A Therapist's Guide to Finding a Therapist

You've decided to see a therapist. Or maybe just curious about what's out there. After some time, you may find the process confusing and complicated. This is not the norm. It's also not uncommon. I hope to give you some context as well as tips for finding a therapist.

Shortage of mental health providers

Ever since before the pandemic, there is a nationwide shortage of mental health providers. Washington State is no exception. The shortage was made further apparent as the pandemic wore on. There have been more conversations about mental health in the public sphere. There is less stigma attached to mental health care. This is a good thing. However, there simply aren't enough counselors and therapists to meet the need.

Insurance

Many who seek mental health services plan to use their health insurance. Unfortunately, there are some roadblocks to using insurance to access mental health care. Insurance's online directories often contain outdated information. The therapist you try to contact may no longer be in business or list contact information they no longer use. The wait to speak with an insurance rep can be long. It can also be hard to find or understand information on insurance benefits for behavioral health. Sometimes, even if an insurance company is listed in a therapist's profile, the therapist may not be taking new patients or covered under your specific plan.

More and more mental health providers are also opting out of taking insurance. Some reasons for this include

• Sharing detailed private health information with insurance companies for payment

• Insurance companies determining what is medically necessary

• Long processing time to receive payments

• Insurance denying claims and/or clawing back pervious payments

The rate set by insurance typically requires therapists to take on higher number of patients at a time which increases the likelihood of burnout. This rate is often fixed and remains unchanged for years at a time.

There are ways to work around these barriers. Here are some tips and what to think through when searching for a therapist.

Therapy type

The most common style of therapy that comes to mind is one-on-one talk therapy that takes place in a therapist's office. Individual therapy offers the opportunity to work with a professional dedicated to addressing your concerns and working toward goals with you. Individual therapy works well for anything ranging from support during a rough transition to structured interventions for something longstanding.

Other common types of therapy include group therapy and family/couples therapy. I will discuss the specifics in a separate post.

What's important to you

Think through what is important to you. Some factors to consider include:

• What you want to work on

• Therapy type (i.e. individual, group, family, couples)

• Therapist's areas of expertise and specialty

• How to pay for services (insurance, out-of-pocket, HSA/FSA, sliding scale etc.)

• Therapist's identities and languages

• Online vs. in-person

I recommend determining what you're not willing to compromise on. These "non-negotiables" can help anchor you in your search for the right fit. This will increase the likelihood of a successful therapy experience by avoiding making a compromise on something important.

At the same time, it's helpful to keep your expectations somewhat flexible. For example, in my experience, a therapist's identities/lived experiences tend to be less important than how well their approach to therapy suits your goals and what you gravitate toward stylistically (e.g. structured vs. open-ended, direct vs. non-direct, humor vs. serious). There can be overlap between identities and specialty areas. Having shared identities/lived experiences with your therapist can help foster connection. However, a therapist's role is not using their personal experiences to facilitate change.

Another common decision to make is online vs. in-person. While online therapy is newer and has its limitations, research has long suggested that online therapy is just as effective. Unless there is a strong personal preference and/or specific therapy approach requiring in-person meetings, meeting with a therapist online can greatly expand your options and minimize possible disruptions in meeting consistently.

You can expand your options by exploring your Out-of-Network (OON) benefits. Many insurance plans have OON benefits. This means that a portion of session cost (typically 40-75%) could be covered by your insurance plan even if a therapist is not in-network with your insurance. You can call or message your insurance provider to ask about your OON benefits for behavioral health/mental health. You can also typically find this information in your summary of benefits. Please note, a deductible (i.e. a set amount of medical spending needs to occur first before your OON benefits kick in) and an allowed amount (the maximum amount an insurance company will pay for a covered healthcare service) may apply.

Making the first contact

Most therapists offer a brief, initial consultation over the phone at no cost. This is a great opportunity to ask about their availability, approach to therapy, and payment/insurance information. If you're not sure what to ask, it's okay to indicate this and ask the therapist to guide the conversation for what you need to know about working with them.

Some therapists may not return calls or emails because they are not taking new patients and don't have dedicated administrative support to respond to every inquiry they receive. Be prepared to reach out to several and take your pick from there.

Where do I get a list?

Your school or workplace is likely to have resources helping you get connected with mental health support. For school/university settings, you can connect with the counseling services on campus for help. Employment benefits typically include Employee Assistance Program (EAP) and/or health insurance. These resources can provide you with a list to contact or help you get connected with a therapist. EAP benefits are available to family members too in many cases.

If you would like to do a search on your own, here are a few online directories to consider:

• Psychology Today 

• Multicultural Counselors 

• Open Path Collective

• Asian Mental Health Collective

Decoding the therapist alphabet

LMFT	Licensed marriage and family therapist. Master's degree specializing in couples and family.
LMHC	Licensed mental health counselor. Master's degree in counseling.
LMFT/LMHC-A	A stands for associate. Meaning they are working toward full licensure.
MSW/LICSW/LASW	There are several variations but the letters are as follows: M - Master's, SW - social work, L - licensed, A - associate, I - independent, C - clinical.
MD	Psychiatrist. Has a medical degree and prescribes medication. Some provide therapy.
PsyD, PhD	Psychologist. Doctoral degree. Can provide formal psychological assessment. Most do not currently prescribe medication in WA.

To hold any of the above, a provider must complete an advanced degree(s) and go through rigorous training/evaluation. It is therefore often more helpful to evaluate whether you find the therapist's style and approach to be a fit for you rather than the degree or license type.

A final word

I will never cease to be amazed by how people lean into this deeply challenging and rewarding process that is therapy. I wish you luck in your search and hope you find the fit you're looking for!