Hi guys! As you may know, I am a licensed therapist and hold an LCSW (Licensed clinical social worker). Something that a lot of people don't realize are the credentials their therapist may hold. Your therapist can be an LMHC (Licensed mental health counselor), LCSW (Licensed clinical social worker), LMFT (Licensed marriage and family therapist), and there are also psychologists and psychiatrists. These are just the commonly seen types, but there are more. It's always good to be informed about who you are seeing. But before I get ahead of myself, these are the important tips I have for you for finding a good therapist that fits YOUR individual needs.
- Find a therapist in network with your insurance or if you don't have insurance, a therapist that takes either self pay (if you can afford it) or has a sliding scale pay rate.
Finding a therapist who takes your insurance is probably first and foremost what you should be looking for. You don't want to be paying an insane amount if your therapist is out of network with your insurance. You don't need to add a stressor that can be easily eliminated from your list. Some of the ways you can do this is by calling the number on the back of your insurance card and going through the correct steps in finding mental health services through your insurance. While this is convenient, you may end up calling facilities or inpatient hospitals that fall under that category but aren't actually one on one therapy sessions. So be careful of that and make sure the first question you ask is if they do one on one therapy sessions. Probably the better route, would be to look online at websites. There are specific websites where you can type in your city and insurance into a search bar and it will pull up therapists in your area that take your insurance.
Here are a list of websites to find a therapist in your area, in network with you.
Psychology Today - Enter in your city first, then it will pull up therapists in your area. There is more criteria at the top you can filter to find a therapist that accepts your specific insurance. If it's important to you, you can also specify gender, age, cost, and more.
Find a Therapist - This website also lets you type in your city first then you can filter for more specific criteria.
If you don't have insurance, a sliding scale may be best. This goes based on your income. So if your income is low, the therapy sessions would also be lower than normal. There will be a form you will have to fill out for this. Self pay or therapists who don't take insurance are going to be the most expensive, so look out for that.
- Make sure your therapist specializes in your presenting problems or the area you need help in.
Different therapists specialize in different areas. To find a therapist right for you, a good step is seeing what areas they treat in. For instance, if you are suffering from PTSD, make sure you find a therapist that specializes in that. I know it seems simple, but not everyone thinks of it. Just because they have the credentials and are licensed as a therapist doesn't mean they have expertise in the area you need to be helped in. If you're struggling with depression and anxiety it may be easier finding a therapist to work with because they all should be well-versed in this. But if you are specifically looking for help with substance use, bipolar disorder, borderline personality disorder, childhood trauma, etc., it is definitely necessary to find a therapist that specializes in these areas.
There are therapists who specifically treat certain populations like the LGBTQ+ population, which is important because you want to know that your therapist understands you, although all should be non-judgmental in their approach. Some others may mostly work with older adults, young children, teenagers, young adults, or middle aged adults. Remember, there are vast and diverse populations, specific mental health illnesses, stressors, hardships, or whatever else a client may be facing and it is nearly impossible for a therapist to have enough knowledge in all areas.
If it's important to you, then it's important to you! It's okay to be picky. You have to be vulnerable in front of this stranger so you should make sure they understand you, where you're coming from, and your mental health.
- What therapeutic approaches are they specialized in?
This kind of goes hand in hand with finding a therapist that is specialized in your area of need. But there are certain therapeutic approaches that specifically help with certain problems. Let me give you some examples so you know what to look for.
If you struggle with substance abuse, it is important to find a therapist who provides Motivational Interviewing, Solution-Focused Therapy or DBT/CBT.
If you struggle with Borderline Personality Disorder, you should find a therapist who specializes in DBT (Dialectical Behavior Therapy).
If you are struggling with depression and anxiety, a therapist who is familiar with CBT (Cognitive Behavioral Therapy) would be beneficial.
If you are struggling with PTSD, some therapeutic approaches would be EMDR (Eye Movement Desensitization and Reprocessing), Prolonged Exposure (PE), Narrative Exposure Therapy (NET), Brief Eclectic Psychotherapy or CBT.
These are just some examples, but if you're able to do a little research into what therapeutic approaches would help you best, then it is worth knowing so you can find a therapist who also specializes in this.
A lot of the time, when you are searching for a therapist, it will tell you what treatments or approaches they are specialized in and they should go hand in hand in what areas of mental illness or stressors they provide.
- If you don't feel a connection with your therapist, find a new one!
This is something that is so very common. Sometimes people will hold resentment towards therapy because they had a bad experience. It is very common for you to not have a connection with your therapist. If you've tried for months, and you aren't connected and don't feel like your therapist is helping you, it is totally okay to find a new therapist and terminate the client-therapist relationship. It should be more normalized! I mean think about it, you are sharing with this stranger some of the deepest most vulnerable parts of yourself that you may not even share with your family or friends. If you don't feel like your therapist is making you feel validated, being receptive, or being understanding of you, it is totally normal to find someone else. With that being said, the therapist bond also shouldn't feel like it's a friend that you're talking to. There of course needs to be a level of professionalism there so it is going to feel different. But there's a difference between not feeling like you're being validated or seen, and just not feeling like your therapist is having a "friendship" relationship with you; because that also shouldn't be happening. Sometimes it can take multiple tries before finding a therapist that's right for you, so don't let yourself get down about it, it's normal.
- Be aware of ethical boundaries and violations.
While every therapist should be very knowledgeable in ethics, values, and boundaries of being a therapist, sometimes there are unethical happenings. It's important to know the red flags and be able to make sure your therapist is practicing ethically. Because this can damage the therapy you are receiving and make you take steps backwards in your mental health.
The first session, the therapist should be talking about informed consent, the client-therapist relationship, and confidentiality. Self-disclosure can be a tricky subject. We, as therapists, are taught to only do this if you truly feel like it would help the client. If your therapist is self-disclosing a significant amount of personal information often, this should not be happening. If you have an uncomfortable gut feeling when your therapist seems to be crossing lines or boundaries, this may be a red flag. Also be aware, there is NEVER a time for a therapist to be friends or have romantic relations with a client. It doesn't matter if you have terminated the relationship, or even if you terminated the relationship 10 years ago, there should never be a relationship outside of the client-therapist dynamic. There is no amount of time that can go by, where you and your therapist could be friends or have relations. It is never allowed to happen. A therapist should always take a non-judgmental stance with the client. They should never judge you or act condescending on choices you've made or how you look, etc. They shouldn't be overwhelmed by information you give them or get frustrated with you. Naturally, we are all human, even therapists, but these are definitely some red flags. And to be blunt, there are just some therapists out there that probably should not have chosen that as their profession. It isn’t your fault.
- Is your therapist challenging you? Or really helping you to reframe some of your negative methods of thinking?
If not, they may not be the therapist for you. You don’t need a therapist who is going to be constantly giving you homework but little things here and there are definitely helpful. Homework is a good thing. With that being said, it is ultimately YOU who chooses whether or not you want to be helped. The therapist is there to guide you and listen and give you validation. But it’s good for your therapist to also question you at times and make suggestions. A good therapist at times will even tell you things you may not want to hear but to ultimately change your frame of thinking. Remember, they are an unbiased person. That’s why therapy is so great. With friends, advice sometimes has too many emotions tied to it because you know someone on another type of level. The therapist-client relationship is not like that.
I hope I've helped in any way I can and I wish you luck on your mental health journey and wish you all well :)
- Sam Carosella, LCSW
