How the Heck Do I Get Started in Therapy?!?!
Updated: Jun 25
Alright! So you've made the decision to start therapy (or at least to look into the idea of it). Either way, kudos to you! Therapy can be confusing and scary as hell to navigate. This post is going to be a little longer, so feel free to ctrl+f at any point. BTW, therapy/therapist and counseling/counselor can be used interchangeably and I do that in this article.
1. Who goes to therapy and why? Therapy can be helpful for any person at any point in their lives. I know that may seem like a simple answer but it's a simple truth. Children, teens, and adults can all benefit from therapy. Sometimes, people notice an increase in anxious or depressed symptoms and seek help, sometimes a specific event happens (such as the death of a loved one, job loss, a breakup, etc) that prompts people to seek help, and sometimes people just need an impartial outlet. Here are some real-life reasons I have seen clients in the past.
Children: struggling in school, unable to make or keep friends, death of a loved one, caregivers getting divorced, increased "acting out" behaviors, anxiety, depression, difficulty getting along with siblings/ other children in the house, transitions (including moving, starting at a new school, adopting a sibling, etc.), processing through gender identity (whether their own or a loved one's), abuse, and managing stress (yes, children experience stress just like adults do)
Teens: All of the above plus breakups, increased peer pressure, teen dating violence, college prep, transitioning into adulthood (honestly, when does that actually happen?), and poor relationships with caregivers
Adults: anxiety, depression, struggling to maintain friendships and/ or romantic relationships, strained relationships with family, childhood trauma, childhood abuse, current abuse, physical aches/ pains, struggling with confidence, struggling with self-love, needing a place to "decompress," stress management, earning more about themselves, and processing sexual or gender identity
Bottom line, if you've wondered if you should go to therapy then you probably should.
2. How do I find a therapist? If you happen to know a therapist in your personal life ask them! Just like any occupation, there are really great therapists and not-so-great therapists practicing. If you know a therapist in your personal life, chances are they will have an idea of who may be a good fit for you based on reputation, specialty, and style of therapy. If you don't know a therapist personally, there are a lot of online directories you can use including:
Inclusive Therapists Psychology Today Good Therapy Therapy Den
You can also just use good old "search therapists near me" as well as request referrals from your insurance company if you'd like to use insurance benefits to pay for services (more on that later). Something to keep in mind when using insurance directories, however, is that they rarely get updated so you may receive inaccurate contact/ specialty information or information for a therapist who was once in-network with your insurance but is now out-of-network. Lastly, you can also likely get referrals from your primary care physician and other medical professionals you may see.
3. What do all of those letters mean?
If you have started looking up therapists, you may have noticed they have a lot of letters behind their names and there are a lot of different letters. Typically, those designate different license types or specialties. Here are some common ones you'll see:
LPC = Licensed Professional Counselor LPC-Associate = LPC Associate LMFT = Licensed Marriage and Family Therapist LMFT-Associate = LMFT Associate LCSW = Licensed Clinical Social Worker LMSW = Licensed Master Social Worker
LPCs, LMFTs, and LCSWs are all considered "fully licensed." This means they have earned a master's degree or higher in a counseling-related field, have completed grueling post-graduation internships (which typically consist of around 3,000 supervised clinical hours), and have completed a set amount of supervision hours. They are "independent" practitioners.
LPC-As, LMFT-As, and LMSWs are considered "partially licensed." This means they have earned a master's degree or higher in a counseling-related field and are currently completing one of those grueling post-graduation internships and attending weekly supervision. If you see a therapist listed as a "master's level intern" this usually means they are currently completing their graduate program (because you have to get a ton of client hours to even graduate THEN you have to get a ton more during that post-graduation internship) but this may not be the case everywhere, so if you have a question about a therapist's experience just ask!
Side note: Psychologists and psychiatrists are different from therapists. Psychologists earn doctorate degrees in psychology-related fields and tend to focus more on assessments and research although they are qualified to provide therapy as well. Psychiatrists are medical doctors who tend to focus more on medication but are also qualified to provide therapy.
4. How do I know if a therapist is a good fit for me? I believe the therapeutic relationship formed between client and therapist is the most important factor for healing to occur and I often encourage clients or potential clients to consider their level of safety and comfort in session. This can be especially true for BIPOC and anyone who has experienced caregiver or medical manipulation/ trauma. Typically, therapists will schedule a 10-15 minute phone consultation with you to give you an opportunity to ask any questions or to give them the opportunity to assess whether they believe they would be a good fit for you. Here are some questions you can ask your potential therapist:
Have you worked with clients like me before?
What is your professional experience?
How will we measure progress and establish treatment goals?
Have you been in therapy before?
What is your therapy style/ what techniques do you use?
How can I let you know if something isn't working for me?
What cultural competence or anti-racism trainings have you taken and what personal work have you done? Tell me your thoughts on BLM, white supremacy, and Stop Asian Hate.
Do you work with other professionals (such as other therapists, psychiatrists, medical doctors, etc.)?
What does the first therapy session with you look like?
What will we do if I feel stuck in therapy?
You may be looking for a specific type of therapy or wanting to work on a specific issue. If so, you can filter your searches to match those categories. If a therapist doesn't think their identity, specialty, or clinical skills would be beneficial to you ask them for referrals or recommendations of specific types of therapy or techniques to look for as you continue your search.
What if your therapist seemed like a good fit at first but you're not so sure a few sessions in? If something has happened in sessions to make you feel uncomfortable, uneasy, offended, dismissed, or like you're not being helped in the way you expected have a conversation with your therapist about it. If your issues still aren't resolved you can break up with your therapist. As a client, you have the right to end treatment at any time.
5. How do I pay for therapy?
There are a lot of ways you can pay for therapy. You can be a self-paying client, which means you pay for therapy on your own. If you are able to afford a therapist's full rate then pay it! Therapists work really hard to receive and maintain their licenses. If you are not able to afford a therapist's full rate, many of them will offer what's called a "sliding scale." This means they will take on a limited number of clients at a reduced rate. Many communities also have clinics that offer low-cost services (these are often associated with universities).
You can use your insurance benefits to pay for therapy. Your individual plan and deductible will determine your copay. It's always best to call your insurance company and verify your mental health benefits. An important thing to know when you using insurance is that your insurance company will have access to your treatment file which includes your diagnosis, treatment plan, and session notes. If your therapist is out-of-network with your insurance, you can request individual receipts or a superbill (usually a monthly summary) of your sessions to submit to insurance on your own for potential out-of-network reimbursement.
If your employer offers an EAP (Employee Assistance Program) you may have a limited number of sessions covered for you. If your therapist is contracted with your specific EAP, they can bill your EAP directly. If they are not contracted with your specific EAP, they can provide you with receipts or a superbill for you to submit to your employer for reimbursement. If you are a university student, a limited number of counseling sessions may already be built into your annual tuition or your university may offer reduced-fee counseling on campus. Check with your advisor.
6. How do I schedule a session and what does the first session look like? Most likely, you'll be able to call or email your therapist to schedule an initial session. Use the contact information listed on their website or directory. You should be briefed on the length of the session, cost of the session, and location of the session before you hang up the phone. You will likely be emailed a link to complete intake paperwork online prior to your first session. This paperwork is important because it helps your therapist get to know you a little bit prior to meeting so they can tailor the initial session more to your needs. Your therapist will likely spend the duration of that session asking you questions to get to know you better, understand your symptoms and family background, and help you solidify treatment goals.
Side note: Most movie and TV portrayals of therapy are wildly inaccurate. The majority of us are not "doctors," while we will ask about your childhood we probably won't say things like, "Tell me about your mother...," and while we may have couches in our offices we won't expect you to lie down on them (although you're totally welcome to if you want).
Now that you know what to do, what are you waiting for?! Get out there and start getting therapized (self-disclosure: I did not think this was a real word until right now when I Googled it). Have additional questions? Drop them in the comments below or hit me on Insta @kaylaisatherapist
If you're interested in starting therapy services with me, shoot me an email at firstname.lastname@example.org or text/ call me at 469.305.1179 to schedule a free 15-minute consultation.