The Ultimate Guide to Therapy
At Zencare, we believe that everyone should have access to therapy (that’s why we’re here in the first place!).
But we also know the search can be an overwhelming process. So we put together this handy guide: Whether you’re totally new to therapy, switching providers, or just curious about the process, read on for ways to find a therapist who’s right for you.
1. Should I See a Therapist? (Or, How Do I Know I’m Ready?)
The short answer is: You should start therapy whenever is right for you. Entering the process with determination and enthusiasm--rather than basing your decision on an external standard or someone else’s opinion--may help you adjust to the time and financial commitment of therapy.
To be clear, there’s no one-size-fits-all timing for therapy, since people start therapy for all kinds of reasons. You don’t have to be in immediate distress to seek out therapy, nor do you need to have been diagnosed with a mental illness. You could be curious about how therapy can help you grow in a general sense, or you might be looking to overcome a particular hurdle.
Here are a few examples of reasons why you might seek therapy, though this list is by no means exhaustive:
To manage symptoms of anxiety, depression, or other mental illnesses
To gain skills to deal with work stress, or receive career guidance
To improve relationships with friends, family, or intimate partners
To address concerns around body image or disordered eating
To process thoughts and feelings about current events and the world around you
To cope with a loved one’s illness or death
To explore questions related to your identity
To heal past or recent trauma
To navigate difficult life transitions, such as starting a new job, moving to a new city, or becoming a parent
Put simply, a therapist is an impartial, trained professional listener whose job is to support you and help you be a force of positive change in your own life, no matter what challenges you’re facing.
You might contemplate starting therapy for a period of time before actually finding a therapist, and that’s completely normal. Sometimes it takes time to get used to the idea of reaching out to a therapist for support, and unless you’re in immediate distress, there’s no need to push yourself to start therapy before you feel ready.
Ask yourself: Why would I like to seek therapy right now? What in my life am I looking to work on? These questions will help you feel out whether you’re ready for therapy right now, find a therapist who is the right fit for you, and ultimately make sure you’re on track towards goals as sessions progress.
2. What are the Different Types of Therapy? Which One is Right for Me?
There is a wide variety of different types of therapies available (these different types are often called modalities), and you may find more than one modality that you’re interested in.
In practice, many therapists use techniques from several different modalities and can tailor sessions to suit your unique preferences and challenges. When you’re looking for a therapist, it’s helpful to learn a bit about common therapeutic approaches and find ones that seem appealing to you – so you can search for practitioners with experience in those approaches.
As with so many other questions about therapy, there’s no single best way to determine which kind of therapy is right for you. Much of your decision will come down to personal preference, and you may even try out a few different approaches before settling on one that works well for you. That’s okay! Finding the right therapist is a personal and nuanced process, and you should feel free to take your time researching and trying out different options.
You can find more information about different modalities here.
Additionally, it may help to familiarize yourself with two of today’s most common modalities, cognitive-behavioral therapy and psychodynamic therapy:
Cognitive-behavioral therapy, or CBT, focuses on helping individuals understand and reshape the thought patterns that underlie their present emotions and behaviors. In particular, therapists work with individuals to identify inaccurate or illogical thought processes that undermine the individuals’ goals. For example, an individual might think, “I never succeed at anything,” and then with the therapist’s guidance, the individual will identify and correct that thought by, say, making a list of past successes. Often, CBT includes the use of worksheets, checklists, and other structured tools in order to identify thought processes and understand how they relate to emotional and physiological responses. CBT sometimes includes aspects of other modalities, but in general it emphasizes building skills and improving current mood and functioning, without necessarily including analysis of the past.
Psychodynamic therapy is the modality that most closely aligns with the popular perception of “talk therapy.” In psychodynamic therapy, individuals work with therapists to dig into the unconscious psychic factors that shape their current mood and functioning. The individual’s childhood and family context are especially important in this process, since psychodynamic theory views childhood experiences as key defining factors of a person’s psyche.
Psychodynamic therapy involves Sigmund Freud’s psychoanalytical theory of unconscious drives – id, ego, and superego – and how they shape personality, but it also incorporates the later theories of those who expanded on Freud’s work. Psychodynamic therapy emphasizes gaining insight into the ways that the past influences the present and using that insight to understand the unconscious aspects of the psyche.
In addition to modalities, you’ll also want to consider the different types of practitioners who fall under the umbrella definition of “therapist.” These may include couples therapists, child psychologists, psychiatrists, and sex therapists. Finding the right provider is particularly important if you know that you’ll need to see someone who can prescribe medication, since only psychiatrists and nurse practitioners are able to do so.
That said, it’s sometimes possible to have therapy sessions with a non-prescribing practitioner (like a social worker) and see another practitioner (like a nurse practitioner) for your medication needs. The important thing is to be sure you understand the qualifications of the therapist you choose and discuss any medication needs with them before starting your sessions.
3. How Do I Pay for Therapy? What Other Logistical Factors do I Need to Consider?
Because therapy requires both a financial commitment and a time commitment, you’ll want to weigh these logistical factors as you decide which therapist to work with.
Here are some logistics to consider:
Timing: Which days and times can you commit to therapy? Therapy sessions generally last about 50 minutes and occur weekly, though certain practitioners or modalities may recommend more or less frequent sessions. If you have limited availability, search specifically for therapists with evening, weekend, or whatever-suits-your-schedule appointments. Alternatively, you can ask therapists you’re considering upfront if they have openings at the times you need. Don’t be shy about finding sessions that fit your schedule; making therapy a manageable part of your day-to-day life can help you stick to your commitment and get the most out of your sessions.
Location: Consider the commute to, and from, the therapist’s office. If possible, it may be easier to see a therapist who has offices close to your home or your job. You can also consider expanding your search to include therapists who offer remote therapy sessions, which can make scheduling easier.
Insurance: Are you going to pay for therapy through your insurance, or can you expand your search to out-of-network providers? While in-network therapists tend to be more affordable, looking for one can be a long and arduous process depending on your insurance plan and location. Seeing an out-of-network therapist can be a great way to avoid many common insurance headaches. For pointers, check out our guide on how to use out-of-network benefits to cover the cost of therapy.
Price: Whether you plan to pay through your insurance or out of pocket, it’s important to know how much you can afford to budget for therapy, since even visits covered by insurance can come with copays. That said, therapy doesn’t have to be an overwhelming expense, even if you’re paying out of pocket. Many therapists offer sliding scale fees, so be sure to talk to potential therapists about whether their fees are flexible and what the cost to you would be for each session.
4. What Should I Know Before my First Therapy Appointment?
You can learn a lot about your therapist and what to expect by scheduling a phone consultation before your first appointment, or even before you decide to schedule an appointment. This phone call can help you gain information about how your therapist works, how they usually structure sessions, and what – if anything – you should prepare ahead of time.
Once you’ve had your phone consultation and scheduled your first appointment, be sure that you’re clear on the following points:
How long the session will last (most are around 50 minutes, but initial sessions can be longer so you’ll want to check with your therapist)
How to find your therapist’s office (public transit directions, parking info, etc.) and what you should do when you get there (Do you need a code for the door? Should you knock when you arrive, or wait to be called in from a waiting area?)
How much the first session will cost and how you plan to pay for it
Some therapists may also ask for a completed form or further information about you before your first session – a process often known as an “intake.” Intakes exist because it can be helpful for your therapist to have some more context about you and your challenges before meeting in person. Intakes often include items such as demographic information, mental health history, and your interpretation of your current challenges. If you’re asked to complete an intake form, be as honest as possible, but don’t feel the need to share more than you’re comfortable with; if the form touches on something sensitive that you’d rather discuss in person, feel free to omit information and let your therapist know that you’d prefer to return to those topics later on.
You may also be wondering what exactly will happen during your first therapy appointment. Typically, therapists use this first session to ask history-gathering questions to help them understand what’s bringing you in. These might include questions about past events, your relationship with family members, and what your daily life is like. Your therapist will may also ask if you’ve been in therapy before, what the experience was like, and what you’d like to get out of your work in therapy. Though all therapists have their own styles and methods, you can read our full overview to get a sense of a how a typical first therapy appointment goes.
5. How Do I Know if My Therapist is Right for Me?
While it may be difficult to gauge chemistry and personality fit prior to your first session, simply knowing that you might not mesh with every single therapist can be empowering – it may inspire you to keep searching until you find the right therapist for your needs.
A helpful idea to keep in mind as you begin your search for a therapist is the idea of the therapeutic alliance. This concept refers to the idea of a strong, productive relationship between therapist and client. This bond can take countless forms and will look different for everyone, but the basic idea is that both parties feel comfortable doing their part in the work toward the client’s therapeutic goals. Some studies have suggested that the quality of the therapeutic alliance may be the biggest factor in the overall effectiveness of one’s therapy. After a few sessions, you’ll likely be able to tell whether or not you’re developing a therapeutic alliance with your therapist.
It can also be helpful to think in terms of two key factors that can help you know if your therapist is right for you: your connection with your therapist, and your progress toward your goals. Take some time to reflect after your first appointment; know that therapy takes time, and that regardless of how the session went, you’ve taken an important step in self-care and that is something to be proud of!
6. How Can I Find a Therapist Who’s Knowledgeable About My Identity?
Any good therapist should be culturally competent, which means that they are attuned to differences in culture of all kinds and considerate of how these differences--particularly differences between the therapist and the client--might affect the therapeutic process.
However, some people find it helpful to work with a therapist who has a specific background working with people from a certain cultural group or who have a particular kind of identity. These groups and identities might include persons of color, LGBTQ+ folks, individuals with disabilities, and many others. Because marginalized identities can come with unique challenges and mental health risks, therapists who specialize in working with these groups may be able to provide more sensitive, effective support.
Furthermore, you might prefer to work with a therapist who shares one or more aspects of your identity, simply because that cultural experience can give you common ground with your therapist and help you feel confident that they understand your struggles. For example, an Asian-American female client may feel more comfortable working with an Asian-American female therapist than with a white male therapist.
This isn’t true for everyone, but if you do prefer to work with a therapist who shares your background, there are lots of resources at your disposal. To get started, you can search for therapists who share your identity, and you can also ask your therapist about their experience with individuals of different cultural identities during your initial consultation.
Related: Search Providers by Identity
The process of finding a therapist is different for everyone, but by keeping these resources in mind and focusing on what works best for you, you’re likely to find a therapist who’s well-equipped to help you work toward your goals.
Ready to find your ideal therapist? Check out Zencare.co to get started!