important to know what to consider both in the research phase and during the therapeutic relationship to find the right one:
How to Find a Good Therapist: The Research Phase
Dig Through their Website
(If they have one). First of all, I’m all for a website. It’s the quickest way to have basic questions answered about what the experience is going to be like. Sometimes the website is just a springboard for thinking of additional questions you may want to ask. And, nobody ever had to fork over a copay to look at a website. I also HATE phone calls, which is a mainly a personal problem.
Look for stated values and theoretical orientation.
“Orientation refers to the psychological theory that the therapist draws from in understanding and treating psychological difficulties. For example, some therapists believe that psychological difficulties stem from problems in thinking. This type of therapist would likely have a cognitive behavioral orientation (Source: Verywellmind.com).
So, if you want someone who has experience working with LGBTQ+ couples, they should highlight this as a specialty of theirs on their website. What I’m going to take from the website is a snapshot of their therapist personality.
Ask about their expertise/training & theoretical orientation
An important part of figuring out how to find a good therapist is knowing what kind of therapy experience you want. Often, your experience will be shaped by the theory a mental health professional uses to guide their therapeutic practice. If you’re uncomfortable about anything you’re reading either on their website or in any additional information about their practice, ask about it. Personally, Cognitive Behavioral Therapy was infuriating to me because *I* felt it attempted to fix me before knowing who I was or what I endured. If you’re dealing with trauma, traditional Rogerian talk therapy can feel inadequate and perhaps you’d do better with someone that has training in Exposure therapies to directly address disturbing flashbacks or memories. Psychology Today has a comprehensive list of the types of psychotherapies that can be used.
Asking about training is not just a snooty way to see if they had a 4.0 in grad program. It’s about knowing if they are the appropriate fit for you. You don’t want to assume all mental health professionals have specialized training with the specific issue you’d like to dive into. If you’d like to be assessed for ADHD, you’d need to find someone with formal training in psychological assessment. Typically, this would be a psychologist with a Doctorate versus a mental health counselor or clinical social worker. And then, the professional who does assessment may not do long term counseling and you’d also need to see a counselor or clinical social worker after your diagnosis.
Medication can only be prescribed by a psychiatrist or psychiatric nurse (both medical professionals). So, if you are someone who needs medication to manage symptoms, you would need to be given a referral to see the appropriate professional for your needs. I received my depression and anxiety diagnosis from a psychiatric nurse practitioner who I then saw about every other month for medication management. However, she was not a therapist so she strongly suggested that I seek counseling as well for best progress.
Where Possible, Get Reviews
Now, this may be an unpopular suggestion. So remember that most of these suggestions are coming from my personal experience. Reviews about a therapist or therapy experience may not be widely available on the internet. However, if it is, take a look. The caveat is that reviews are not to be taken at face value (like, in general life but especially for this). Read between the lines. Look at reviews as clues rather than rules about how a person or practice is.
When possible, try to locate a therapist by referral from someone you know. It’s an easier way to be to ask questions about the style of a particular therapist or what the administrative process was like.
Before You Sign on the Dotted Line
Read the informed consent form thoroughly
I’ve been guilty of signing just to sign in the past. After learning about what goes into these forms, I encourage you to read and be comfortable with the contents. Your therapist will likely operate under the assumption that you’ve read and completely understood before you signed. This document will include info such as:
- cases where they’d be required to break confidentiality and disclose information you share
- as an extension of above, requirements (which vary by state) on reporting abuse
- important information about billing, such as late fees or cancellation fees
Pay Attention to Every Step from Initial Outreach to First Session
Every part of the process in trying to find a good therapist is a part of an overall interview to see whether this person will be worthy of you as a client. It is typically safe to assume that hiccups in try to get started will become hiccups when you’re a client. When I had Medicaid, I was told that the one person at a practice I would be able to see was booked solid and I would be called back when they had an opening. 5 months later, I called them back and there was an opening. (The callback I was promised did not happen. Once I started with the person, she said she wanted to see me weekly but it took several weeks before I was able to get on her calendar regularly.
Are they distracted during your session?
I once had a therapist type on their laptop during our session to take notes and none of that felt good. It was as if she was gathering notes on a case to be solved rather than focusing on empathy and really paying attention to what I was giving. There was no way I was going to be vulnerable with this person. I ghosted after the 2nd or 3rd session.
There is a skill in the counseling profession called “immediacy”. In a nutshell, it is the therapist calling to attention any issues that may be present in the therapeutic relationship. For example, if the therapist thinks you were texting on purpose during the last couple sessions because something has gone wrong in the therapeutic relationship. If you’re angry and rejecting their feedback, it’ll be hard for you to make progress. Therefore, it is important to see if there is something larger happening there. Use this concept as well. If your therapist does anything that you don’t like, address it.
Your time, money, and mental health are on the line. Don’t follow through with anything that doesn’t feel right.
Note and question the power dynamic in the session
Your therapist is a trained professional but they are not the authority on your being. Pushback when you feel they are fundamentally misunderstanding who you are or your feelings. Reject any analysis that comes from the perspective of white (heteronormative) dominant culture, if it ignores any aspect of your lived experience. And yes, the Black woman therapist sitting across from you can absolutely be guilty of this.
Bonus: While they may not be able to answer a question about how many black or people of color they’ve counseled, you can ask other questions. Perhaps you want to know where they stand on the Black Lives Matter movement. Do they know what’s happening at all? What do they believe about the roles of police brutality and systemic oppression in the lives of Black and Brown people? Ask about how they use theories on race and race relations to inform their therapeutic practice. I can’t tell you what their answers should be. But I can tell you that you should be comfortable with what they say.
More Resources for how to find a good therapist:
SJ & Wellness Guide: In this (free) guide I created earlier this year are links to mental health resources and provider directories for Black & QTPOC.
Psychology Today: Read articles about psychology and utilize their therapist directory
Learn more about Trauma and interventions for dealing with trauma. Read: The Body Keeps the Score
- Check the listing of in-network mental health professionals from your health care provider (if you have one)
- Some therapists who don’t take insurance or will see clients without insurance have sliding scales for fees based on what you’re able to pay. Please ask if this is an option that would be available to you.
If You or someone you know is in Crisis and needs to speak to someone NOW:
- Mental Health America Crisis Text Line: text MHA to 741741
- SAMHSA Disaster Distress Helpline: Call 1-800-985-5990 or text TalkWithUs to 66746
- National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
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