Finding and working with a therapist

You’ve thought about it: talking to a professional counselor, finding a therapist, going to group sessions. Perhaps you’ve wondered if your child or teen needs therapy, looked online to see what therapy costs, or checked the mental health coverage on your insurance plan.

But you’re still not sure. Are your problems “all in your head”? Do you have to tell a therapist everything? What if you don’t like the therapist’s advice?

We often talk about balancing your mind, body, and spirit for optimal health. Various types of therapy are often a part of treating anxiety, depression, trauma, and relationship challenges. Therapy can help you cope with grief, loss, post-traumatic stress (PTSD), and conditions such as migraine and chronic pain.

So, could therapy help you? Whether your primary concern is physical, such as pain, or mental and spiritual, such as anxiety or loneliness, working with a therapist could be a part of creating better health. In this blog, we provide answers to some of the awkward questions about therapy.

Where can I find a therapist?

Asking your primary care provider is a great place to start looking for a therapist. Get tips for talking to your primary healthcare provider about mental health from the National Institute of Mental Health.

You can also check the mental health section of your insurance company’s website. Psychology Today can help you search a directory of therapists worldwide. Or you can browse by U.S. state at Find a Therapist.

A friend or family member who has searched for therapists may be helpful with the search process. “Approach finding a therapist like you’re looking for a job,” says our friend Lisa, a Seattle-area project manager. “Be patient. You don’t want to hire just anyone, and you usually search a bunch of sites to find the right person.”

Decide on some basic characteristics. Would you be more comfortable with a male or female therapist? Someone older or younger than you, or about the same age? Do you want someone with many years of experience? Someone who shares your faith beliefs or philosophy of life? That said, keep an open mind. You may find a good fit with someone who’s not quite what you expected.

How do I choose the right one?

Mental health professionals have different qualifications than some other health-care providers. For example, some can prescribe medications, and some cannot. The checklist below may help you decide what’s important to you.

• Do you want to work with someone who can prescribe medications? If so, look for a psychiatrist (MD). If you don’t need this ability in a therapist, you can look for a psychologist (PhD or PsyD), social worker, or counselor.
• Is cost an important factor? If so, visit your insurance company’s website to find a therapist on your plan. When you find someone promising, call their office to make sure they still take your insurance and are accepting new patients.
• Do they have an office close to your home? Or do they offer telehealth appointments?
• Do you want someone with a particular specialty, such as coping with the chronic pain of migraines or healing from family or sexual trauma? Or someone who uses a specific approach, such as CBT or EMDR?

What type of therapy will help me?

Healing your mind and spirit can help your body heal and thrive. From a whole-person perspective, any type of therapy that supports your mental, emotional, and spiritual well-being is likely to bring physical benefits, too. However, researchers have studied specific types of therapy as treatments for certain conditions. The chart below shows what we know based on the latest research.

The information below is not intended to serve as a comprehensive list or as treatment recommendations—it’s just a starting point for exploring the possibilities. If a type of therapy interests you but is not listed as a treatment for your condition, feel free to interview individual therapists about how their specialty might help you.

Therapy type	Has been shown to help with	Other things to know
Mindfulness-oriented recovery enhancement (MORE)	Opioid use disorder, chronic pain	Encourages greater awareness of your thoughts and feelings to decrease your automatic destructive responses or habits
Acceptance and commitment therapy (ACT)	Depression, social anxiety disorder, test anxiety, workplace stress, eating disorders, substance use disorder, obsessive-compulsive disorder   May also be used to help chronic pain	Uses mindfulness exercises to encourage you to develop a new relationship with your challenging experiences
Eye movement desensitization and reprocessing (EMDR)[i]	PTSD, sexual trauma	Uses therapist-directed eye movements to change the way memories are stored in your brain May provide quicker relief of PTSD than CBT
Hypnotherapy	Smoking cessation, eating disorders, phobias, chronic pain, pain during childbirth or cancer treatment, menopausal hot flashes	Allows you to be more receptive to suggestions about how to achieve your goals; you remain alert and aware throughout the session Hypnosis is considered safe and effective when done by a trained therapist
Cognitive therapy Behavioral therapy (These two therapies may be combined into cognitive-behavioral therapy, or CBT)	Depression, anxiety, panic disorder, PTSD, eating disorders, obsessive-compulsive disorder, insomnia, smoking, low-back pain May also help with anxiety and emotional control problems	Requires a motivation to change and a willingness to practice new skills (behaviors) and thought patterns (cognition) You may learn stress management and relaxation techniques, coping skills, or assertiveness Those with PTSD might also be interested in exploring cognitive processing therapy (CPT) or trauma-focused cognitive behavioral therapy (TFCBT).
Psychodynamic therapy	Depression, eating disorders, borderline personality disorder	Looks at childhood and other past experiences and relationships for keys to your current challenges
Interpersonal psychotherapy	Depression, eating disorders	Focuses on challenges regarding your relationships with others: for example, grief; arguments and disputes; a lack of “people skills”; distorted thinking with regard to other people; and a transitioning role in life
Motivational interviewing	Substance use disorder, weight loss, smoking cessation, managing complex physical conditions (such as heart failure), developing success with physical habits and skills (such as exercise or breastfeeding)	Helps you to recognize problem behaviors, come up with plans, and take steps when you are ready
Dialectical behavior therapy (DBT)	Borderline personality disorder and other conditions that affect emotional control	Provides intense, frequent therapy (often several times a week) with a strong focus on skill building
Motivational interviewing	Substance use disorder, weight loss, smoking cessation, managing complex physical conditions (such as heart failure), developing success with physical habits and skills (such as exercise or breastfeeding)	Helps you to recognize problem behaviors, come up with plans, and take steps when you are ready
Supportive therapy or counseling	Coping with medical and physical challenges (such as cancer or a chronic health condition), dealing with a temporary crisis, helping you or your caregiver find needed services and other support	Uses a mix of techniques based on empathy (understanding what you are feeling and going through) to help you find services you need May be used for short-term or long-term therapy

Some text adapted from Lebow J. Overview of psychotherapies. Available at www.UpToDate.com. Last updated June 7, 2019. Literature review current through December 2021. Accessed January 24, 2022.

You can look for these types of therapy by using them as keywords when searching for a therapist online via your insurance company website. You can also ask a prospective therapist if they use any of these specific approaches. Learn more about different therapy types in this medically reviewed article.

How do I interview a therapist

You will probably talk with possible therapists by phone, or perhaps online, before making a commitment to work with them. Some therapist and counselors may offer a free “get to know you” session, but most need to charge for their time.

In your first conversation, be open about the help you are seeking. Ask about the therapist’s experience with your concerns. They should be open about whether they work with people in your situation. If they do not specialize in the kind of therapy you’re looking for, but you feel comfortable talking with them, you can ask if they will recommend another therapist who specializes in your concerns.

Questions to ask a therapist

• Do you specialize in working with a specific age range, gender identification, or type of issue?
• What is your experience with the issues I have? (If you aren’t sure what to call your issues, give them a brief example of one of your challenges.)
• Do you take notes during our session? (Some people prefer the therapist not to take notes during the session.)

If you are in emotional pain or grief, you may want a therapist with a softer approach. Or you may be looking for “tough love” to help you solve a problem. Let your personality come out during the interview. See how the therapist responds.

Interview several therapists

Finding a therapist with available appointments can be challenging, especially now. Still, resist the temptation to choose the first person with available appointments. Take the time to talk with several people. Finding a good fit for your personality and needs is important to avoid starting your therapy journey with a negative experience.

What to say if it’s not a match

You may know it from the start, or it may take a conversation or two to show that you and the therapist are not a good fit. If that’s the case, you can say, “I appreciate your time. I’m not sure this approach will work for me right now but thank you again for speaking with me.”

Can you pay for therapy yourself?

Generally, yes. You might do this if

• you find a great therapist, but they don’t accept your insurance.
• you are seeking couples therapy, which is not usually covered by insurance.
• you prefer not to use insurance to pay for therapy.

Some therapists charge based on your ability to pay—less if your income is low, more if it is higher. Most therapists list payment options on their websites, which also gives you a great opportunity to check out how they present themselves online. Feel free to ask about private payment options.

Did I find the right therapist?

The benefits of therapy can come slowly or quickly. If you are honest with your therapist, respect their advice, and work with their suggestions, you are likely to see results sooner.

Like physical therapy, talk therapy can be challenging. Talking about your concerns, health problems, or past experiences in therapy can be emotionally wrenching. However, every session should not be bothersome or upsetting. And if you do get upset, your therapy session, whether in an office or online, should be a safe place to express your feelings.

Signs that a therapist is NOT a match

Yellow flags—caution, go slowly

• You feel like the therapist’s advice will do more harm than good.
• The therapist seems to harp on a single topic while you want to discuss more issues. If they resist, this may mean they are not helping as much as they could be.
• The therapist appears rushed, is late to the session, misses sessions, or sometimes seems inattentive.
• The therapist frequently cancels or postpones your sessions.

Red flags—time to find someone new!

• The therapist’s suggestions are contrary to your core beliefs or religious ideas. When you tell them this, they aren’t willing to adjust their advice.
• You feel judged instead of heard.
• They talk more about themselves than you. An occasional personal example or anecdote is okay—their entire life story is not.
• They are constantly inattentive during your sessions.
• They talk negatively about other clients, complaining or sharing a lot of details about other sessions.
• They are physically too close to you for comfort; or they dress, speak, or act unprofessionally or in a way that makes you uncomfortable.

Should I give therapy more than one try?

Sharing your feelings and challenges can be awkward at first, so give therapy a try for several sessions unless you get a bad feeling after the first one. Working with a therapist is like meeting a new friend or co-worker—it can take some time to sync up.

If you don’t agree with something your therapist says, be polite but clear. You can say, “I appreciate your thoughts, but I don’t feel comfortable with that,” or something similar. If that does not put you on a better track, it is time to leave. This may feel awkward, but you are not the first to leave a therapist (and you won’t be the last).

Licensed therapist Kris Wright, LCPC, notes that she welcomes being corrected: “We work with you to find solutions that work for you, and that involves getting to understand your perspectives and experiences, some of which can be pretty complicated. I know things are going well with a patient when I offer an idea or comment and they are comfortable enough to correct me or clarify what they were trying to express.”

Also, remember that therapy is not intended to last forever unless you want it to. Your sessions may be a form of self-care. You don’t always have to bring a major problem to your therapist. “Therapy can enhance your ability to thrive,” says one psychologist who specializes in working with professional women.

How will you know when you’re feeling better?

Knowing when to move on can be challenging, especially if you like your therapist and enjoy your visits. However, it might be time to stop sessions when:

• You’ve learned new skills and tried new strategies that work for you, and you are confident that you can use them on your own moving forward.
• You don’t have much to talk about at your sessions.
• You’ve resolved the problem you originally brought to therapy.
• You feel ready to go.

A good therapist appreciates knowing that they helped you. However, if a therapist tells you that it’s time to leave therapy and you don’t agree, this may be another sign that you and that therapist are not the best match.

Is group therapy for you?

Group therapy can be a helpful option, especially if you have financial concerns, prefer to be with groups of people, or are struggling with a common concern.

Group therapy allows you to share ideas and tools for coping with your issues, whether it’s addiction, divorce, cancer, or PTSD. When her daughter Ellen was a teen, Janetta attended a group session for mothers of teenage daughters. “It was so supportive to know I wasn’t alone,” she says. Many groups are very specialized, such as Celebrate Recovery or Alcoholics Anonymous for those with substance use disorders, or specific support groups for caregivers or those going through divorce. Sometimes it is useful to join a group for its activities and social connections, even if it is not working on the specific issue you are seeking to solve. To get insurance to pay for such groups, however, the therapy may need to address a medical diagnosis, like diabetes, obesity, or substance use. Check with your insurance.

What about an app?

There’s an app for everything, including mental health. Therapy and mental health apps can connect you with a therapist almost immediately.

Apps for therapy include Calmerry, Talkspace, and BetterHelp. For couples therapy, there is ReGain. You may like MDLIVE if you are more interested in video sessions than encounters via email or text. For LGBTQ people, there is Pride Counseling, and people aged 13–19 may like TeenCounseling, which is part of BetterHelp. CBT-i Coach is helpful for many people with insomnia.

The website eCounseling.com can guide you to online therapies of all types, from faith-based services to marriage counseling and much more.

As an alternative to therapy, you may want to try an app like Headspace or Calm for meditation and relaxation. These integrative approaches may boost your mood and your mental health.

Personalizing your treatment

Other mind-body practices to add to your therapy can include:

• Movement, including yoga and tai chi
• Mindfulness meditation
• Acupuncture
• Music therapy or art therapy

You can watch a video lecture on meditation, yoga, and cognitive behavioral therapies from the National Center for Complementary and Integrative Health at the National Institutes of Health to learn more about combining these practices for better mental health.

More therapy and mental health resources from Dr. Wayne Jonas

• Depression Doesn’t Have to Cripple Your Life
• Depression Pocket Guide
• Music Therapy Pocket Guide
• Art Therapy Pocket Guide

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