How to Find Your Therapist

Tips for your search and what to expect

The new paperback edition of Quarterlife includes an essay in the appendix about how to find your therapist. The following is an abridged version of what I wrote there. If it speaks to you, please share it and know that there’s a lot more info and nuance available in the book, including what to expect when therapy begins and some red flags to watch out for.

This is written mainly for the very-complicated American healthcare system, but much of it will apply anywhere you may live.

Where to Look

Word of Mouth

Talk to your friends and family! Ask them about who they’ve seen and liked in the past or if they know of a great therapist in your area.

But don’t see the same therapist as a close friend or family member.

This is a hard and fast rule of mine. Suffice it to say, while sharing a therapist with a friend may seem like a perfectly good idea at the start, it can end up feeling very sticky and not totally safe later on. You need to know, without having to wonder for a moment, that what you’ve shared in therapy is confidential and that your therapist does not have competing loyalties if things were to ever get complicated.

I also strongly recommend that you not see the same therapist you saw when you were growing up, or your parents’ therapist, or the family doctor. These people may be the easiest logistically as they already know your name and can get you in for an appointment, but that ease may come at a cost.

Quarterlife is all about growing beyond childhood patterns and old family systems and it can be counterproductive (and even destructive) to see someone clinically who was part of your childhood or who knows your parents. I firmly believe in the value of finding someone new.

The Internet (of course)

In addition to a quick search for types of therapy in your location, there are a number of well-developed online therapist directories like Psychology Today and Good Therapy. (This is not an endorsement, necessarily, of either.)

Therapists pay to have profiles listed on these sites and if they’re there, there’s a good chance they have openings.

Your Insurance

If you have insurance, your insurance company should have a list of “in-network” therapists who are contracted to work with your insurance company. As a result, your insurance website can be a great place to start looking for names.

How to Narrow the Search

I have my preferences and beliefs about what kind of therapy works for a given situation, but research studies have proven that, more than anything, it’s the therapeutic relationship that heals. At the end of the day, the most important thing is that you feel safe, seen, and supported by your therapist. The goal, therefore, is to find the right person more than the right orientation.

Having said that, if you have a list of names or a screen with a blinking search bar, here are some keywords I use when looking for therapists for friends who are not in my personal network. (This is, by no means, even remotely, a complete list of modalities.)

Types of Therapy

• Psychodynamic therapy

• Trauma-informed care

  • This might include certification in EMDR or Somatic Experiencing or a wide range of body-centered trauma healing methodologies. Don’t hesitate to look up what the modality is if it’s not familiar to you!

• Jungian psychology

• Depth psychology

• Psychoanalytic psychology

• Humanistic psychology

• Family systems work

• Attachment-oriented therapy

• Socially-informed

  • This may show up in various ways on a therapist’s profile, but I always value a therapeutic perspective that honors the ways in which a traumatized and fragmented society affects our well-being or lack thereof.

Credentials

There are many types of education and licensure that enable a person to practice psychotherapy and they differ from state to state. It’s worth looking up the different acronyms if you’re unfamiliar with the letters behind a person’s name to help you understand further what type of training and credentials they have. You can also always ask if you’re not sure, including confirming that they are licensed or under supervision by a licensed clinician.

How to Get an Appointment + What to Ask

Once you’ve got a list of possible candidates, plan to call or email at least five people to inquire about therapy and their availability.

I know that may seem like a lot!

You’ll want to start with a handful of names because, honestly, you’re likely to feel a little demoralized when you pick up the phone or start shooting off emails. Therapists, like all healthcare professionals, are busy and often not taking on new clients. Meanwhile, others may be taking clients but their office is really far from you or they don’t take your insurance or your schedules don’t match or you just don’t like their vibe. So it’s valuable to start with a bunch of names rather than to lose steam just as you’re getting going.

If you’re new to therapy, I then recommend setting up appointments with at least two different clinicians.

The goal, ultimately, is that you genuinely like the therapist you end up seeing regularly. So in addition to the logistics—openings, insurance, location—you’ll probably need to get a sense of more than one person to see who is going to work for you.

Paying for Therapy

Insurance

Of course, if you have insurance and it covers therapy, use your insurance!

And if you’ve already tried this and come up short, you’re not alone. I so wish this system were less convoluted and problematic for patients and clinicians, but it’s very frequently confusing.

Not all therapists are in-network with insurance companies. If they are, they are probably selective about which companies they work with. There are many (many) insurance companies, each with its own contracting system, and every insurance company pays for the same service at a different rate— which they determine. This is bad for patients and clinicians.

If you’ve struggled to find someone who has openings and takes your insurance that you like there may still be options for using your insurance to help pay for therapy!

I say a lot more about this in the paperback edition, but one of the primary additional options is to see if your insurance covers out-of-network therapists. Many plans do. You can then pay for therapy out of pocket and send in “superbills” for your sessions. Your insurance will reimburse you directly for their out-of-network rate.

Pre-Licensed Clinicians

If money is tight, you’re uninsured, or using your insurance isn’t an option, you can look for a supervised, pre-licensed intern (they go by different names in different states).

These therapists are working towards licensure and often provide therapy for a lower fee as they “gain hours.” They can be excellent, devoted clinicians.

Sliding Scale

Most therapists hold spaces in their practice to see people on a sliding scale, which is to say at a lower rate. Some therapist directories will also include this in search criteria.

If you start therapy on a sliding scale your therapist may ask that you pay the full fee when your financial situation changes, or that you work to get insured on a plan where your therapist is in-network, if you’re able to do so.

Paying the Full Fee

If you can pay the full fee out of pocket, I encourage you to invest in yourself.

Despite requiring a great deal of training and experience, therapy can be viewed as a “soft skill” and be misinterpreted as both easy and easy to find without financial investment. (This is also a gendered issue as therapists tend to be female and people tend to undervalue female work.)

Relatedly, as naturally empathetic humans, therapists are often expected to charge low fees because there are a lot of people who need help and healthcare should be free. There are, and it should be. But well-meaning therapists need to earn a living and not burn out and leave the field.

The affordability of therapy is a systems issue that needs to be addressed broad scale and not left on the shoulders of every clinician and client to stress over endlessly.

But I digress.

If you need therapy and can afford therapy, do not put it off. Find the best person you can find and pay their fee. Therapy should change your life and it’s a powerful investment. I say this as a client myself who has paid the full fee of different excellent therapists over two decades (even when I really struggled to afford it). It’s worth it.

What to Expect in Therapy

Here again, there’s a great deal more in the book (forgive the repetition), but a few things you should absolutely expect when in therapy:

Your therapist’s full attention

You should feel, without having to make excuses for them, that your therapist is completely present with you and focused on you.

Having your therapist’s full attention is an implicit part of the work you are doing together. Yes, every therapist has some not-so-great days, but in general, you should expect that your therapist will pay attention to your words, your body language, and your experiences. Quite simply, they should feel there with you, in the way that you knew as a child if an adult was really present with you or mentally wandering off.

If you don’t have this, try talking with them about it and/or find someone new.

Consistency & Commitment

Ideally, the therapeutic space is consistent and reliable. Your weekly or bi-weekly appointment will ideally be held at the same time on the same day, for instance, so that you can come to expect it and know it’ll be there for you. There are certain ways in which seemingly mundane logistics like a consistent appointment can provide comfort when weeks are stressful and you know there’s an hour waiting for you when you can release and process.

Similarly, just as your therapist should clearly indicate that they’re reliable and two feet into the work with you, your commitment is important too.

Therapy exists to support you to break old patterns, heal from old hurts, metabolize day-to-day life, uncover your creativity, dream, build for the future, and gain the wholeness you seek. And there are ebbs and flows to everything. Some weeks will feel super helpful and others may feel a little confusing or not as valuable.

If you can, stick with the downs rather than jumping out too early.

Sometimes, your defense mechanisms may masquerade as boredom or irritation. You may think that you’ve said everything you can say in therapy and that you’re all done. Maybe you are! But also: tell your therapist this. Talk with them about your feelings about therapy itself. This may be the most important part of the therapy because it allows interpersonal communication and, most likely, a mirror for other dynamics in your life around intimacy. Your commitment to the hard times in therapy may enhance commitment in the hard times in other relationships too. (But also, again, don’t make excuses for your therapist. If any relationship is not safe or working for you, it is absolutely okay to move on!)

The Value of Therapy

The therapeutic container can be a truly sacred space where your soul is given the time and attention that it likely craves in this complex and distracted world. It should be a place where your wounds are tended, and where you are able to explore whatever it is that is on your mind and heart. Take advantage of this space. Be indulgent. Be curious. Be determined to see change. Once you find the right relationship for you, you’ll never look back.