Finding a Therapist
Looking for a therapist can be overwhelming, especially since lots of folks turn to therapy when they're going through a particularly rough time. Below are some tips and tricks for understanding who you're looking for and how to find them.
Finding the right counselor is like dating or looking for a job. It's unlikely you'll find the best possible fit on the first phone call or session (or date or job interview). As you go through this process, be prepared to do a lot of reaching out before you find someone who might be a good fit who is also accepting new clients. Therapists who don't have openings often don't return calls or pick up the phone, which can make the process feel insurmountable at time, but you can do it.
Therapists and Payment Methods
Types of Professionals Who Become Therapists
Many professional paths lead people to becoming therapists. You may see some of the following:
LMFTs (licensed marriage and family therapists) and pre-license AMFTs (associate marriage and family therapists)
LCSWs (licensed clinical social workers) and pre-license ASWs (associate social workers)
LPCCs (licensed professional clinical counselors) and pre-license APCCs (associate professional clinical counselors)
Who you pick is going to depend on a lot of different factors. On the whole, license doesn't matter as much as you might think. Look for a good fit first.
Finding a Self Pay Therapist
Paying for therapy out of pocket offers the widest variety of options. Full fee therapists usually charge between $125 and $195 a session for individuals and $200 and $280 a session for couples and partners. There are many self pay therapists available; not all of them will be a good fit, but many will have unique specialties, evening and weekend appointments, and extensive experience.
Plug in your city, "therapist" or "counseling", and a keyword about something you'd like to work on and see what comes up on Google, or check out a directory to find therapists near where you live.
Finding a Low or Reduced Fee Therapist
Community mental health clinics and some graduate schools have counseling centers, where graduate students and recent graduates gain experience before becoming licensed. Insurance rarely covers low fee services, and they usually cost between $20 and $80 a session. The Open Path Collective is a directory for clinicians with low fee slots in their practice.
Some therapists are willing to lower their fee based on financial need or scheduling. Other therapists offer reduced fees to allow them to work on their favored clinical issues (polyamorous relationship agreements, phobias, self esteem, etc.) or with their favorite populations (people of color, single parents, queer people, etc.). Sliding fees usually range from $60 to $120 a session and are often for daytime slots.
Finding a Therapist Who Accepts Your Insurance
If you'd like to use your insurance, call your insurance company and request a list of approved providers. Research and reach out to the ones you think could be a good fit. If you are a MediCal recipient, you can find low or no cost services through your county's mental health ACCESS or 211 line. If you are a Kaiser member seeking an outside referral, there are instructions on how to do that here.
It can be very challenging to find a therapist who accepts insurance and has openings because insurance companies usually pay therapists well under half their usual rate.
How To Look
Get Help Before You Get Help
If you have a friend or loved one you trust, see if they can help you do some of the legwork of finding someone, especially calling around and see who has openings or finding out who your insurance covers.
Niches and Directories
Many professional organizations and activists offer lists of clinicians and agencies who serve given populations. Bay Area Open Minds, the Polyamory-Friendly Professionals Directory, Tristan Taromino's Open List, and Kink-Aware Professionals all cater to alternative sexuality clients. Both The Pacific Center for Human Growth and Gaylesta focus on LGBTQIQ2-S clients. Native American Health Center provides both physical and mental health services for people of color. Therapist directories like PsychologyToday have detailed search features.
Questions For You
Before you reach out to a therapist, consider the following questions:
Am I more comfortable with a male, female, cis, trans, GQ, or NB counselor? What age ranges am I most comfortable with?
Figure out what kind of person you would feel the most comfortable talking with, but leave yourself open to being surprised.
What level of education should they have? Experience? Do I need to see someone licensed?
Clinicians will have either a masters of a doctorate, having spent 2-6 years in school to complete that degree.
Meeting with a pre-licensed person can result in a clinician with fresh knowledge who is more affordable, but who might also have less wisdom and intuition. Someone who has been practicing for longer can bring finesse and extensive knowledge to the room, but may also be less informed on the newest techniques.
How much is each session? Do they have a sliding fee scale? How frequently do I want to have sessions? How much can I pay?
These questions will all inform each other. If you have $200 a month to commit to therapy and it's $100 a session, it's likely that you'll go twice a month if you went with that therapist. You can look for a reduced fee, but haggling doesn't work well here.
How do I want my therapist to work?
A therapist's clinical orientation tells you how they view their client's struggles, how those struggles came to be, and how they best feel they can help. Most therapists use a blend of orientations. What matters is that a therapist can tell you why they have chosen to work the way they do.
Do I want my therapist to have any particular clinical specialties?
Virtually every therapist will have a good understanding of depression and anxiety, as those are the two most common presenting issues in therapy.
Therapists will specialize in order to build a more cohesive practice working on challenges they enjoy. Determine what you feel is pulling into therapy now and consider looking for a therapist that specializes in that thing.
Do they share lived experience with me? Do they already understand people like me? If not, are they willing to spend some time educating themselves?
If you are a member of a subculture or marginalized community, working with a clinician who understands how that impacts your life can be incredibly validating.
Unfortunately, it can be challenging to find folks with both a clinical specialty that fits your needs and population-specific knowledge, especially if they're seemingly unrelated (such as a polyamorous person seeking support in managing panic attacks).
Connecting With Me
My name is MacKenzie Stuart and I'm a licensed marriage and family therapist (LMFT) who specializes in LGBTQIQ2-S issues, polyamory and consensual nonmonogamy, and suicidality and chronic depression. I might be a good psychotherapist for you or your loved one. Feel free to explore my availability for new clients and reach out to me directly.
© 2011, MacKenzie Stuart, LMFT