Why Is Finding a Therapist So Hard?

Tips from a therapist on finding one for yourself

Have you ever seen a post (or series of posts) on social media that makes you say, “Chile, you need to back away from the keyboard and go get a journal and a therapist.” That happened for me this week as I saw two seemingly politically aligned people go after one another for what was, to me at least, trivial. That seems to be happening a lot lately: social media beefs between people who are probably more alike than different. A lot of us are politically, socially, emotionally, and physically exhausted. We have years of piled up stress and trauma, and too often we confuse clapping back with emotional regulation. A lot of us, perhaps nearly all of us, need therapists.

I can’t tell you how many times I’ve advised people to get therapists over the years. It’s an occupational hazard of being a psychologist. But I’ll confess: finding a therapist is often a lot harder than we acknowledge. It might be harder than the search for any other medical practitioner. If my oncologist is highly skilled at treating cancer, I can work with them even if they have a crappy bedside manner. If my rheumatologist is skilled and has a good bedside manner, I will simply politely change the subject when they assume that being a seminary professor means that I am conservative.

It’s not as simple with a psychotherapist. When you’re sharing your most private thoughts with someone, you need to be able to trust them not just to be skillful but also to “get” you. In fact, their “getting” you is part of their skill-set. Your comfort with them is part of their skill-set. Therapy is part art, part science. The “science” part you can usually figure out with a look at their bio. That will give you the information about their degree and type of license, areas of specialization, theoretical orientations, and any special training. The “art” part, though, takes discernment and often some time spent in conversation.

“She who finds a therapist finds a good thing, and obtains favor from the LORD.” Okay, that’s not what Proverbs 18:22 says, but let’s be real: wives were abundant in ancient Israel. It’s not like women could be anything else. And even today with some of these cishet gender ratios. It’s definitely harder to find a therapist than to find a wife. Well, I’ve never looked for a wife, but I’ve had to look for a therapist a few times. It’s exponentially harder when you are a therapist because we have ethical guidelines that prevent us from working with people we know (it clouds our professional judgment and objectivity). But even in that situation, there are some tricks that many therapists use. So let me give some advice on how therapists recommend finding a therapist.

Step One: Get some names.

Start by asking for referrals from people you trust. Do you have a friend, relative, or church member who’s a therapist or other healthcare provider? Ask them for recommendations. You don’t need to provide a lot of detail about what you’re going through, but it would help them to have a broad description of the type of issue that you’re dealing with so that they can identify the right type of referral. That can be as broad as “I need to work through some family stuff” or “I think I’m going through some depression.” Don’t worry that they’ll be all in your business. Trust me, they don’t want to be. It’d put them in a serious ethical quandary.

If you don’t have anyone to ask for a direct referral, look at therapist directories. There are several online therapist directories that specialize in differential racial/ethnic groups, such as Therapy for Black Girls, Therapy for Black Men, Asian Mental Health Collective, South Asian Therapists, Latinx Therapy, Therapy for Muslims, and Native American Therapists (this last one does not seem to have been active for a few months and asks for more up-front info than I’d be comfortable giving to an unknown organization). You don’t have to be a member of those identity groups to use their directories. In fact, I think they’re great resources for people who do justice work and who want a therapist who is knowledgeable about race, racism, and systemic oppression. Another option is the largest therapist database, Psychology Today, which allows you to filter searches by a wide range of therapist characteristics, including gender identity, race/ethnicity, sexuality, faith, language, and specialities. [FYI, I tell students in my pastoral counseling classes to steer clear of anyone who leads with “Christian counselor'“].

If you are planning to use your healthcare plan to cover therapy, check your insurance provider to see if the therapists you’ve identified are on your plan. You should also check the therapists’ websites to see what insurance and payment options are available. A lot of therapists don’t take insurance (it’s a pain and often doesn’t pay well) but they will provide you with the paperwork necessary to get reimbursed as out-of-network providers.

If you don’t have insurance and cannot afford private pay, there are still options. Some therapists offer a sliding fee scale (check out Open Path Collective for a list). Many states have hotlines that will help identify a therapist for you. But a lesser known resource are the training clinics associated with graduate programs in clinical/counseling psychology, clinical mental health counseling, marriage and family therapy, and social work. A quick google search will help you figure out what schools in your area have programs. Then look at their websites to figure out if they have a training clinic. The clinicians in those programs will be graduate students, so they don’t have the same experience as licensed therapists. However, they are closely supervised by faculty and they are often more knowledgeable about the latest advances in clinical research than people who’ve been out of school for a while. And the faculty supervisors are often widely respected experts; in some cases, they might be the people developing the interventions that students are being trained in.

Step Two: Make contact.

Don’t assume that you’ve found your therapist just because you found a therapist. Ask for a preliminary consult. Many therapists will do a free 20-30 minute initial conversation just so you can feel each other out, either via webconference or face-to-face.

When you make contact, be honest with the therapist about why you’re coming in. Don’t pull a bait-and-switch, telling the therapist that you’re coming in for one problem and then springing something else on them once the relationship is established. No therapist is qualified to treat every issue. You don’t want to put the therapist in a bind where they are faced with a presenting problem that’s outside their limits of competence. So don’t tell them that you’re just going through a rough time and need some support when you’re actually dealing with an addiction.

When you meet with the therapist, pay attention to whether it’s someone that you feel like you can trust and like. Remember, this is someone whom you may see weekly (sometimes more often) for at least a while. You’ll be talking about tough things with them. It makes it more likely that you’ll stick through it if you have some sense of connection. You want to feel like your therapist cares about you. Don’t confuse your therapist with your friends, though. Therapy is not the same as friendship.

This list of questions from Psychology Today are good to ask during that initial consult: How might you best be able to help me? Have you dealt with concerns such as mine before and if so, how frequently? How does this process work? What kind of treatment modalities do you use? What’s a reasonable timeline for meeting and for treatment? If you are a minoritized person, I would also ask: What experience and training do you have working with people from minoritized backgrounds? If you’re not satisfied with any of their answers, move on.

Step Three: Don’t give up.

Therapy is hard even when you have the right fit. Stick with the process for a while. When I was in clinical practice, I would ask clients to commit to six sessions, at which point we could re-evaluate to see whether we were the right fit for each other. Sometimes it takes time to figure out if you’ve go the right person.

If you don’t have the right person, you are allowed to fire your therapist. Sometimes a therapist can only take you so far in your healing process and you need something different, even a different provider or treatment modality. It’s okay to acknowledge that and to bring the relationship to a close. Ideally, you will feel comfortable letting them know that you want to terminate treatment and telling them why. In some cases, they may even be able to refer you to someone who might be a better fit for you. If you have to end a therapeutic relationship for any reason, allow yourself to grieve. But don’t give up on finding the right – or the next right – fit.

Do you have a positive therapy experience that might help someone who’s considering finding a therapist? Or perhaps something that you’d wish you’d done differently in looking for a therapist? Please share it in the comments.