As the new year begins, you may be thinking about starting up therapy. But where do you start? After all, with something so personal and vulnerable, you want to make sure the person sitting on the other side of the room from you is someone you feel comfortable with.
First things first, congratulations on making this big step toward not only bettering yourself but feeling better! However, we know that getting started can often feel like the hardest part.
That’s why we sat down with Dr. Ken Jones, Behavioral Health clinical officer for Texas Health Resources. Jones is a Licensed Clinical Social Worker, and has a doctorate in Clinical Psychology, to get his insight on why it’s important to know what you’re looking for and where to look.
Type of Mental Health Professionals
One hop online to research mental health professionals and you may be overwhelmed by all the different types, acronyms and specialties. How can you make heads or tails on which professional is right for you and your particular goals or circumstances?
So we’ve outlined some key distinctions among various mental health professionals to help help you decide what kind of help you need:
- Who They Are: A mental health professional who can provide a safe space for people who want to talk through life issues, changes, or symptoms of a mental health condition
- What They Can Do: Perform talk therapy; diagnose and treat mental health conditions
- Qualifications: A master’s or doctorate degree
They may also specialize in a particular area, like marriage and family therapy or trauma processing.
- Who They Are: An individual within the mental health field who concentrates primarily on biological factors, such as genetics, social sciences, and neurology.
- What They Can Do: Perform talk therapy, help clients with issues not related to specific mental health conditions, like stress, grief, or big life changes; administer exams and assessments to help diagnose a condition
- Qualifications: A doctorate degree; a 1-year, full-time supervised internship during graduate school; a 1-year, full-time supervised postdoctoral fellowship after graduate school; a national exam
Because Psychiatrists are medical doctors (MDs), they are also able to prescribe medication and order tests for your diagnosed condition.
- Who They Are: A professional who collaborates with diverse individuals and communities, aiming to support them in achieving a healthier and more fulfilling lifestyle
- What They Can Do: Work in settings like hospitals, mental health facilities, schools, and transitional living facilities; coach individuals or groups by discussing issues like communication, empathy, organizational techniques, and self-care skills
- Qualifications: A master’s degree in social work (MSW); 2 years of supervised clinical experience after graduate school; a license in the state they practice in
Licensed Professional Counselor
- Who They Are: Someone who may specialize in a certain type of therapy approach, such as Cognitive Behavioral Therapy or interpersonal therapy, and may work alongside a person’s medical doctors to provide a more holistic approach to therapy
- What They Can Do: Perform talk therapy; treat mental health conditions and issues like anxiety, depression, phobias, bipolar disorder, etc.; in some states, they can provide a diagnosis
- Qualifications: Licensing varies by state, but in Texas a LPC must hold at least a master’s degree in counseling or a counseling-related field, and also must complete 3,000 hours of supervised experience in the field of professional counseling
Finding the Right Fit
Researchers have found that the bond between you and your therapist is likely to have a big impact on your growth. That’s why it’s important to do your research, ask questions, and pay attention to your own responses in your search for the therapist right for you.
That’s why Jones suggests addressing the following when considering a therapist:
Defining Your Goals
In preparing for therapy, it’s important to spend some time thinking about your why, and chances are this may be one of the first questions your therapist asks you. It gives both them and you a good place to start and a main objective.
Jones suggests asking yourself what your actual purpose for seeking therapy at this time and what you are most concerned about.
“This isn’t always as easy as it might sound, and if this part is difficult to articulate, that’s perfectly fine. Share with your therapist the process of trying to sort out your why, where you seemingly became stuck,” Jones explains. “Perhaps your ‘why’ is to simply gain the clarity to move forward with confidence, in whatever direction that might be. This can be really helpful to a trained therapist in terms of collaboration on treatment goals.”
Jones adds a sense of compatibility typically emerges from the elements of this initial conversation, where your expressed need finds understanding and the hope that by working together, you can find some relief.
This process of defining your “why” may also help inform if you may need to see someone who has the ability to prescribe medication, or who specializes in a type of therapy that seems like it would best suit you.
If you're seeking a group of people who get what you're going through, finding a therapist involved in support groups or group therapy could be a good idea.
Likewise, ask yourself if it’s important to you that your therapist be a certain gender or have personal experience with your culture or religion, especially if you feel those things may be barriers to understanding and connection if not met.
As you keep meeting your therapist, what you want might shift, and that's totally fine. Talking to your therapist about changing your treatment plan as your needs change is okay.
Keep Insurance and Finances in Mind
It’s no secret that cost has been a long-time barrier when it comes to accessing therapy. So it’s important for you to define how you intend to pay for therapy. If you plan to pay for therapy through your insurance plan, your first step might be to look through your plan’s network for a therapist. Also, see if your insurance limits how many sessions you can have each year and if going to a therapist outside the network affects what you pay.
While you don’t have to stick to a therapist that is within your insurance network, choosing someone out of network might cost more. If you really click with a therapist not in your network, the benefit may outweigh the cost. However, you can always ask if your insurance will pay you back for the appointments.
You might also want to consider training programs that may be connected with colleges or universities. Student interns who are working towards their degree are typically supervised by a licensed professional and/or credentialed faculty member while they are providing services, and sessions with them typically come at a reduced cost, or in some cases, free of charge.
Jones also notes that online therapy has opened so many doors not just for accessibility but cost as well. Instead of having to choose from therapists in your immediate area, you can partner with someone in another city who may be within your network or have lower fees.
“Online therapy has really removed a lot of access barriers to receiving mental health care, especially as our culture has become increasingly comfortable with interacting with each other utilizing technology,” Jones explains. “Combined with in-person therapy options, it’s an exciting time for the advancement of therapy services, especially when it comes to connecting specialists with individuals who may live in remote locations.”
Just remember, even if they are not currently located in Texas, they must be licensed to treat in the state of Texas if that is where you reside.
Tapping Into Your Resources
Personal referrals, and utilizing online databases or connecting with national or local organizations can be great places to start when it comes to finding a therapist as well.
Many mental health organizations maintain up-to-date, searchable databases of licensed therapists. You can start by typing your ZIP code to find nearby counselors. You might also search for specialists, such as marriage and family counselors or therapists for drug and alcohol issues.
Some popular online tools for this include:
- American Psychological Association
- Black Mental Health Alliance
- American Association for Marriage and Family Therapy
- Therapy for Latinx
- Association of LGBTQ+ Psychiatrists
- The National Asian American Pacific Islander Mental Health Association
If you’re looking for a therapist to help with a specific mental health condition, you might find local therapists through a national association, network, or helpline, such as”
- National Alliance for Eating Disorders
- Anxiety and Depression Association of America
- National Center for PTSD
Additionally, many workplace organizations and trade unions have resources to help you identify professionals who can assist with employment-specific mental health needs. For example, the International Association of Fire Fighters offers help with mental health, post-traumatic stress disorder (PTSD), and substance use.
You may even find it helpful to tap your friends, family, coworkers or your health care provider for a referral on a good therapist. However, while a referral is a good place to start, it’s important to recognize that you may have different needs and goals than the person giving you the recommendation. So, a good match for one of you might not be as beneficial to the other.
Ask Questions and Be Open
Once you find someone who you’d like to get started with, Jones notes that the initial session is a great time for both you and the therapist to get to know each other more and see if this will be a good fit.
“The first session is usually what I would refer to as a conversational assessment. The therapist will ask you a broad set of questions designed to give them a holistic picture of you as an individual, along with the environments that have contributed to your development and current functioning,” Jones says. “It will likely include a collaborative conversation about treatment goals, what you’d like to accomplish, and a ‘look ahead.’ For example, ‘What would things look like in the future for you if therapy were to be successful?’”
Take this time to ask your therapist some questions, as well.
The American Psychological Association suggests a few questions to consider asking your therapist during your first session:
- How many years have you been in practice?
- How much experience do you have working with people who are dealing with [the issue you’d like to resolve]?
- What do you consider to be your specialty or area of expertise?
- If I need medication, can you prescribe it or recommend someone who does?
- What kinds of treatments have you found effective in resolving [the issue you’d like to resolve]?
- Do you provide access to telehealth services?
- How soon can I expect to start feeling better?
- What do we do if our treatment plan isn’t working?
- What insurance do you accept?
- Will I need to pay you directly and then seek reimbursement from my insurance company, or do you bill the insurance company?
- Are you part of my insurance network? Do you accept Medicare or Medicaid?
“Ask about their experience working with diverse populations, and inquire about any additional training or certifications in cultural competency, if that’s a topic of importance to you,” Jones adds. “A culturally competent therapist will respect and appreciate diverse identities, while adapting their approach to your unique needs.”
Give it Time
If you walked away from your first session feeling a bit nervous or unsure, that’s completely common. You just did something vulnerable and maybe even a bit awkward if you’re not used to talking so openly with a stranger about personal issues.
But if you’re already questioning if this person is the right fit for you, Jones suggests attending a minimum of 3-5 sessions before making a decision about whether or not a therapist is the right fit for you.
“If you have a sense that things aren’t quite jelling the way you’d like, tell your therapist! Whether your therapist asks for direct feedback on how you perceive things are going, or uses a questionnaire or other measure to gather feedback, be honest,” he adds. “Most therapists are highly skilled at making adjustments, and just like any relationship, giving candid feedback can create a turning point and even strengthen the connection moving forward.”
The one caveat Jones notes is that if for some reason your therapist reacts defensively or otherwise, it’s probably time to move on.
Here are some general tips from Jones for identifying “green flags” that indicate the therapist may be a good fit for you:
- You feel safe and comfortable in their presence.
- They are present and engaged with you in the moment.
- They maintain and establish clear professional boundaries.
- They are willing to gently challenge you and hold you accountable when necessary.
- They maintain strict confidentiality. This includes ensuring that conversations are held in a private setting, and that the confidentiality agreements signed at the beginning of treatment are adhered to in practice.
- They are honest about any professional limitations, and are willing to make a referral if and when they are outside of their scope of practice or specialty.
Trust Your Gut
Even if your therapist has many qualifications, what matters most is feeling comfortable and trusting them. Therapy might get tough from time to time because you are talking about personal things. But if you ever feel uneasy with your therapist for any reason, it's okay to find someone else. You don't need a special reason to switch therapists. Feeling uncomfortable is reason enough, Jones adds.
“Look for a therapist whose expertise aligns with your needs, and don’t hesitate to schedule an initial session to assess your comfort and connection with them. Trust your instincts in finding someone with whom you feel safe and supported, yet challenged,” he explains. “Change by definition is somewhat uncomfortable, mainly because it represents the unfamiliar, but it’s the only true path to growth. Developing a relationship with a therapist who can provide a safe space while encouraging us to think and move in different ways can be life-changing.”
If you or a loved one needs behavioral health support from a professional, Texas Health provides outpatient and inpatient care across North Texas. For information on physicians and services near you, visit Texas Health Behavioral Health or call the helpline at 682-549-7916, which is available 24/7.