Options -> Choice -> Evaluation -> Decision
After a considerable amount of time experiencing symptoms of anxiety, you have decided to seek the help of a licensed therapist. First, though you need to find a therapist. Often with medical doctors, you can simply ask friends and family which doctors they go to, but finding a therapist presents a trickier challenge. Whereas people often talk quite frankly about going to a medical doctor, they tend to be much quieter about their trips to mental health professionals. Furthermore, if this is your first time seeking therapy, you might not be comfortable openly asking those around you for guidance. So what should you do?
This article will provide some suggestions for where to start and what sort of questions you should be asking when you evaluate a therapist. Keep in mind, the perspectives presented here are based on my experience as a research scientist and as an individual who himself goes to therapy for an anxiety disorder. Always consult with a licensed professional when possible.
Step 1: Determining Your Options
The first step in choosing a therapist is to figure out what options are available near you. If you live in a major metropolitan area, you likely live in proximity to hundreds if not thousands of licensed therapists. However, if you live in a more rural area, your options might be more limited. Below are four approaches to determining your options.
College Clinical Services
If you happen to be a college student, many colleges and universities now offer on-campus counseling services. These services are often limited in scope such that students can only attend a set number of sessions before they are referred to a therapist in the community. However, they may have exactly what you need to cope with your symptoms. Furthermore, they often provide a full evaluation of your symptoms, help identify potential diagnoses, and have strong connections with therapists in your area. Consequently, they are capable of providing incredibly helpful advice in finding a therapist who you can see for a longer period of time.
If you do not have access to college services, the next best step would be to consult your medical doctor. Family and general practitioners often have some experience with mental health issues, and they will typically know of qualified individuals in your area who can be of assistance. This option is a strong one in that, assuming you have seen this doctor more than once, they will be aware of your experiences and might have a better sense of which therapist will be a good fit for your particular symptoms.
If you don’t have any of the above options, you can also search for therapists in your area by visiting websites such as MentalHealth.gov or the American Psychological Association’s (APA) Psychologist Locator. Both of these options allow you to narrow your search results by the type of services you are looking for, and the APA tool even allows you to specify therapists with certain specialties or who treat certain age groups. You can also use the search engine of your choice to see what is available in your area. Simply searching “clinical psychologist anxiety [insert your area]” will return any number of results. However, I must caution against taking this approach. Search engines often return an overwhelming number of responses, and you are left to your own devices to determine the quality of these results.
Your Insurance Provider
Insurance providers not only have a list of therapists that they cover in your area, they can also help you find one who specializes in your symptoms. Thus, in addition to all of the above options, you can contact your insurance provider for assistance as well.
Step 2: Choosing Who to See
Your search has probably returned more than one viable option. The next step then becomes determining which therapist to see. Remember! You are never “locked-in” to seeing a particular therapist (more on that later). However, here are some pointers for winnowing down your choices.
Does the therapist have experience with your particular symptoms?
Often clinicians are skilled in helping with any number of common mental illnesses and symptoms; however, others specialize to a much greater degree and focus only on certain issues. In most cases, you should be able to see what a given therapist specializes in by checking their website (if available) or calling them at their office. When examining their specializations, you also want to ensure that the individual is licensed and qualified to provide therapy.
Does the therapist utilize “evidence-based” approaches?
In the world of clinical psychology, there are an untold number of theoretical approaches and beliefs regarding how to treat mental illnesses. However, they are not all made equal! You want to be sure that a potential therapist uses techniques and approaches that have been scientifically proven to work. Specifically, you will want to look for phrases such as “evidenced-based therapies” and “clinical experience” including but not limited to behavioral, cognitive behavioral therapies (CBT), or dialectical behavioral therapy (DBT). Good therapists will not limit themselves to only one set of therapeutic techniques and will often incorporate a combination of approaches to help their clients. To see what approaches a particular therapist uses, you can check their website or contact them directly.
Payment – Does your insurance cover this particular therapist?
Fortunately, most insurance companies cover even routine visits to therapists. Unfortunately, much like their colleagues in the medical field, not all therapists are covered by all insurance plans. Always double check with your insurance provider that your insurance will cover the person you are about to visit – as well as how many visits are covered and what are the deductibles, co-pays, and annual maximum payments. In addition, you want to know how much each session will cost you and what forms of payment they accept.
Step 3: In-Person Evaluation
After finding and choosing a therapist that you want to see, the next step is to determine whether or not a particular therapist is right for you. But what makes a particular therapist the “right” one? You want to see a therapist who you trust, respect, and believe has a good understanding of you and your symptoms, and you also want to get along with this person on an interpersonal level. You will not know these things immediately. In fact, you probably want to attend at least four sessions with a therapist before determining if they are the right fit for you. Selecting a therapist is an important life decision, and you want to make sure that you have enough information before deciding anything for certain.
Along this line, you want to prepare ahead of time before your first visit. Ask yourself questions such as, why are you seeking therapy? What is bothering you emotionally/mentally? Have any of your behaviors changed? Be honest when answering these questions, and don’t be afraid to write down the answers and bring them with you to your first session. Also, prepare any questions you might have for the therapist. For instance, you might want to know what times of day they usually schedule appointments, how much experience they have with people like yourself, and how they might handle emergency situations. Any therapist should be prepared to answer these type of questions.
Step 4: Making Your Decision
At this stage, it is quite possible that you have found a therapist that is right for you. You sought out the therapists available in your area; you found one who specializes in your symptoms and uses evidenced based therapies; and after a few sessions, you now feel comfortable seeing this person on a consistent basis. Great! It is also possible, though, that you still don’t feel like this person is a good match for you and/or your symptoms. What then?
To be sure, you need to give a therapist a legitimate shot. Often times, the treatment of mental illness is a slow process, so you must be careful to not write-off a given therapist simply because your symptoms are still bothering you. If you do not feel that your therapist is properly addressing your needs or concerns, first bring it up with them. Talk to them about how you don’t feel they are helping you. More likely than not, they will understand that every client’s needs are different and will have no problem trying to reframe their approach.
However, if after having this conversation with your therapist things do not improve, you might want to consider finding a new therapist. In some cases, you can even ask this therapist for referrals to other individuals they think might be a better fit, especially if you can articulate why you want to see a different person. For instance, you might want to see a therapist who specializes in a different approach or is the same gender, race, or sexual orientation as yourself. If for some reason you can’t ask the therapist you are seeing for a referral, you can return to Step 1 of this list and start again. Remember, you are not locked-in to seeing a particular individual.
Hopefully this has provided a useful starting place for finding a therapist. If for whatever reason, you need more immediate care, please do not hesitate to call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or contact them online at https://www.mentalhealth.gov/get-help/immediate-help/. Both of these sources are “crisis hotlines”, meaning that you can contact them even if you aren’t contemplating suicide. In the case of an emergency, please call 911. Though treating mental illness can sometimes be a long and slow process, know that there are resources out there to help.
Sam Hunley holds a doctorate in cognitive psychology from Emory University. He pursued his Bachelor's degree in psychology from Furman University and a master's from Emory. Sam's research, alongside Dr. Stella Lourenco, focuses on human perception of the space surrounding the body, exploring the impact of anxiety and phobias on this perception. Together, they contribute to Anxiety.org articles. Post-graduation, Sam became a Presidential Management Fellow.