Finding a Therapist

Looking for a therapist can be overwhelming, especially since lots of folks turn to therapy when they're going through a particularly rough time. Below are some tips and tricks for understanding who you're looking for and how to find them.

Finding the right counselor is like dating or looking for a job. It's unlikely you'll find the best possible fit on the first phone call or session (or date or job interview). As you go through this process, be prepared to do a lot of reaching out before you find someone who might be a good fit who is also accepting new clients. Therapists who don't have openings often don't return emails or voicemails, which can make the process feel insurmountable at time, but you can do it.

Therapists and Payment Methods

Types of Professionals Who Become Therapists
Many professional paths lead people to becoming therapists. You may see some of the following: 

Who you pick is going to depend on a lot of different factors. On the whole, license doesn't matter as much as you might think. Look for someone who is a good relational fit first.

Finding a Self Pay Therapist
Paying for therapy out of pocket offers the widest variety of options. Full fee therapists usually charge between $160 and $280 a session for individuals and $200 and $360 a session for couples and partners. There are many self pay therapists available; not all of them will be a good fit, but many will have unique specialties, evening and weekend appointments, and/or extensive experience.

Plug in your city, "therapist" or "counseling", and a keyword about something you'd like to work on and see what comes up on Google, or check out a directory to find therapists near where you live.

Finding a Low or Reduced Fee Therapist
Community mental health clinics and some graduate schools have counseling centers, where graduate students and recent graduates gain experience before becoming licensed. Insurance rarely covers low fee services, and they usually cost between $30 and $90 a session. The Open Path Collective is a directory for clinicians with low fee slots in their practice and Sentio Counseling Center offers online counseling at affordable rates.

Some therapists are willing to lower their fee based on their schedule or the client's financial need. Other therapists offer reduced fees to allow them to work on their favored clinical issues (phobias, moral injury, self esteem, etc.) or with their favorite populations (people of color, single parents, queer people, etc.). Reduced fees are usually about half of a therapist's usual fee and are often for daytime slots.

Finding a Therapist Who Accepts Your Insurance
If you'd like to use your insurance, call your insurance company and request a list of approved providers. Research and reach out to the ones you think could be a good fit. If you are a MediCal recipient, you can find low or no cost services through your county's mental health ACCESS or 211 line. If you are a Northern California Kaiser member seeking an outside referral, back in 2021 a group put together tips and tricks for obtaining therapy here.

It can be very challenging to find a therapist who accepts insurance and has openings because insurance companies usually pay therapists well under half their usual rate.

Finding a Therapist Who Can Provide a Superbill
If you have out of network coverage, 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 helps.

How To Look

Get Help Before You Get Help
If you have a friend or loved one you trust, see if they can help you do some of the legwork of finding someone, especially calling around and see who has openings or finding out who your insurance covers.

Niches and Directories
Finding a directory that includes clinicians who specialize in a clinical issue or population relevant to you is 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 cater to alternative sexuality clients. Both The Pacific Center for Human Growth and Gaylesta focus on LGBTQIQ2-S clients. Native American Health Center provides both physical and mental health services for people of color. Therapist directories like PsychologyToday have detailed search features. 

Questions For You
Before you reach out to a therapist, consider the following questions:

Figure out what kind of person you would feel the most comfortable building a relationship with, but leave yourself open to being surprised.

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

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

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. You can look for a reduced fee, but haggling doesn't work well here. 

A therapist's clinical orientation tells you how they view their client's struggles, how 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.

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.

If you are a member of a subculture or marginalized community, working with a clinician who understands how that impacts your life can be incredibly validating.

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.

Connect With Metaphor Therapy

My name is MacKenzie Stuart and I'm part of Metaphor Therapy. We might have a good psychotherapist for you or your loved one. Learn more about our team and reach out.

© 2011-2024, MacKenzie Stuart, LMFT