Finding a Therapist

Clinical Specialties, Niches, and Identity
Using a directory to identify clinicians who specialize in a clinical issue or population relevant to you can be a great starting point for any search. Many professional organizations and activists offer lists of clinicians and agencies who serve given populations:

• Bay Area Open Minds, the Polyamory-Friendly Professionals Directory, Tristan Taromino's Open List, and Kink-Aware Professionals all center the needs of alternative sexuality clients.

• Both The Pacific Center for Human Growth and Gaylesta focus on LGBTQIQ2-S clients.

• AAPA Therapists, Therapy for Black Girls and Latinx Therapy help clients find clinicians from similar cultural backgrounds, while Native American Health Center provides both physical and mental health services for people of color.

• The Jewish Therapist Collective, Bay Area Muslim Therapists, and Christian Counselor Directory have listings for clinicians familiar with or of given faith backgrounds.

• The Association of Family Therapists of Northern California, Northern California Community for Emotionally Focused Therapy, and the American Psychoanalytic Association center particular ways of approaching therapy, rather than clinician identity.

• The COVID-Conscious Therapist Directory supports clients seeking therapy from clinicians who acknowledge that the pandemic never ended.

• Therapist directories like Inclusive Therapists and PsychologyToday have detailed search features, which often include many of the identity or knowledge facets above.

There is a directory for virtually everything, so if what you're looking for doesn't happen to be here, try a web search.

Questions For You
As you explore options, consider the following questions:

• Might I feel most comfortable with a male, female, cis, trans, GQ, agender, or NB counselor? What age ranges might I feel most comfortable with?

Figure out what kind of people you would feel the most comfortable building a relationship with, but leave yourself open to being surprised. Having lots of things in common with a therapist can be a shortcut to establishing rapport, but isn't necessary to build a strong therapeutic alliance over time.

• What level of education do I want my therapist to have? Experience? Do I want to see someone licensed? 

Board of Behavioral Sciences-registrant therapists will have either a masters of a doctorate, having spent 2-6 years in school to complete that degree.

Meeting with a pre-licensed clinician can result in a therapist with fresh knowledge who may be more affordable, but who might also have less wisdom and intuition. A clinician who has been practicing for longer can bring finesse and extensive knowledge to the room, but may also default to offering the same thing to most clients or be less informed on the newest techniques. 

• How much is each session? Do they offer a reduced fee? How frequently do I want to have sessions? How much can I pay?

These questions will all inform each other. If you have $200 a month to commit to therapy and it's $100 a session, it's likely that you'll go twice a month if you went with that therapist. Some therapists are open to meeting every-other-week or monthly; other therapists only meet weekly or multiple times weekly. You can explore whether the therapist offers a reduced fee, but haggling doesn't work well here. 

• How and where do I want to meet? In an office? Outside in nature? Via telehealth? Telephone? Over text?

Therapists offer sessions in a variety of settings: offices, regional parks, client homes, remotely, and more. Regardless of whether you ever meet in person, seeing a local therapist can be helpful for identifying resources and referrals. Working with someone elsewhere in your state can minimize the chance that you'll encounter your therapist outside of session. State laws almost always require therapists to hold a license or registration for the state where the client is during the session. This means your therapist usually can't legally meet with you when you're out-of-state, even if you usually meet over the phone or via telehealth. 

• How do I want my therapist to think about mental health challenges, personal growth, and/or treatment?

A therapist's theoretical orientation tells you how they view client struggles, how they think those struggles came to be, and how they best feel they can help. Most therapists use a blend of orientations, commonly referred to as being an "eclectic practitioner." What matters is that a therapist can tell you why they have chosen to work the way they do and how they have seen that benefit clients, rather than any particular buzzword.

• Do I want my therapist to have any particular clinical specialties?

Virtually every therapist will have a good understanding of depression and anxiety, as those are the two most common presenting issues in therapy.

Therapists will specialize in order to build a more cohesive practice working on challenges they enjoy. Determine what you feel is pulling into therapy now and consider looking for a therapist that specializes in that thing.

• Do they share lived experience with me? Do they already understand people like me? If not, do they have the capacity to spend some time learning?

If you are in recovery or a member of a subculture, targeted population, or marginalized community, working with a therapist with experiential understanding of how that impacts a person's life can be incredibly validating. It can also lead to situations where you and your therapist know the same people or go to the same places, which not everyone wants to navigate with their therapist.

Sometimes it can be challenging to find folks with both a clinical specialty that fits your needs and population-specific knowledge, especially if they're seemingly unrelated (such as a polyamorous person seeking support in managing panic attacks). Again, leave yourself open to being surprised.

Therapists Who Can Provide a Superbill
If your insurance plan offers out-of-network coverage for mental health care, some therapists provide a special receipt called a superbill you can submit to your insurer for reimbursement. Begin by calling your insurance company to learn more about your OON coverage, including any deductible or limits to the kind of therapy your insurer will cover. At each session, expect to pay the therapist's full fee out of pocket, then get reimbursed by your insurer weeks or months later after submitting your documentation. Most insurance companies do not reimburse the full amount of the session, but every bit can help.