Hi, my name is Jessica. I’ve been providing psychotherapy for over five years, now. That means a lot of introductions and assisting individuals with starting their therapy journey. Very often, I have someone come in feeling completely confused by and anxious about the entire process- which is fine; I am, of course, happy to help. It did inspire me, however, to share my own “Getting Started” guide. I’ve broken it down into parts. I hope that someone will find this helpful!
Identifying Needs for Mental Health Help
I believe that this is the very beginning of the journey. That is, identifying that you need help from a mental health professional. Here are a list of questions to ask yourself that will help you to create a clear picture of what it is that you need. For each, I will give a few examples of how each question may be relevant to different mental health needs.
What is happening?
-Are you experiencing severe anxiety? Would you describe your concentration as poor recently? Have you been struggling with the desire to abuse substances, or hurt yourself in other ways?
How long has this been happening for?
-Has it been a couple of weeks, or a few months? Do symptoms come and go? Or are they always present?
How bad is what is happening?
-Are you unable to concentrate on work tasks or homework? Are you unable to enjoy time with friends and family? Does the problem last all day, or only when in certain situations?
Who else notices that there is a problem?
-Has your boss mentioned an issue with your productivity? Is your spouse concerned? Do your friends say that you’re acting differently?
Have you spoken to a physician, or been referred by another medical professional?
-Have you seen a doctor, and been told that it may be a psychological issue?
Are there physical symptoms you are experiencing in your body that may be relevant?
-Do you experience severe headaches or stomachaches before a presentation? Are you feeling so tired that it’s hard to get out of bed, or take a shower?
What places or things are being affected by what you are experiencing?
-Are you able to go to the grocery store, or to the bank? Have you been avoiding certain places? Are you getting into issues within your relationships?
Are you aware of the cause of what you have been experiencing?
-Did these symptoms start after a major change? Did the symptoms happen gradually? Have you been feeling this way for about as long as you can remember?
Mental Health Professionals
Before we even get into some of the nuances of mental health professionals, I need to explain that no two therapists are alike! Below are just some of the most common differences between therapists, but they are not limited to this list.
Common Differences between Therapists:
-Therapeutic approach (e.g., Psychodynamic, Gestalt, etc.)
-Specialty (e.g., trauma specialty, psychological testing for ADD/ADHD, couples/relationships, etc.)
-Age
-Personality
-Culture
-Race
-Religious Beliefs
-Political Position
There are different types of mental health professionals that you can possibly work with. It will depend on where you are regionally located. I am based in the United States, but even here, titles can vary by state. That being said, the possibilities are not limited to this list.
Mental Health Professional Titles:
Psychiatrist (MD) [prescribes medication, but may also offer counseling]
Psychiatric Nurse Practitioner (PNP) [prescribes medication, but may also offer counseling]
Psychologist (Psy.D, PhD,) [administers psychological testing, but may also offer counseling]
Psychoanalyst
Licensed Marriage and Family Therapist (LMFT)
Licensed [Clinical] Mental Health Counselor (LMHC)
Licensed Clinical Social Worker (LCSW)
Licensed Professional Counselor (LPC)
Credentialed Alcoholism and Substance Abuse Counselor (CASAC)
Therapeutic Approach
There are several different types of therapeutic approaches! I can only list a few. I strongly recommend using Google to read more about what different approaches can offer a client/patient. Below are a few of several approaches:
-Cognitive Behavioral Therapy (CBT)
-Dialectical Behavioral Therapy (DBT)
-Gestalt Therapy
-Psychodynamic Therapy
-Eye Movement Desensitization Reprocessing (EMDR)
-Cognitive Processing Therapy (CPT)
-Somatic Therapy
-Acceptance and Commitment Therapy (ACT)
-Internal Family Systems (IFS)
Setting and Location
Therapists can be found in hospitals, schools, and community health centers. There are therapists for couples, for families, and for groups. For the sake of this guide, I will assume that you are seeking a therapist for individual therapy, that you will be seeing in an office (or virtually). You also have the option of seeking a professional group practice (where many therapists work under a group name) or private practice (solo therapist).
Methods of Contact
Okay, now you may have a good idea about what kind of help you need and what type of mental health professional you may need to see. You may be wondering now, “how do I find someone to see??”
Insurance Directory
If you intend to use your insurance benefits, taking a look at your insurance company’s directory is the best place to start. Your insurance company’s directory will be the easiest way to find out which therapists are in-network providers. You can also directly call and ask a representative for a list of referrals in your area.
Specialized Directory
Depending on how you self-identify, or on the issue that you hope to focus on in therapy, it may be worth looking for a directory that lists therapists from a specific group or with a certain specialty.
Examples of Specialized Directories:
-race/ethnicity based
-sexual orientation based
-gender orientation based
-presenting problem specialty (e.g., eating disorder, bereavement/grief, etc.)
-group based (e.g., veterans, teenage mothers, etc.)
-religion/belief based
-Mental Health Directory
Mental Health Based directories are specialized directories where the focus is on the provider. Usually the provider has joined after filling out a questionnaire that lets the directory know what specialties and populations they work with, and what insurances they accept. A popular directory is Psychology Today.
Google can help you to find therapists listed in your area, in addition to any of the other specifiers that you feel will be relevant to you finding your perfect match.
Doctor Recommendation
Your doctor may be able to offer a recommendation- it doesn’t hurt to ask!
Word of Mouth
Sometimes, people ask family and friends if they know of any good therapists. This is a very effective method too!
How Do I Pay For This??
Another consideration that sometimes causes individuals to become overwhelmed with this process is the payment! There are many options for payment, and one should not let this part get them discouraged. Most therapists are very understanding and offer options for if your insurance does not cover their services (more on this later in this guide).
Payment Options:
Insurance
According to your insurance plan, the costs may be fully or partially covered- you will need to follow up with your benefits through your provider. There should be a directory offered by your insurance company that lists all of the medical providers covered in-network. You can also call them to obtain a list of referrals.
Out of Network Coverage
If you find a therapist using a method other than your insurance directory, (e.g., Google), you may find that this is not an in-network provider. Some insurance companies will partially cover the session costs; that will depend on your insurance plan. It is best to call your insurance provider and obtain the information.
Advekit makes the process of using your Out of Network benefits much easier! Check them out here.
Employee Assistance Program (EAP)
Your employer may offer this program where they cover a certain number of sessions for you to see a therapist. It is worth looking into this option.
Sliding Scale Fees
If the previous methods do not apply to you for the therapist that you are interested in working with, you may ask for a reduced rate. Typically, this is referred to as a sliding scale fee. Most therapists have a predetermined set of rates that they are able to offer to those that cannot afford their full fees. Approval is subject to each individual therapist.
Out of Pocket/Self-Pay
This refers to fees that you are paying yourself.
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Okay! I have given you a lot to consider!
TL;DR:
-It can be helpful as you get started on your therapy journey to start thinking about why you need to work with a therapist. Thinking about who, what, where, when, why, and how is good.
-There are many different types of mental health professionals! Narrowing down which type you might benefit from working with can also be very helpful.
-There are several different ways to find a therapist to speak with. Two of the easiest to start are checking your insurance directory and using Google for therapists located in your area.
-You have many options for paying for therapy- don’t panic! Start with your insurance company first. You can also check with your job to see if they cover sessions.
Make sure that you check out Part II!