So you want to start therapy but have no idea where to begin?
You want help but you’re not sure what kind, you have insurance but you don’t know if it covers mental health services, and you’ve heard of CBT but it’s just another acronym to you. Don’t worry; I’m here to help walk you through all that today! Choosing a therapist can be a daunting task, but it doesn’t have to be. If you’re prepared with the right information, it can be a simple and painless process.
The first thing you need to do when starting this process is reflect on why you’re seeking help. Ask yourself: What do I want from therapy? Take some time on this one. Are you looking for a solution to a problem? Wanting to develop coping skills to better deal with life’s difficulties? Or hoping to gain insight into deep-rooted thought and behavior patterns that have been tripping you up? All of these things are wonderful, but it’s important to get specific on what you want so you can find the best therapist to help you work towards your goals for therapy.
Brief Therapy Versus Depth Therapy
If you’re seeking therapy because you want to find a solution to a problem or develop coping skills to better deal with a problem, you probably want to look for a therapist who practices some kind of brief therapy such as solution focused brief therapy or CBT. These therapies are focused on finding solutions to problems and therapists who practice this way are often more directive, giving you practical tools to deal with whatever you’re dealing with and make it better quickly.
If you’re seeking therapy because you want to gain insight into why you feel and act the way you do so that you can address your issues at the core, a depth-oriented therapy would probably be a better fit for you. A few examples of depth therapies are psychodynamic, existential-humanistic, gestalt, psychoanalytic, and Jungian. These types of therapies often explore patterns of thoughts and behaviors with curiosity around their origins. The idea is that when we’re able to gain insight into why we engage in certain thought and behavior patterns, we will realize our power and ability to change these patterns. This kind of therapy generally takes much longer than brief therapy but often results in longer-lasting improvements.
To help you understand… client presents with social anxiety:
Therapist A (Solution-focused therapist) approaches by: helping the client change their thoughts about how others perceive them and develop anxiety-reducing skills or behaviors (think relaxing breathing techniques or self-affirmations).
Therapist B (Insight-oriented therapist) approaches by: exploring the origin of the client’s social anxiety and digging in to some of their beliefs around how others perceive them. Deep-seated and long-held beliefs are often challenged and new perspectives are presented and explored.
*Most therapists integrate many theoretical orientations/approaches into their practice, so it’s likely that a therapist would say they practice both brief and depth therapies. Therapists often tailor their theoretical approach to what they feel is the best fit for their client and many times this incorporates elements of both solution-focused and insight-oriented therapies.
**If you know for sure you don’t want to talk about childhood trauma or your relationship with mom and dad, don’t go to a depth or insight-oriented therapist.
***If you want more than just tips, tricks, and skills to better cope with what you’ve got going on, don’t go to a strictly solution-focused therapist.
Insurance Versus Private Pay
I get it, you have insurance (and you pay an arm and a leg for it every month), so you want to use it! Unfortunately, it’s not always that simple when it comes to mental health care. We live in a country where there’s a lot of money to be made off of sick people and not a lot of money put towards helping people stay well. Insurance providers only want to cover what is absolutely necessary medically to keep you alive (but maybe not thriving), so therapy isn’t always something that’s covered.
I want to help you make an informed decision on how you choose to pay for therapy, so I created this handy diagram to guide you through the decision-making process (because it’s a lot more involved than people think it is). I know it looks confusing, but this is as simple as I could make it. More detailed information following the diagram to help you better understand and make a decision about your payment method.
Counseling for: a mental health disorder or personal growth?
Go back to your motivation for seeking therapy. Are you seeking therapy because you’re hardly making it through the day and life is super unmanageable? If that’s the case, chances are you’ll meet criteria for a mental health disorder. This is something insurance will cover if your plan covers mental health care (not all plans do). In order for insurance to pay for your therapy, you must receive a diagnosis of pathology. If life is pretty manageable but you’re wanting to go to therapy because you know things could be better if you put some work in, insurance isn’t going to pay. Self-improvement and personal growth are not considered medical necessities and therefore are not covered by insurance.*
*You can try to use your insurance for this, but it puts your therapist in an awkward and ethically sticky spot where they either have to tell you they’re unwilling to give you a diagnosis because they don’t feel you meet criteria or they have to stretch the truth a little to prove to your insurance provider that you need this service.
I think I may qualify for a mental health disorder, should I use my insurance?
Maybe. A few things to consider before you decide one way or the other. First off, are you okay with a mental health diagnosis being on your permanent health record? A few reasons you might not want that: could disqualify you from life insurance (a diagnosis of depression causes you to be seen as more at-risk for suicide) or cause your premiums to be higher than what they normally would be, could cause you to be denied from the military or security clearances, and you could potentially be treated differently by health professionals (or whoever else has access to your medical record) because of the diagnosis you have been given. If these are concerning to you, you may want to avoid going the insurance route. If these things aren’t concerning to you, insurance could be a great option.
What will my insurance cover?
To find out what kind of mental health coverage your insurance plan provides, you can call the number on the back of your insurance card to inquire about coverage. Some insurance providers don’t cover any mental health services, so if that’s the case, you’ll need to pay out of pocket for services and leave the insurance company out of it.
Some insurance providers require you to reach your deductible before they begin paying for any part of your therapy, so if this is the case for you, it’s important to know what you’re deductible is and whether you think you’re going to meet the deductible at some point throughout the year. Many people are on plans with super high deductibles that they never meet and these people may be better off choosing to not use insurance because their insurance most likely won’t be kicking in anyways.
Some insurance plans only require you to pay a co-pay (and they pay the rest) when you see a therapist, and this is usually when it is most beneficial to utilize your insurance. Ask your insurance provider what your co-pay for counseling services is so that you know what you’re getting yourself into financially.
Some insurance plans will cover a portion of out-of-network care. Ask your insurance provider if you have any out of network benefits, as you may be able to get reimbursed for part of your therapy cost even if your provider doesn’t accept your insurance. Your therapist will need to provide you with a superbill or receipt of services to send in to your insurance company for reimbursement and this is something that most therapists are willing to do if you ask.
I don’t think I’m eligible to utilize my insurance for therapy, but I don’t think I can afford privately paying a therapist. Help!
Therapy can be expensive and not everybody can afford the going rate of a weekly counseling session. Luckily, therapists understand this and many are accommodating of people who can’t afford the full fee. Some therapists offer a sliding scale fee schedule to accommodate clients with financial constraints and those who don’t offer this are often able to refer you to someone who is within your price range. You can also pay for therapy with an HSA or FSA account if you have one of those, which is pre-tax dollars. Also, don’t be afraid to rearrange or eliminate some of your daily, weekly, or monthly expenses to free up some cash for therapy. Making more home-cooked meals and cutting out alcohol or other unnecessary luxuries never hurt anyone that I know. Plus, the more you actively value your personal growth, the more growth usually happens.
Okay, I think I know what kind of therapy I want to do and how I want to pay… what now?
The fun part… now you get to look for a therapist! Psychology Today is a great place to go to find a therapist as the majority of counselors/therapists are on this site. For that reason, I’ll mainly focus on Psychology Today’s features but I would also like to give a shoutout to a new therapist directory site called Therapy Den because the search options are way better than Psychology Today’s in my opinion. There aren’t nearly as many therapists on it yet since it’s new, but it’s a wonderful site that’s focused on social justice and inclusivity, so if you’re looking for a therapist who is especially open to minority groups or oppressed individuals, this is a good site to check out.
If you type in counselor/counseling/therapist/therapy and your city and state, chances are Psychology Today will be one of the first sites listed, which is why most therapists are on this site. If you look at the search tools, you can filter therapists by specialties, approaches, gender, faith, ages they work with, insurances they take, languages they speak, and sexualities they’re comfortable working with. Most everything but the price of the session (which irks me because I think health professionals need to be up front about the price you’re going to have to pay for their services- but that’s for another time).
Filter out therapists based on whatever’s important to you. If your sexual identity is important to you, make sure you find a therapist who is affirming of that. If you want someone of the same faith, filter for that. If you’re struggling with a specific issue, look at who specializes in that in your area. If you’re looking for someone to help you develop skills to better deal with life’s obstacles, pick someone who seems competent and sounds like they know what they’re doing. If you’re looking for someone to help you explore the depths of your soul, pick someone you think you could connect and be vulnerable with. This is the fun part. Shop around. This is a huge decision. You’re about to choose someone to walk with you on your journey to becoming a happier, healthier you.
If you’re unsure about whether a therapist would be a good fit, ask them whatever questions you need answered so that you can feel confident about going into your first session. Therapists know that first sessions can be scary and most are willing to do a short phone consultation or at least answer whatever questions you have via email to make you feel more comfortable with beginning therapy. If a therapist doesn’t get back to you after you reach out to them, they may not have enough time in their schedule for new clients. Don’t let that discourage you, there are lots of options! And if you had a first session with someone and it didn’t go well, you don’t have to go back! You’re allowed to try out therapists for good fit and you don’t need to feel committed to the first one you try.
Happy hunting!
If you’re in the Lexington, KY area and looking for insight-oriented depth therapy, I might be your girl! I don’t do insurance but I have a very reasonable (at least in my opinion) sliding scale ranging from $60-$100. I especially love working with young adults in transition but I also specialize in working with those struggling with eating disorders and addictions if that’s something you’re looking for. Shoot me an email if you’re thinking about therapy or go ahead and book an appointment if you’re ready to get started!