Finding A Therapist

Here you are. You’ve arrived at the stage of contemplating mental health treatment. For me, this came after a weekend of being unable to do anything but lie in bed and cry. I finally realized my mood swings and suicidal thoughts were not healthy and I should seek help and support from a professional. Some of you may even be at the preparation phase of seeking out treatment. In this stage, you have to engage in the dreaded task of finding a provider.

When looking for a provider the three best sources to get referrals are:

1. Your primary care doctor who can give you a recommendation (I strongly recommend against using your primary doctor for mental health treatment);
2. Your insurance website, if insured; or
3. Personal recommendations from friends or colleagues who have had treatment.
   
   

If none of the above sources have been useful, start checking websites like psychologytoday.com and even begin just a basic internet search that can start you down the rabbit hole on getting names and phone numbers. If cost is a major concern, there are places that offer sliding scale rates for mental health treatment or provide financial assistance.

Once you have your list, here are five pointers for choosing the best therapist based on my experience of being in and out of various therapies throughout the last 20 years.

1. Costs: Look at what your insurance will cover. Unfortunately, therapy, evaluations, checkups, medication, etc. can get expensive. This is by no means an excuse not to get help, but getting some of it paid for is valuable. When you schedule your first intake appointment (that will be longer since it is basically a mutual interview between you and the provider), make sure you go over costs. The last thing you want is to find someone you like and then not be able to afford them.
2. Distance: Consider how far you are willing to travel for your visits. If you are recommended for talk therapy, that could mean weekly visits or even twice a week visits for some or all of your time in treatment.
3. Provider type: There are three different types of mental health providers. Besides price, here are the differences:
   1. Psychiatrists are medical doctors who specialize in mental illness from a clinical standpoint. Although some can engage in talk therapy, many primarily just prescribe medication and do medication management.
   2. Psychologists are professionals with either a Ph.D. or a PsyD who study the mind and human behavior. They will pull from a laundry list of therapy styles, including CBT and psychoanalysis, and pick which one they feel would work for you.
   3. Licensed Clinical Social Workers (LCSW) are professionals with a master’s degree in social work. They tend to be less expensive than a similarly situated psychologist or psychiatrist. Unlike psychologists who are more flexible in their therapy style, LCSW tends to stick to strength-based therapy.
      Ask what therapy style the provider generally uses. At one point I had psychoanalysis therapy twice a week, and after a year I felt the needle had not moved in my treatment. I walked away and found something different. I have found better results with skills-based therapy, instead of the psychoanalysis treatment, so I switched to a provider who does Acceptance and Commitment Therapy (ACT), a skills-based therapy.
4. Specialty: Have you been crying all the time and feel shitty? Do you find yourself hearing voices and seeing things that are not there? Have your postpartum blues turned into postpartum despair? Do you have hang-ups about sex? These questions matter, because the provider you choose should know and specialize in treating whatever ails you. Usually, on the provider's website, they will note what their areas of expertise are. Take this seriously, as you would not go to an ENT doctor for a broken leg.
5. Background: Since you will be sharing a lot of personal details with this person, it may not be a bad thing to screen them based on the characteristics of a person you would feel comfortable talking with. If you are female, it is reasonable to want to use a female provider. If you are not comfortable talking about feelings or intimate details with someone your grandmother's age, that is also an excellent way to whittle down the list. (Note of caution - if you go to a provider based on ethnicity, do not assume they will relate just because they share your ethnic background).

Overall, the fact that you feel you need mental health treatment and you are seeking it is a big step. Furthermore, if you are having anxiety about making that first phone call, like I did, ask a friend or loved one to call around on your behalf. Do not get discouraged or give up when trying to find a provider you click with. Also, always remember that you can vote with your feet. If you are working with a provider who is not a good fit, just find a new one. You are the customer, and you deserve to find someone suitable to help you get well.