How To Start Therapy: From Finding a Therapist to Your First Session
Sometimes people get caught up in searching modalities, degrees, or a number of things- but they don't consider the type of person they could envision themselves having real and vulnerable conversations with.
Starting therapy can feel overwhelming, especially if you’ve never been before. Between figuring out what kind of therapist you would need, understanding what their credentials mean, navigating pay structures, and scheduling your first appointment- the process can feel like a lot (because it is).
We previously launched our four-part Therapy 101 resource series to help people through the process of finding a therapist. Now we’re bringing everything together in one piece for anyone that is still asking themselves: How do I even start therapy?
But first… Have you decided that you want to start therapy already, or are you still on the fence?
How do you know if you want to start therapy?
There are many reasons why someone may seek to start therapy and there is no right or wrong way to do it. Some people start therapy due to feelings of anxiety, depression, grief, or general overwhelm about life (or honestly the state of the world). Some start to help make sense of something they can’t process or figure out on their own, though they’ve tried.
Sometimes, depending on what the person is looking for, the support needed might be better achieved through different services. In our What Type Of Support resource we provide a quick checklist to help determine if what you are looking for might be found through coaching, community groups, or therapy. For a deeper look at the differences, explore coaching vs. therapy blog post.
If after considering your options, you feel ready to start therapy but aren’t sure where to start, let's dive in!
What should you look for in a therapist?
It shouldn’t come as a surprise that people like to ask us therapists- “how do I even find a therapist?”. Our founder’s go-to response is asking them to consider what type of person they would feel most comfortable speaking with. Sometimes people get caught up in searching modalities, degrees, or a number of other things- but they don’t consider the type of person they could envision themselves having real and vulnerable conversations with.
It’s hard to make that type of determination if you’ve never thought about it- but we invite you to consider these prompts as outlined in the Before You Search resource. No one can advise you on who you would feel comfortable with, because no one can know better than you.
As therapists, we like to tell our clients that you are the expert of your own life and we are here to help guide you on your path- and we mean that.
As a young woman would you feel comfortable talking with an older male? As a person of color would a BIPOC therapist help you feel seen or more scrutinized because of the assumed similarities? Keep in mind that shared social identities do not equate to shared experiences, values or comfort. Perhaps you know someone that has spoken highly of “DBT” or “CBT”, “EMDR” is a hot one right now too- all of these are things to consider when you are looking for a therapist.
What do therapist credentials mean?
What do all of those letters mean when they follow a mental health practitioner’s name? Do any of them determine which one will be a better therapist than any other? Not necessarily- Decoding the Alphabet Soup resource breaks down what common therapy credentials mean. The difference between counselors, social workers, and psychologists (doctor levels)- has a lot to do with the specific curriculum and course materials that each field requires. A Psychiatrist is an MD (or DO) that prescribes psychotropic medications. Psychiatric providers also include Nurse Practitioners (NP) that have specialized training in the psychiatric field.
These professions involve years of schooling and clinical training, with certification and licensure requirements that vary by role and state. All must be in good standing in order to practice.
How to find a therapist
Now that you know what kind of therapist you think you would feel comfortable opening up to, including modality and credentials- where can you find them?
Many therapists are findable in Google searches. Therapists put a lot of work into making themselves easier to find online, so you can get as detailed as you’d like and a list of individuals that fit that criteria will appear. AI is also able to pull information on who is available based on your request and prompts. Note that AI can make suggestions but they may provide information that is inaccurate or outdated- always check any details you get from AI directly from the source (the therapist’s website is a great place to start).
The “old school” ways still work perfectly well. Before we go as far back as using a rolodex at your next annual doctor’s visit (some do in fact still have rolodexes and this is how some referrals could reach a good match), Psychology Today is a classic online directory that for decades was the go-to and standard.
Nowadays there are dozens of online directories where you can note what your preferences are; including gender, race, ethnicity, sexual orientation, religious standing- and search based on those criteria. You may be able to find a therapist with more aligned values who has greater compatibility with you. In these directories therapists will disclose how to reach them, their rate, and how they handle compensation.
Does insurance cover therapy?
Some therapists and psychiatrists take insurance (this is often referred to as being paneled or credentialed with insurance). If you are planning to use insurance benefits let a therapist know and ask if they accept your specific insurance plan. The most helpful approach (helpful is a strong word here) is to call your insurance provider and ask if your coverage includes mental health services or if they do reimbursements afterward. This would be a part of your out-of-network benefits, if applicable in your plan. Therapists that do not take insurance can often provide superbills to assist with getting reimbursed by your insurance company if you should go that route.
Now that you have searched for all your preferred criteria and have a few therapists you want to contact- what do you do next?
Many therapists offer free 15 minute consultations where you can have a low-stakes conversation and get a feel for each other during that call. Some therapists offer video sessions as an option instead of a phone call (note that a therapist that offers consultations might be one of your criteria for finding one!).
What to ask during a therapy consultation
During this consultation you can ask any questions you may have and gauge how their responses land with you. Finding the right fit resource showcases some red and green flags that may emerge from the interaction. Anything that you may be curious about- that is the time to ask! Do they have experience working with someone that has the issues you are coming in with? Are they in their own therapy? What are their policies and how do they respond to accountability (on either end)?
If the vibes are there- and you schedule your first appointment- congratulations! You did it! You booked the thing you had been considering but were a bit scared to do! And now, again, what’s next?
What to expect during your first therapy session
There can be a lot of anxiety leading up to the first session- whether or not you have been in therapy before, having a first therapy session with someone new can be very nerve-racking (or exciting!). The intake session will usually consist of going over consent, policies, and overall expectations from both parties. Your therapist will likely explain how confidentiality works in this dynamic and what the limitations of it are. Sometimes the intake session can feel lengthy and boring because of the admin work and ongoing list of questions. Many therapists are skilled in asking the questions they need about your background, history, and therapeutic goals- in a way that feels more conversational and less like an interrogation.
Remember that there is no right or wrong way to get started. Showing up means you’re not just trying, you’re already doing! Whether there are long periods of silence, or a lot of talking and even tears, all of these reactions are normal and valid.
What if your therapist isn’t the right fit?
What happens if after your first session you feel uneasy, uncomfortable, or just like something is off? Feeling some discomfort when opening up to someone new is completely normal and expected. However, feeling pressured, unsafe, or repeatedly dismissed is different and does not need to be tolerated.
Depending on the intensity of the feeling, you can choose to do a number of different things. If you feel comfortable naming that to your therapist, you can call it out at the next session- this can lead to a great opportunity to see how your therapist handles conflict and a potential rupture. If the feeling is more alarming and you absolutely do not want to continue beyond that, you are entitled to let them know that it doesn’t feel like a right fit and you would like to cancel all upcoming sessions.
Therapy is meant to be treatment for your benefit, and choosing a therapist to start treatment with does not obligate you to continue working with them if you don’t feel alignment.
Therapy can be a wonderful process that can help ease a difficult time, answer lingering questions about yourself, or even provide a space to unravel for an hour (or more) a week because no other area of your life has room for error. Therapy is not always easy- the cliche of “doing the work” is a reminder that it is actual “work” and some days may be harder than others.
Wherever you are in your journey, know that there are resources and help available to you, it’s okay to ask for support before a situation becomes dire.
You’re allowed to prioritize yourself.
To learn more about therapy, ask questions, or find the support that's right for you, start here.
