I remember the first time I considered going to therapy. I had so many questions and wasn’t sure how any of the process worked.
How could I find a “good” therapist? What kind of questions should I ask or paperwork would I need to do before even having an appointment? What would happen in the appointment?
So many unknowns!!
Many folks find themselves facing these same, or similar, questions when they are considering therapy for mental health support. In this 2-part series, I’ve outlined the process with specifics from my own approach as a therapist. Some of the information included is specific to my practice and how I operate as a mental health provider, but quite a bit of it applies to overall questions about the therapy process.
As a reminder (or in case you’re new here), I’m Michelle F. Moseley, LCMHC (Licensed Clinical Mental Health Counselor) in North Carolina. I provide both individual and group therapy services to adults via telehealth. I specialize in working with survivors of spiritual abuse and religious trauma. I also provide counseling around body image concerns from a weight-inclusive, HAES-aligned perspective. Sometimes these concerns overlap for my clients. Other aspects of my therapy practice include neurodivergent-affirming assessments and services for late-identified ADHD, Autistic, and/or AuDHD adults, continuing education for mental health providers, and informational workshops on mental health topics.
Now back to the topic at-hand. You’re not in a crisis, but you are interested in starting (or resuming) therapy. Where do you begin? (Feel free to skip sections or jump around based on your particular needs or questions.)
Identify Your Needs / Preferences
Some folks may be able to identify quite a few specific needs or preferences that will help guide their search for a therapist. Others may have more of a general sense that they need some support in navigating life, but aren’t sure about the specifics.
Here are a few things to consider as you’re thinking about what to look for in your search:
- Your current concerns, issues, or symptoms. Think about what is going on that you’d like to address in therapy. You may be dealing with something specific such as the impact of a recent life transition or loss, ongoing symptoms of a diagnosed mental health condition, or difficulties related to past experiences of trauma. You may not be able to identify a specific concern or symptom, but are aware of an overall sense of overwhelm or not feeling like yourself. Identifying these needs will help you in searching for a therapist.
- Specific traits, characteristics, or identities of the therapist. Consider if there are certain traits, characteristics, or identities that you would prefer in a therapist. For example, some folks desire to work with a therapist who shares important identities with them (things like race or ethnicity, being a part of the LGBTQ+ community, religion, or political views). Personally, I have had folks specifically seek me out based on my identities as a fat person, a survivor of spiritual abuse, and/or being late-identified neurodivergent. I have also had folks ask me about aspects of beliefs and values that are important to them. You, as the potential client, are free to ask about anything that matters to you. Each therapist is responsible for making their own determinations about how much they share with clients regarding their identities and beliefs. Some individuals looking for a therapist may know there are specific characteristics or traits they do not prefer in their provider. For example, I have frequently worked with folks who wanted to talk about body image but did not want a thin provider due to fear of being judged. I’ve also often been sought out by those who wanted to work with someone who understands religious trauma but who did not come out of the same group the client was part of because that felt too close to their harmful experience.
- Speciality areas of the therapist. Do you want or need to work with someone who specializes in a specific concern or type of therapy? Maybe. Seeking a specialist can be helpful when you have a very specific area where you need support or when you’re seeking out a certain type of therapy that requires additional training (things like EMDR, Brainspotting, Somatic Experiencing, etc.). Working with someone who has a more generalist approach can be helpful if you’re uncertain exactly what you want/need in therapy or if you’re new to the therapy process and just beginning to learn about your mental health and coping skills.
- Location. Telehealth or In-Person Services. Where are you? How do you want / need to receive therapy services? In the United States, licensed mental health providers are limited to only providing therapy services to folks who are located in states where we hold a license to practice. Some providers hold a license in multiple states, while others are licensed in only one state. This law can feel like a hindrance in a time of virtual therapy, but it does currently dictate where therapists can provide therapy services. So, be sure to consider your location. For in person services, how far are you willing and able to travel to get to therapy? Are you near a state border, which may open up your search to therapists who are located in towns near the border (assuming you can travel there as needed)? For telehealth, you’ll want to search for therapists who are licensed in the state where you are located (or where you will be located during sessions).
- Payment options and pricing. Consider if you want/need to use insurance to pay for therapy or if you prefer to pay privately. Use of insurance often means lower out-of-pocket costs per session. However, using insurance also means you are required to have a mental health diagnosis placed in your medical records and that the insurance company can dictate aspects of your therapy (read more here). Working with a private pay therapist may mean a higher price out-of-pocket for each session. However, you and the therapist are able to work together regarding any use of diagnosis and the format / frequency of sessions, without worrying about insurance regulations. Private pay therapists may offer reduced rates for some clients, and are often able to accept FSA/HSA cards for services – you can ask about these options.
These are some of the things that can be important to consider when thinking about starting therapy.
Searching for a Provider
Once you have an idea of what you’re looking for in a therapist, the next step is to search for a provider. Many people are familiar with the big, online therapy directory hosted by Psychology Today. While this can be an okay place to find a therapist, I am not going to link them here. They have recently partnered up with one of the multiple venture capital tech companies that is advertising to offer mental health services and many therapists believe the directory is suppressing independent therapists from showing up in searches and directing folks toward those employed by the tech company. The issues of tech companies controlling mental health access and practice are beyond the scope of this post, but I wanted to mention why I am not including this well-known directory.
So, what are some ways you can go about searching for a therapist?
Ask Around. If you have friends, family, or other connections who value mental health and therapy, you can ask them if they have suggestions for a therapist. If you know a therapist in your personal life, ask them if they may know someone who might be a good fit for you. I’ve been able to offer recommendations to friends when I knew someone who fit their needs, and I was happy to help make the search a bit easier. (My code of ethics prevents me from providing therapy to people in my personal life, such as friends, family, etc.)
Your Insurance Carrier. If you do want / need to use insurance for therapy, contact your insurance provider and ask for a list of therapists in your city / state. You may need to request a list of “behavioral health providers” as this is a term frequently used by insurance carriers.
Internet Search. Some states or counties have a listing of local mental health providers available online. It may be helpful to search one or more of the following terms:
- “Therapist in [city, county, or state]” – for example, “therapist in Chapel Hill, NC”
- “Mental health counseling in [city, county, or state]” – for example, “mental health counseling in Chatham County, NC”
- “[specific concern] therapist near me” – for example, “anxiety therapist near me”
- “[specific identity] therapist near me” – for example, “Black therapist near me”
Online Directories. There are several online therapist directories out there. I have listed a few (in alphabetical order) that I am either personally familiar with or have heard positive things about from other therapists.
- Asian Mental Health Collective – Asian mental health providers; offers a US Directory and a Canada Directory.
- Body Trust Provider Directory – Professionals who have completed the 12-month Body Trust Certification and work from a weight-inclusive lens; not limited to therapists.
- EMDRIA Therapist Directory – Therapists who are trained in EMDR; hosted by the the EMDR International Association (EMDRIA) and only includes EMDRIA members.
- Inclusive Therapist Directory – Therapists who embrace values of inclusivity; provides ability to search by various identities of the therapist.
- National Queer and Trans Therapists of Color Network (NQTTCN) – Therapists who hold identities as Black, Indigenous, and/or People of Color, as well as queer and/or trans identities, and who work with those who hold these identities.
- Neurodivergent Therapists Directory – Providers who are neurodivergent and who provide neurodivergent-affirming services.
- Open Path Collective – Providers who are committed to offering lower-cost services through Open Path.
- Reclamation Collective – Providers who have experience working with spiritual abuse and religious trauma; includes some providers from outside the US.
- Religious Trauma Therapist Directory – List of therapists who work with religious trauma, hosted by Empathy Paradigm.
- Therapy for Black Girls – Directory of providers who focus on therapy for Black girls and women, many of the providers listed are Black or people of color.
- Therapy for Latinx – Providers of Latino/a / Latinx background who focus on serving Latino/a / Latinx clients.
Contact Provider(s)
Once you have found a therapist (or a few) who seem like they might be a good fit for your needs, the next step is to contact them. Hopefully their website or directory listing makes it clear how you can get in touch with them.
My website has a contact form linked at the top of every page and in several other places on most pages. This allows visitors to easily complete the form, which comes directly to me, so I can follow-up on their needs. I do my best to follow-up on any inquiries within 24 hours. I provide a free consultation prior to scheduling a therapy appointment to allow for potential clients to ask any questions they may have and to help ensure that it seems like my services are a good fit for the potential client’s needs.
Check out Part 2 where we take a look at what happens after you’ve made initial contact with a potential therapist.
Michelle F. Moseley is a Licensed Clinical Mental Health Counselor in NC. She believes ALL people deserve respect, compassion, and access to mental and physical healthcare. Michelle specializes in working with survivors of religious trauma, and with those who have body image concerns, finding there is frequent overlap in these areas. She also frequently supports late-identified neurodivergent individuals as they navigate the grief and relief of a new understanding of self. You can learn more about Michelle by visiting her website at MichelleFMoseley.com or following her on Instagram – @therapy_with_michelle
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