26: How to Find a Good Therapist
If you’ve thought about finding a counselor or therapist, you know it can seem overwhelming. Remember that those first few sessions are essentially a time for YOU to interview the therapist to see if there are good vibes and a good fit for you. Don’t be intimidated by the process! I’m breaking it down with tips and advice about finding the right therapist for you. Join me for this episode!
Show Highlights:
The basics: What is the difference between therapy and counseling?
A breakdown of different providers and what they do: psychiatrist, psychologist, therapists, and counselors
How to find a provider–with and without insurance (Visit my Shop at www.strugglecare.com to download my FREE pdf file, Finding a Therapist.)
How to contact a provider when you’ve chosen one and what to say (Hint: It matters whether your private insurance is a PPO or HMO.)
What to ask during the first phone call about scheduling constraints, experience with your specific issue, typical sessions, etc.
Why it is OK to go into the first session with questions of your own
What you should communicate to the provider during the first session
How to ask the provider about their supervision, cancellation policies, emergencies sessions or phone calls
How to tell the provider that they aren’t a good fit for you
Probing questions you can ask to determine any biases/prejudices your provider might have around religion, spirituality, interventions, faith, LGBTQ people, gender identity, sexuality, psychiatric medications
How to figure out the therapist qualities that matter most to you
Safety resources in the US (See Resources below for details.)
Resources:
If you are in a domestic violence situation and need safety now, call the 24-hour hotline 1-800-799-7233.
If you are under 18 and need help, safety, counseling, or services, text “Safe” with your address, city, and state to 44357.
The Rape, Abuse, and Incest National Network (RAINN) is America’s largest anti-sexual violence organization. If you’ve been assaulted and need help, call their hotline at 1-800-656-HOPE.
Lifeline Suicide Help can be reached at 1-800-273-8255. They provide 24-hour free and confidential support to people in distress who need crisis resources.
The Trevor Project is a chat, text, and phone support line for LGBTQ youth in crisis. They provide peer programs and resources. Reach them at www.thetrevorproject.com.
NEXT Distro is an online and email-based harm reduction service designed to reduce the opioid overdose death rate, prevent injection-related disease transmission, and improve the lives of those who use drugs. Find them at www.nextdistro.org.
Never Use Alone can be reached if you choose to use drugs alone. Their operator will stay on the line with you while you use and notify emergency services if you stop responding. Find them at www.neverusealone.com and 800-484-3731.
Connect with KC:
Connect with KC: TikTok, Instagram, and Website (Find the FREE pdf, Finding a Good Therapist, under the “Shop” tab.)
Get KC’s book, How to Keep House While Drowning
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KC Davis 0:05
Hello, you sentient balls of stardust. Welcome to Struggle Care. I'm your host, KC Davis. And this is the podcast where we attempt to Depop psychologize, mental health and self care. Today I want to talk about how to find a good therapist. If you've been thinking about getting therapy or seeing a counselor, then maybe take a listen here. And I'm just going to talk about how to find somebody that you vibe with. Because it is intimidating to go into a therapists office because you feel like they are the expert. They are the authority. But the reality is, those first few sessions with a therapist, you are the one interviewing them, you are the one giving them a job. So keep that in mind as you look for a therapist. Now let's start off with some basic questions. What is the difference between therapy and counseling? Well, the truth is, there's not really a difference whether somebody calls themselves a counselor or a therapist. Tomato tomahto, really, there might be some instances where people would say, Well, you know, career counseling is not therapy. So that's true, right? And that, or people might say, well, occupational therapy is not counseling. But when we're talking about mental health counseling, we're talking about mental health therapy. So that's kind of how that works. Let's also break down the different types of providers that you might come across. Because I get this question a lot. What's the difference between a counselor, a therapist, a psychologist, and a psychiatrist? Well, let's start with a psychiatrist. Of all those people that I listed, a psychiatrist is the only one that can prescribe you medication. So a psychiatrist actually goes to medical school with other medical doctors, they are an MD, but instead of you know, when they go through medical school, but then instead of going to like a residency, and doing extra training for surgery, or for podiatry, they actually do their extra training in psychiatry, in mental illness. So they're the people that are going to give you medication. Now you can I have known psychiatrists that do talk therapy, but the majority of them really don't do therapy, or counseling even, except for medication counseling, meaning they'll counsel you on what medication is good. Typically, the experience of going to a psychiatrist is this, you go see them for an assessment, which is maybe 45 minutes or an hour, they prescribe you some medication, and then you'll meet with them again, a month later, for a 15 minute follow up. And for the most part, all of your sessions with your psychiatrist after that are going to be 15 minutes. It's just like any other doctor, they pop in, they ask you about the side effects, they ask you how your mood is doing. They adjust your meds, or they don't adjust your meds and then you come back in whatever time period. So a lot of people will have a psychiatrist and a therapist because the psychiatrist is handling the medication and the therapist is handling the actual therapy. So stepping down from a psychiatrist or not, sorry, not stepping down. But going down the list. A psychologist is someone who has gone to college, and then they went to get a PhD. So it's like college. And then they did like several more years of schooling. And then they did a postdoc, they went to school for like a long time. And psychologists, many of them do therapy. And psychologists are also the ones that are qualified to do testing. So if you want to be tested for ADHD, autism, any of those types of things, a psychiatrist can diagnose you with mental disorders, a psychologist can diagnose you, and a therapist can diagnose you as well. But a therapist can't do the kinds of assessments that psychologists can do, where you are sitting down and answering a long questionnaire that's getting, you know, rated and scored this sort of battery of tests. So oftentimes, you may be in a situation where you go to psychiatrists, you want medication, they'll say, Well, you got to go to psychologists to get tested and get your diagnosis. So that can be frustrating. And then of course, we have therapists and counselors, depending on what state you're in what country you're in, the laws around how therapists and counselors get their license may be different. I'm in Texas in the United States. And we require a graduate degree for licensed professional therapists and licensed professional counselors. And you can verify anyone's license online. And you should so whenever you're looking at someone, it's always good. You could just go on Google, honestly, and Google like your state or your country and then say licensed verification or something like that, and it should bring you up the ability to do that. Okay, so if you're looking for therapy, you're probably looking for a therapist or a counselor but there are some psych apologists that will do therapy as well. So how do you find this person? Well depends on if you're gonna go through insurance or not, if you're gonna go through insurance, there's a couple of ways you can do it if you have private health insurance like you do in the US. So and because I'm in the US, I'm going to primarily be talking about the US systems that we have to navigate. But if you're outside of the US, I'm still going to talk about like, how to vet somebody so that that's going to be helpful for you. Okay, so you're in the US, you're gonna call your insurance and ask them for a list, you could do it that way. You can also go on to websites like psychology today and filter by that you can look online for therapists near you and ask them if they have that. And then there are a lots of other ways that you can look for good therapist, I'm going to give you kind of a little list here. And this list by the way, you can go onto my website, struggled care.com, go to the shop and look for the PDF finding a therapist, it's free to download with all this information on it. Okay, so start we have Psychology Today. It's one of the oldest and most used therapist search sites, okay, it allows you to search by area expertise and insurance acceptance. If you're looking for low cost therapy, or you're having trouble affording therapy, I would check out Open Path psychotherapy collective, okay. It's a nonprofit nationwide network of mental health professionals dedicated to providing in office mental health care at a deeply reduced rate. Okay, open path. collective.org is that one, you can also check out the National Alliance on Mental Illness, which is nami.org. Therapy for black girls is an online space dedicated to encouraging the mental wellness of black women and girls, which is therapy for black girls.org. The Loveland foundation is committed to showing up for communities of color in unique and powerful ways focusing particularly on black women and girls. So check that out at the Loveland foundation.org. And then if you are a person of faith, you can look through your various churches or synagogues or communities of faith. If you are a Christian person, there's something called biblical counseling.com. You could look through that. And so those are places to start for when you're looking for a therapist. Okay, so what do you do when you pick somebody out? How do you contact them? What do you say? Well, let me make another note about private insurance, you have to know whether your private insurance is what's called a PPO or an HMO. Because if it's a PPO, you can go and pick somebody that's on your insurance. If it's an HMO, that means that you have to go to your primary care doctor first and get a referral in order for insurance to cover that. So as your primary care doctor about that, you can also ask, by the way the doctors in your life that you trust, if you have a primary care doctor, if you have an OBGYN, ask them for a referral, they often have somebody that they know. So let's talk about what do you actually say when you call this person on the phone? Remember that you are interviewing them, okay? Now, there may be the rare cases where you don't get to choose who your professional is, but we're going to talk about when you do, okay, so what's the first thing you do? When you call them? You're gonna call them up? And you're gonna say, I lost my notes. Here we go. Hello, are you currently accepting new clients for individual therapy? If so, let me know what your fee is. If you accept insurance, like what you know, put your insurance or if you accept Aetna. And if there's a convenient time, we can speak briefly to see if we might be a good fit. Thank you. You can say that on the phone. You can say that via email, unless you're going through a community organization or you're being assigned to therapist, most private therapists, they should give you a phone call, or a free consultation over the phone. Okay. And when you get that consultation, when they get a phone call, it's just a short call to ask them some questions. And here's what I would suggest asking, number one, talk about any scheduling constraints that you have up front. So say like, Hey, I'm wondering if you see clients on the weekends, because that's the only time I have available? Or do you see clients in the evenings I have a job from nine to five? Or do you see clients in the mornings, I have a nighttime shift, get that out of the way first, because a lot of therapists will have specific schedules and you would hate to get to the end of all these questions and realize that they can't even see you when you're available. Okay, the next question is, what kind of experience do you have with fill in the blank? So these might be identity related with so with gender identity with working with stay at home moms or issue related, what kind of experience you have working with depression or trauma? And then ask them in terms of approach? What is a typical session look like?
Your next question is I'm looking to attend therapy for that. And then either tell them the short or long term, okay? And ask them how long do you typically see clients because some therapists work on the short term. They'll say, Oh, I usually see clients for you know, eight sessions, and then we'll be done. Versus someone will say, Oh, I usually assume for years, and that it's helpful to end with you know, do you have any questions for me because often that therapist lost some questions for you. This is totally appropriate to ask for a short conversation to ask these questions, because not every therapist works with every expertise, and you can get a vibe and some answers done there. Okay. So when you go into your first session, typically speaking, you know that therapist will have something They want to ask you, they'll want to hear about your life. But you can also ask questions. So don't feel like you have to go in and let them drive, you can go in and say, you know, I have some questions I have for this first session. And here are some things that you can communicate with them. If you've had a therapist before, it's okay to communicate with them. Here are some things that my therapists have done in the past that have been really helpful to me. And here are some things that therapists have done in the past that were very unhelpful or harmful to me. And if you've never had therapy before, maybe just you can talk about your friends, it's helpful when you know, friends do this, or friends don't do this, during therapy, I would like to first focus on and then I'm going to give you sort of two examples here. And because one of these will be more applicable, you might be telling your therapist, I'd like to focus on exploring the roots of my issues and where they came from, and getting some sort of like deep healing, I want to jump right into that. Or you may tell them, I want to focus first on developing coping skills for the present moment, because I'm in a lot of distress right now. My biggest concern about therapy is tell them that and then ask them do you engage in professional supervision? So a lot of people will say, ask your therapist, if they have a therapist, I understand why. The idea that, you know, people should be in their own healing journeys to be any good to help others. However, that's a personal medical question, one that your therapist may not feel comfortable answering, it also doesn't really tell you how much work that person has done on themselves. Like just because they're not currently in therapy doesn't mean they've never been in therapy, doesn't mean they don't have other methods or communities that they're engaging in to continue their work. So asking if they have professional supervision is better. Now, professional supervision is something that is required, if you are a new therapist or an intern or something like that. However, most good therapists also engage in what's called peer supervision, where they'll get with other therapists, and they will help each other grow. They'll ask about cases, they don't use any of your identifying information. But if they're helping you, and they're kind of feeling like, gosh, I don't know what to do about this, they can go to somebody else and go, Hey, I've got a, you know, a female in her 20s really struggling with depression, you know, how do you think I should help? And then ask them what their cancellation policy is, you want to know whether this is someone who is going to require you to pay for a session, if you miss it, maybe they have, you know, you can miss one, or maybe you have to pay $50. And then also ask them if they offer emergency sessions or phone calls. You may not need it, but it's good to know. So those are questions that I was just asking in that first session. Now, if a therapist just isn't the right fit, you know, how do you tell them that? Well, first of all, I am someone who will tell you that it is okay to go see a therapist. Now, if you want to not go to a therapist, that's great. ending a relationship with a therapist is a wonderful opportunity to practice your skills in a safe place. But if the difference between you getting a therapist that works for you, and staying with a therapist that doesn't, is you're afraid to ghost them, just ghost them and go get somebody that works. If they're not the right fit, and you want to address that you can always just say thank you so much for your time. I don't think we're a good fit right now. But do you have a recommendation for a similarly experienced therapist that you respect, and I think you're gonna find that that will be helpful, because maybe they know someone. Let's pause here for a quick word from our sponsors. And then let's come back and talk about how to ask some deeper probing questions that might let you know whether your therapist has any bias that you need to know about. Welcome back, we're talking about how to find a good therapist. And I want to get into some questions that I think are going to be helpful to ask someone upfront things about religion, things about gender identity, things about medication, because, unfortunately, people have had the experience of working with a therapist that they really liked, that was really helpful. Getting six months down the road, when their therapist says something that's deeply hurtful, that's deeply prejudiced or bias. So for example, let's say that you do not want a therapist that is religious, and that's really important to you. Well, here's the issue. If you ask someone, are you religious, they will probably tell you if they are or they aren't. But that doesn't always give you the information that you need. Because I know some therapists that would not say that they are religious, but have like deeply, religiously influenced views about life. I also know therapists that are religious, that are incredible therapists that never bring religion into sessions that understand the difference between their personal religious beliefs and the goals and workings of a client that are like way better than even a nonreligious therapist. At the end of the day. Most of us don't want to know or care what the religion of our therapist is, what we do want to know our care is care Can this person do the job we need them to do without their own personal beliefs coming in? So here are two questions that I believe are more helpful in getting you the information that you need. Number one, do you believe that I can fully recover from the symptoms outside of a religious belief? or religious practices or religious ideas? That is a much better probing question. Because people might say to you, oh, I don't know what I don't bring religion in at all. But if this person has a personal belief that you can never not be depressed, unless you know, Jesus, that is going to influence the way that they give you therapy. Okay. The second question is, if I said, I do not want spiritual concepts to be a part of my therapy, what interventions would you use? And do you think that that would be sufficient to meet my goals, you don't want someone whose only tools in their basket are spiritual tools? If that's not what you're looking for? Now, let's talk about the flip side for a second, let's say that you are a person of faith, and you want to know whether your therapist is going to be prejudiced against that. So here are two a question and a statement that I think are gonna be helpful. Number one, just how familiar are you with the fill in the blank faith? Open ended? Let them answer. And then the second one would be, I would like for my religion, or my spirituality to be either you can say respected during our work, or you might even say incorporated into our work. So pick which one of those for you. And then the question is, are you equipped for that? And in what ways? So I would like for my religion to be respected during our work? Are you equipped to do that? And what would that look like? I would like for my spirituality to be incorporated into our work. Are you equipped for that? Okay. Next thing, when you are assessing whether somebody has bias or prejudice against the LGBTQ community, in my experience, it's not enough to say, do you work with gay people? Will you work with transgender people? Are you against XYZ? Because the most conservative therapists that I know would say, Oh, yes, I work with anybody. Everyone's welcome here. But they don't mean the same thing that somebody else means when they say that. Okay, so here are the two questions that I think are going to be more helpful to you. And here's the reason I say this, y'all, I got my counseling degree out of seminary. So I intimately know the kinds of people that are religiously trained. I am a professional therapist, I know lots of therapists that are not from seminaries, I know those people, like I know, therapists. And I can tell you that there are some of these people coming out of religiously trained institutions that you do not want giving you therapy. And there are some people coming out of religious institutions that are much better therapists than people coming than somebody coming out of a non religious place. There are people coming out of non religious places that have deeply embedded bias and prejudice that they're unaware of around these issues, and there are some coming out that don't so it's not enough for your own safety, it's not enough to just know are they are are they not religious? Or they? Or were they not trained in a religious place? Here's the question that I believe is going to be much more helpful to you is, do you feel I can fully recover from my mental health symptoms without changing my gender identity? Or my sexuality? Or might just like fill in the blank? Right? You need an honest answer to that question. Because if you're with somebody that at the end of the day is going to bring it back to well, I really think that, you know, you're not gay, it's really just the abuse, you need to know that upfront. Okay. The second question, how will we work on managing my symptoms while still honoring my gender identity? Or my sexuality, etc, etc? Make them get specific with you? Because someone who does not know how to do that will not be able to answer that question. Okay. And then the last question, I think is helpful is to ask somebody, what is your view of psychotropic medication? Or what is your view of psychiatric medication? Or what is your view of taking medication for mental health
symptoms? Because y'all some people have some wacky ideas. Some therapists have some weird ideas about mental health medication, and that's something you want to know before you go in. I have another worksheet on my in that packet of finding a therapist that talks about therapist qualities that I think is helpful to take to your therapist. It's about what kind of therapist Do you prefer, and allows you to rate your preferences things about? Do you want someone that mostly listens or someone that leads the conversation? Do you want someone to help you discover things for yourself or to tell it to you straight? Would you rather have someone understand you or challenge you? Do you like it when a therapist relates to you about their own life? Or does that make you uncomfortable? Do you want to focus on healing the past or do you want to focus on developing new skills? And then lastly, some people like it when their therapist shows them that they care error. And some people are deeply uncomfortable if their therapist gets emotional, and good therapists can do both of those things, or all of those things, or some of those things. It's just so if you're with a therapist and they get emotional, that's uncomfortable, you don't have to break it off that therapist doesn't work, she gets emotional, good therapists, can meet you where you are, and change their approach depending on what you need. So we have to communicate with our therapists, a therapist, at the end of the day, is not an expert there to tell you what to do or give you advice. A therapist is a practice relationship with someone who is paid to put their own shit aside, so that they can accurately reflect to you what you are going through what you are feeling, and give you the arena to work some self stuff out. So it's a safe place to practice saying, Hey, I didn't like that you said that. It's a safe place to practice saying, you know, I wish we would go in this direction, give that therapist a chance to, you know, shift to a different thing. But it's helpful to take this sheet in at the beginning and say, this is kind of what I'm thinking. So I want to end this by giving you guys just some safety resources. Some things to know about. Particularly these are going to be USA resources. I'm just not familiar with ones and other countries. And so if you are in a place where you need safety now for you or your children, you're in a domestic violence situation. There is a 24 hour phone hotline chat hotline, if you call 1-800-799-7233. If you're under 18 and you don't know where to go for help. You need a place to stay you need counseling services, you can text safe with your address, city and state 244357. The Rape, Abuse and Incest National Network is America's largest anti sexual violence organization. If you've been assaulted and you need help, you can call their hotline at one 800 656 hope that 656 H O P E, the lifeline suicide helpline number is 1-800-273-8255. They provide 24/7 free and confidential support to people in distress prevention and crisis resources for you or your loved ones and best practices for professionals as well. The Trevor Project is a chat text and phone support line for LGBTQ youth in crisis. They also offer pure programs and resources. You can check them out at the Trevor project.com Next distro is an online and mail based harm reduction service designed to reduce the opioid overdose death rate prevent injection related disease transmission and improve the lives of those who use drugs. You can check them out at next bistro.org They will send you Narcan in the mail and other harm reduction supplies. Never use alone. If you are going to use drugs by yourself call them you will be asked for your first name, location and the number you're calling from. An operator will stay on the line with you while you use and if you stop responding after using an operator will notify emergency services of an unresponsive person quote unquote at your location. They are at never use a lone.com or you can call them at 800-484-3731 Stay safe out there you beautiful people stay safe. Until next time