How to Find a Good Therapist

As I’ve mentioned before, doing personal therapy during your counseling psychology program is usually strongly recommended or required in most cases.

There are a lot of benefits to doing personal therapy: you won’t look like a total naif in class when everyone else is talking about their therapy experiences, you’ll have experience from the patient’s point of view, you can learn a lot from your therapist, you learn about yourself, and you have somewhere to process the stuff that might be coming up during your classes/readings with someone outside the program. There are probably reasons that you chose to become a therapist in the first place. You can talk about those reasons and talk about whether this is the right career for you before you get further down this track.

Personally I had a lot of difficulty finding a therapist I liked and clicked with after moving to California. It took a lot of research and interviewing/consultations before I was able to find my current therapist who I am happy with. Part of the reason it was so difficult was because of the way insurance works in this state. (In Ontario, using insurance is so much easier, I really wish it worked the same way here.)

To anyone not familiar, California health insurance usually requires you to pay an enormous deductible completely out of pocket until you are eligible for coverage. You are also only able to see certain “approved” therapists that have applied to work with your insurance board. So certain therapists will take only certain types of insurance and if you want to see someone that does not “take” your insurance, you have to pay out of pocket. You might not be able to use your health spending account to pay for your sessions if the therapy was not ‘prescribed’ by a medical doctor. Some workplaces may offer an “EAP” or Employee Assistance Program where they allow you a certain number of therapy sessions that are fully covered, but these are usually only able to be used for short-term goal-based therapy like CBT (cognitive-behavioral therapy), and if you have any concern that is not easily put into a small box and “cured” with a few weeks of exercises and homework (read: most, if not all, psychological concerns), you’re out of luck.

Add to all this the fact that many insurance panels here are very nosy and require a label/diagnosis, may dictate treatment and how many sessions are covered, and add a mental illness diagnosis to your permanent medical record and it’s no wonder that many if not most therapists in private practice in my area do not apply to work with insurance panels and therefore are not covered by insurance. How in the world do you afford therapy out of pocket when you’re in school for counseling psychology and unable to work as an international student?

The first step will probably be trying to find a low-cost provider. Try looking on Open Path Collective to see if there are any in your area. You could also use a therapist-finder website like Therapy Den and check out providers’ websites to see if there is any mention of “sliding scale fees.” Many therapists will offer a lower fee to clients that are in need and can’t afford their usual fees. You might be able to come to an agreement on a fee that works for both of you, or you might be able to find someone whose fee you can afford as-is. You could also look for clinics where pre-licensed intern therapists work to accrue their hours before they attain licensure, such as those offered by CIIS, the SF Jung Institute, and other local graduate schools.

Gather a couple of leads on potential therapists and get in touch with each of them. You probably don’t want to just settle for the first therapist you find. This is a big investment in your time, money, and emotional energy, so you want to make sure you and your therapist have a good fit. Email the therapist about setting up a short consultation to talk about their personal style of therapy. Many therapists will offer a free 15-20 minute consultation to talk to you over the phone before you go ahead with therapy. Personally I think if they do not offer such a consultation it’s a huge red flag and I’d rather not be their patient. The consultation is not therapy, but rather a chance to see if you “click,” if you like their general vibe and get a good feeling from them, and to ask any specific questions you might have. Sometimes they might ask about what your main concern is just to get a general feel for whether they’ll be a good match for you, or sometimes they might rather stick to only discussing their approach and answering questions about logistics. Either way, you can learn a lot about a person through these short contacts and I would recommend consulting with multiple therapists before settling with one.

Once you do some consultations and choose a provider that you liked, you can schedule your first session. Many therapists with a full-time private practice will want you to commit to a certain weekly time-slot so pick a time that will (almost) always work for you. But don’t feel locked in, even once you have started therapy. You are always allowed to change your mind! You are allowed to “cheat” on your therapist and keep shopping around if you feel like it’s not quite right. You are allowed to fire your therapist at any time, for any reason, and to just stop seeing them without giving an explanation. Of course, for the sake of your own growth, it can be healthy to tell your therapist when they have done something that’s upset you, and to tell them you’re thinking of ending therapy before you do so so that you can work through those things together, but you are under no obligation to do that, especially if you don’t feel comfortable talking about that to this person, and especially during the first few sessions before you’ve really built much of a relationship. Do not feel that you owe the therapist anything in the beginning. Do not force yourself to “just stick it out and give it one more try” week after week if you are not feeling it with them. If you find yourself still questioning things after week 3-4, it might be time to schedule another consultation with someone else and keep searching. Ideally, you are looking for a natural fit, you want to find someone that you do feel comfortable talking about anything to.

This might sound like a lot of work, and it can be, but it once you find someone you really like to do therapy with it can be such an amazing, healing experience! Therapy can also be emotionally exhausting and sometimes uncomfortable, but having the right therapist that makes you feel supported through it all makes such an incredible difference. Genuinely liking and trusting your therapist and feeling genuinely liked by them in return is such an amazing experience that I hope you get to have, too. Don’t force yourself to keep seeing a therapist who you’re not sure of when there are so many great practitioners out there, especially now that Covid-19 has everyone offering appointments virtually. Life is too short!