finding a therapist

Part 4: Navigating Initial Consultations

Most therapists offer some sort of free initial consultation as part of their intake process. For myself, this is a 20-30 minute phone call in which I ask potential clients more about what they’re looking for, tell them about how I work, and overall see if we would be a good fit.

Here are some things to reflect on and that you can ask the therapist:

  • What is their style? Do they offer specific and tangible feedback or do they prefer to remain neutral? Do they have a structured approach or are sessions open-ended? Are they directive or do they offer more of a listening space?

  • What modalities do they draw from? Specific certification isn’t that important, but there is a vast difference between traditional styles (psychodynamic, Freudian, etc.), cognitive styles (CBT, changing thoughts, etc.), somatic styles (feeling into your body, tapping, EFT, etc.), and so on. Other styles are more skills-based and behavior-oriented, like DBT.

  • What does a session with them look like?

  • Do you want homework/exercises to do between sessions?

  • Do they have experience working with people like you, or who are facing similar challenges?

  • How frequently would you like to have therapy? Weekly is standard, although due to a variety of factors I have many clients who I see every other week.

  • What is their full fee? Do they offer any sliding scale spots? It never hurts to ask.

  • If your insurance reimburses you for out-of-network care, can this therapist offer you a super-bill? This is an itemized receipt that you would submit to your insurance for reimbursement.

Most of all, just feel them out during the call. Is this somebody that you can imagine trusting and opening up to? A client once said they chose me because they thought I looked like somebody they could cry in front of, which I took as a compliment. Research shows that the strength of your relationship with your therapist is the most important factor in whether or not therapy will work.

If you’re not sure, let them know you’d like some time to think about it. Even if you decide to schedule a first appointment with them, you’re never locked in. Sometimes after a handful of sessions the connection you’d hoped for doesn’t materialize, and that’s okay too. Especially if you haven’t had therapy before, you’re simply learning more about yourself and what kind of support you need.

That’s all for now on this topic. I hope this series was helpful for you, and best of luck in your search.

Check out the other posts in this series, “How Do You Find a Therapist?”

Part 3: Starting the Process

So you’ve read the first post in this series and you have a general understanding of the lay of the land. You feel ready to take some action and start your search but don’t know where to start.

First, if you are lucky enough to have insurance, check with them first. In-network providers are the cheapest route, if it’s available to you. The trade off of going in-network means that you usually have less options for who you want to work with. Sometimes, workplaces also offer mental health benefits through a separate provider like Lyra. If you have a PPO plan, it’s possible that they will reimburse you part of your fee even if you find an out-of-network provider.

If you have the means to pay out of pocket, you can cast a much broader net. Check out the Therapist Directories. If you have trusted friends, ask who their therapists are and if they have any openings. It’s important to know that in the US, psychotherapy licensing is governed by state, so whatever therapist you find needs to be licensed in your particular state. Here are some questions to reflect on to narrow your search down:

  • Do you want to see them in person or via telehealth (phone/video)?

  • Do you feel more comfortable with a therapist of a certain gender?

  • Would you prefer a therapist around the same age range who feels like a peer, or somebody older? How would you feel if they were noticeably younger than you?

  • Do you care if they are licensed? Licensed clinicians have passed the licensing exam and usually operate independently. Associates/Interns are not licensed yet and work under a supervisor. While they have less experience they also usually charge a lower rate.

  • Does it matter to you if your therapist has any shared identities with you? Race/ethnicity, life experience, LGBTQIA+, etc. See my post about cultural sensitivity.

  • What specific issues are you hoping to address in therapy? Does this therapist specialize in that?

Hopefully this will give you some ideas about what you’re looking for. You can also google “therapist + issue + location” and see what pops up. Look at their photos, read their websites and their bios, and just see who resonates with you. There’s no exact formula to figuring out if you two will get along so don’t feel the pressure to figure it out right away. Most therapists offer a consultation call of some sort where you can feel each other out and see if it would be a good fit.

Then, start contacting the therapists on your list. Unfortunately, it is common to not get a response at all. Many clinicians don’t respond if their caseload is full, or they have a hard time keeping on top of their communications. It’s definitely a frustrating part of the process. For those who do respond, set up a consultation. Shopping around is normal, and a consultation doesn’t mean you’ve committed to this person. Next time I’ll talk more about how to make the most of these initial consultations.

Check out the other posts in this series, “How Do You Find a Therapist?”

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Part 2: Therapist Directories

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This post is part of my series on finding a therapist. This is a running list of resources to find an individual therapist.


General Directories:

Culturally Specific Directories:

California/Bay Area Specific:


Have any other ideas? Is some thing I listed no longer active? Let me know in the comments below.

Check out the other parts of this series, “How Do You Find a Therapist?”

Part 1: How Do You Find A Therapist?

This is a question I get asked all the time by family, friends, and even people I’ve just met. The American healthcare system is sadly dysfunctional and access to quality mental health services is challenging. For this series of posts, I’m going to give the same rundown that I give to my friends in hopes that it will make your process easier as well. Please note that my knowledge is limited to California, so your experience may vary.

First things first, finding a good therapist is HARD. Money, time, cultural fit, and availability all get in the way. Demand is high right now and most of my colleagues are burnt out to some degree or another. In my own practice, I’m noticing that clients are no longer leaving my caseload, whereas in years past there was a fairly constant turnover rate. Acknowledging that you need more support is an amazing first step, and it’s normal to feel demoralized when you really start looking. So cut yourself a bit of slack if you feel tempted to give up - it’s rough out there.

Secondly, a clarification of the different types of providers out there:

  • Psychiatrists (M.D.) have gone through medical school training (4 years) and a psychiatric residency (4 years) afterwards and maybe some additional fellowships. They are allowed to prescribe medication and most of them focus on medication management (prescribing, monitoring, etc.). Some psychiatrists also offer individual therapy, but it’s not common.

  • Psychologists (Ph.D or Psy.D) have a doctorate degree, which is usually a 3-7 year training program. They are trained to facilitate psychological assessments, such as if you wanted to find out if you have ADHD. They also have more research and clinical experience as well. Generally psychologists charge more for therapy because of their extended training.

  • Psychotherapists are Master’s level clinicians, meaning that they’ve gone through a 2 year graduate school program. There are a couple of different licenses that you might see out there, but in my experience as long there is enough variation between different graduate schools that their type of license doesn’t make much of a difference. I would say their clinical work experience is more important to take note of, mainly if they have experience working with clients like you.

    • Licensed Marriage & Family Therapist (LMFT)

    • Licensed Clinical Social Worker (LCSW)

    • Licensed Professional Clinical Counselor (LPCC)

Check out the other posts in this series, “How Do You Find a Therapist?”

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What Does Culturally-Sensitive Mean Anyway?

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Nowadays, “culturally-sensitive” care is a big buzzword in the mental health field. You might also hear the terms “cultural humility”, “culturally-responsive”, or “culturally competent” (although this one is less popular - how does one become “competent” in a culture?). But what does this all mean, and why does it matter?

Culture plays a huge role in shaping how we view ourselves and the world around us. Culture includes the arts, yes, and it also includes the values, beliefs, expectations, behavior norms, laws, institutions, and so much more that come with belonging to a particular group. These groups are formed based off of location, citizenship, race, ethnicity, gender, sexual orientation, religion, interests, literally anything you can think of. Culture is passed onto us through our experiences of being a part of that group. Sometimes it is explicitly stated (like No Smoking signs) but a lot of it is indirectly taught, based on how those around us behave or react to us.

We learn a lot of “rules” throughout the course of our lives as we soak in the culture of different groups. This teaches us what is “right” or “wrong” or “normal”. However, when you exist in communities where the dominant culture is not aligned with some part of your identity, it can be easy to think that the ways in which you are different make you “wrong” or “bad”. If you struggle to fit in, you may think that you are the problem. Even if you are a part of the dominant culture, nobody can get it “right” all the time.

Culturally-sensitive care recognizes that being different from the people around you doesn’t make your experiences any less valid. Culturally-sensitive care acknowledges that there is a wide breath of rich cultural heritages that all offer something unique and meaningful, and that often the problems come from the clashing of cultures instead of there being something inherently wrong with you. Culturally-sensitive care invites in all the different aspects of yourself and the cultures you belong to, knowing that your personal experience lives at the intersection of these groups.

So whether it’s finding a therapist who pronounces your name right, to finding a therapist who shares a similar background, getting culturally-sensitive care can make a difference. Feeling seen and understood by your therapist is the number 1 factor that indicates the effectiveness of therapy. Don’t you want to feel accepted for who you are, and all parts of yourself?