The cool thing about therapy is that everyone can benefit from it. Everyone has a brain and thoughts and emotions, so it’s worth having a professional help you examine those thoughts to determine if they are healthy.
“Everyone can use therapy,” says Kinsey McManus, services manager for the New York City chapter of the National Alliance on Mental Illness. “Therapy is about having someone in your life who is solely invested in your success.”
Deciding to go to therapy is easy. Finding a therapist can be hard — a confusing, frustrating process where it feels like there are no right answers.
You can do it, and we’re here to help. We promise if you read through this guide, you will leave feeling optimistic, informed and empowered to do something about your mental health.
Figuring Out If You Need Help
If there is a time in your life to consider seeing a therapist, it’s when you’re a young adult. “This is a particular time of immense growth and struggle,” says McManus. “Having a therapist is an incredible way to have this emotional support to make basic life decisions.”
The most important thing to keep in mind when deciding to seek therapy is to not get caught up in a diagnosis. There are warning signs to be aware of in terms of clinical condition, but it’s okay to seek help if the issues in your life seem vague and maybe inconsequential.
Maybe you’re just struggling to make new friends. Maybe you’re not sure where to go next in your career. Maybe your last few breakups have some similarities and you’re not really sure why. Maybe you feel like you’re leaning a little too much on your friends for direction. These are all good and valid reasons to seek professional help.
For the most part, life is difficult. And you can’t really expect yourself to come up with good solutions to all the problems it presents. “There are some big questions that young adults face,” says McManus. “And there aren’t so many outlets for them to talk about it.”
Finding The Right Therapist
The first step to determining which therapist is right for you is not going on ZocDoc and searching for psychiatrists. No, the first step is figuring out what makes you comfortable.
In order to get something out of therapy, you’re going to be asked to open up. So think about who might make you feel at-ease enough to do that. Woman? Man? Older? Younger? “There are a lot of things that we don’t even realize, and it’s all fine,” says McManus. “It’s about feeling comfortable and finding the right therapist isn’t time to stretch your comfort level.”
Once you have an idea of who your potential therapist might be, it’s time to, uh, go out and find them. If you’re not too worried about cost, then yeah, go wild on ZocDoc. But chances are, you are worried about cost. In which case, you’ll want to find a therapist who takes your insurance.
Of course, there is no easy way to do this. You can ask your insurance company for a list of in-network providers — most, if not all, will have an online search tool to do this. Insurance companies being what they are, however, that list might, and is, probably outdated. ZocDoc does have a handy feature where you can plug in your insurance plan and it’ll generate their own list of “in-network” therapists, but like the insurance companies it also is not perfect.
In the end, you’ll probably have to end up using some combination of Google/ZocDoc/insurance company to build a shortlist of potential therapists. It’s not a perfect system, and it’s going to require some effort on your part, but this is just one of those things that is not easy.
Eventually, you’ll have a shortlist of potential therapists, people whom you’ve Googled and read reviews about and are vaguely confident would be good fit for you. Great. Now it’s time to pick up the phone.
Before your schedule your first session, McManus suggests you ask a few basic questions.
First, you’ll want to know if you can even see them in the first place. Do they accept your insurance? And if they do, are they accepting new patients?
Next you’ll want to get an idea of who they are. Who is their typical client? Do they work with younger people or older people? Do they deal in a specific diagnosis? “If someone says they work from kids to all the way up to older adulthood, any diagnoses, that always makes me concerned,” says McManus.
Finally, once you’ve found a therapist that is both accepting new patients and seems like a good fit, ask them about their consultation policy. Some therapists don’t charge for the first session, some do, and others will offer a free consultation but then retroactively bill you if you do decide to stick with them.
“There are lots of different ways providers can bill,” says McManus. Knowing what you’ll be charged and when will help you decide if it’s worth going to multiple consultations with different therapists to continue to test your personal fit with them. Think of it like dating, only here the end-goal is to improve your mental health, not deteriorate it.
Your First Visit
By now you’ve probably sunk a fair amount of time into researching therapists. It was probably not easy. Finally you’re scheduled for a consultation. You’re done, right? Not exactly.
To reuse the dating analogy, the consultation is like a first date. You and your therapist are both using it to get a an inkling if this relationship is going to work out. In your first 45-50 minute session (a typical “hour” session is a little less than an hour since the therapist needs to do documentation), expect just to talk about the basics. They’ll ask you why you’re seeking therapy, your experience, if any, with therapy in the past, and your family history with mental illness.
“People shouldn’t feel like they need to put everything out on the table regardless of your comfort level, when they first start,” says McManus. “The expectation is that your first several sessions are just getting to know each other.”
There are a few obvious red flags, says McManus. If the therapist offers you a diagnosis after the first session, that’s not good. Or if you left feeling like the therapist made you divulge too much, that also isn’t a good sign. But mostly, when it comes to figuring out fit, go with your gut.
“The reality is that if there’s something that feels off after your first or second session, don’t go back,” says McManus. “Even if you can’t even put your finger on it, but you felt a little uncomfortable, your subconscious is probably picking up something that will become an issue further down the road.”
And it’s okay to want to see another therapist. In fact, if this is your first time seeking therapy, McManus suggests that you see a few professionals before settling down with one. “It’s not your job to make it work,” says McManus. There’s that dang dating analogy again.
And Then The Rest Of Your Life
Even after you’ve found a therapist that you feel comfortable around and can connect with, it’s important to be responsible for your own progress. “A question to always ask yourself, a month in, two months in, three months in, is ‘Do I feel like things are getting better?’,” says McManus. “And if the answer is ‘No,’ or ‘We don’t even spend time talking about what I came in to talk about,’ that’s a warning sign.“
Ultimately, therapy should bring you to a place where do you don’t need it anymore. “Unless you have a legitimate illness, people do not need therapy forever,” says McManus.
I found a therapist I like, but they don’t take my insurance. Instead they’re offering something calling “sliding scale” payment. How does this work and is it better?
Ah yes, you’ve stumbled upon one of the many wrinkles of the US mental health care industry. A sliding scale just means your per-session payment is based off of your income. Which might mean you’re getting a deal, paying $150 per session instead of $300 or $500, but will still probably be more expensive than an insurance co-pay. But like most things, it depends! “Sometimes they will ask you what you’re willing to pay, which is a sticky situation,” says McManus. “Which is why I really encourage people to find in-network providers, if at all possible.”
A therapist I’m looking at says they take my insurance, my insurance company says they take my insurance, but that therapist is no longer taking any more patients with my insurance. What gives?
Yet another wrinkle of our excellent health care system. You’re kinda caught between a financial struggle between providers and the insurance companies. This is a huge area of advocacy for McManus and NAMI, but it boils down to the fact that there are there aren’t enough providers, and the insurance companies refuse to pay those providers more. “They won’t even give cost-of-living increases,” says McManus. “From a provider perspective it’s like ‘Why would you accept insurance?’ It seems ridiculous.” And so those providers opt to accept patients who can afford to pay the full per-session sticker price.