How to Pick a Therapist
There are several excellent reasons to see a therapist. When beginning the search, most people will ask their friend 'Google' who the best counselors are in their area. While the internet can be a great resource, your real-life friends will typically be able to connect you more effectively. Even so, if you're stuck with the internet, www.psychologytoday.com is a great place to start. Like most things, the idea of doing something is often more straightforward than actually doing it. When it comes to navigating the bevy of credentials, certifications, specializations, and licenses, finding a good counselor or therapist can be daunting. Even with all the degrees and letters aside, there are many practical, ideological, and relational dynamics that may help you narrow your search.
Why consider all of these issues? According to the Family Institute, the quality of the therapeutic relationship is one of the most reliable indicators of success in therapy. Therefore, putting in the effort to make a good therapy choice in the beginning, can pay significant dividends in the end.
Practical Questions
What can you afford?
Maybe the first and most basic question is price. What can you afford? Going into debt or taking on financial burdens will only increase the stress in your life, so it's wise to keep affordability in mind when looking for the right therapist. As a point of reference, Licensed Professional Counselors (LPC) in Colorado Springs generally charge around $125/hour.
Do you want to use insurance? If so, are they paneled with your insurance company?
You may be able to use your insurance, and if you're in crisis, don't hesitate to do so. That said, if you go the insurance route, it can introduce some limitations. Before you try to use your insurance talk to your insurance company about what kind of mental health benefits you have. You may be able to see people out of network and get reimbursed. Or an in-network provider can bill your insurance company directly and collect a copay at the point of service. If you use insurance, the therapist you work with will have to issue a diagnosis based on the information you provide. That diagnosis will then be part of your permanent medical record. If you don't meet the criteria for a diagnostic condition, later the insurance company may not pay your claim. Of course, there will be a limited number of therapists that take your insurance, thereby reducing the number of therapists to consider.
Do they offer a free consultation?
Try them out! Not every therapist is for every person; if it's not a good fit, try a different therapist. Not even a counselor will connect well with every person they see. A free consultation allows you to get a feel for the energy and approach of your prospective therapist (and occasionally a good cup of coffee). Getting a feel for different clinical methods will give you more of the information you need to find the right therapist for you in your current situation.
Can they work with your schedule, or can you work with theirs?
How soon do you want to see a therapist? The more flexible your schedule, the more choices you'll have. If you've found the therapist that you want to work with, but are struggling to find a workable time, consider taking an extended lunch break? Can you come in an hour early or leave an hour late to facilitate your meeting with a therapist during their counseling hours? We all make time for what we value, including time for our personal and emotional wellbeing . Work with your prospective therapist to find a time to connect, and if they are unavailable, wait for the time slot you'd like to open up or ask to be added to their waitlist. If the challenges abound as for anyone they would recommend that may be able to work with you within your time constraints.
These practical questions are worth considering and may limit the field considerably, making the choice more straight-forward. Many therapists will work with you to figure out timing, affordability, and other considerations, so don’t be afraid to ask.
Ideological Considerations
Are they in alignment with your values? Does that matter to you?
Values have to do with faith, worldview, politics, drugs and alcohol, sexuality, and morality. These values aren't equally relevant or prominent for everyone, and that's okay. Sometimes people are just looking for a safe place to explore their the story they find themselves in. They don't put a high premium on their therapist completely aligning with their values. After all, an ethical counselor will work diligently to avoid imposing their values on their client. For others, that question is at the top of the list. Take time to figure out how important your values are to you and use this awareness to help you narrow your options to the therapists that will be best for you. Feel free to ask your prospective therapist(s) what their orientation is regarding the values most important to you.
If having your therapist align with your values is important to you, there are other questions to consider along those lines. Will they support your faith system, for example, while also calling out its failures or harm? Will the therapist be affirming of your sexuality? Will they help you navigate the complex spaces that have emerged between sexuality and faith. A good therapist is there to help you, so be honest and transparent regarding your values and goals. This posture will bring clarity and direction to the work you embark on together.
What's their specialty?
Some therapists are trained specially to work with people that have specific issues or challenges. Some counselors specialize in trauma, sexuality, faith, addiction, couples, testing and assessments, and medication. If you're navigating a specific kind of challenge, there are certainly therapists that have dedicated their practice and career to someone like you. If you're having a hard time finding the right practitioner, tap into your network. You'd be surprised by how many of your friends and acquaintances know someone who may be well suited to your needs and preference. Some people want to journey with people who have been there. Despite their experiences, some therapists can still help get to the root issues you wish to address without having similar experiences as you. Do that free consult, or sit with a potential therapist for a few sessions to see where it goes. Again, the quality of the therapeutic relationship is one of the most reliable indicators of success, so if the chemistry is there, you may not need the specialty.
Relational Questions
Does gender matter?
The vast majority of the mental health field is female, so if you’re looking for a female therapist you’re in luck. However, it is important to be openminded; different genders can help you work through distinctive parts of your story. If you’re not sure, taking therapists up on their offer of a free consultation can be valuable. Also, take into consideration the critical parts of your story. If you're often triggered by one gender more than the other, that can inform the therapist you choose. If you're new to therapy, it may be wise to work with whichever gender you find safest. If you've done some work, and you're looking to venture into uncharted territory, it may be time to work with a more challenging therapist.
How do you receive feedback?
Regardless of who you choose to work with, know that a good therapist will give honest and insightful feedback. If you are struggling to find the right therapist, you may want to consider if you are willing to contend with the issues that therapy is exposing in your story. If you've struggled to connect with several therapists, it may be that something continually resurfaces that you're unwilling to address. Take note of this; it may be your invitation to go deeper into your personal narrative.
Navigating Credentials
One of the most overt considerations, even if it's not the most important, is to evaluate your prospective therapists' qualifications. Different licenses allow therapists to do different things and knowing this can help you choose the right one. Keep in mind, if a therapist has more education, experience, and demand, it is likely they will have a higher price-point. Here is a list of the various types for reference:
RP – A Registered Psychotherapist is unique to the state of Colorado. This practitioner is not required to have any additional training or credentials and only needs to pass a state test to earn their title and practice.
LPC – A Licensed Professional Counselor (LPC) has a masters degree (but can have a doctorate as well), has passed the Colorado Jurisprudence Exam, logged 2,000 hours of post-degree of supervised experience, and can specialize in a variety of arenas.
CAC I, II, III – A Certified Addictions Counselor (Level I, II, or III) is a title that identifies clinicians specially certified to work with substance abuse and addiction.
LAC – A Licensed Addiction Counselor has completed all the training of the CAC and has received sufficient addictions-specific supervision to carry an Addictions License with the state.
LCSW – A Licensed Clinical Social Worker (LCSW) typically has a masters degree and usually works at providing and identifying relevant community resources. In a more clinical setting; their focus is often, though not exclusively, related to resourcing clients with various community-based interventions and programs.
LMFT – A Licensed Marriage and Family Therapist has a masters degree and two years of post-masters supervised practice. As their title indicates, they specialize in marriage and family dynamics. If you're interested in couple therapy, or if you're dealing with a difficult family situation, the LMFT could be the right pick for you.
A Psychologist holds a non-medical degree and cannot prescribe medication. In the state of Colorado, they have at least one year of supervised post-doctoral work. Psychologists can offer high-level assessments and then interpret and deliver the results. They are often trained in research and have deeply specialized experience in their given areas of clinical practice. They are frequently on the leading edge of new clinical explorations.
A Psychiatrist holds a medical doctoral (MD) degree with specializations in psychiatry and psychiatric medicine; this means they can prescribe medication. They're required to practice for four years under supervision, typically in a residency program. They often, though not exclusively, do a lot of work with medication management. In other words, you're likely to get an initial consultation, followed by appointments every few months to ensure that your medication levels are adequate and effective. It is not unusual to see Psychiatric Nurse Practitioners functioning in the similar spaces as psychiatrists.
Finally, there are community mental health centers. I've saved this for last because you will likely find all of the above categories in these organizations. They can be useful, but often practitioners are overworked, seeing as many as 40 clients a week. If you're on Medicaid* or other government-mandated or managed care, this can be a great place to start, though many clinicians in private practice also accept Medicaid..
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*Medicaid recipients may not pay out-of-pocket for covered services. Charging a Medicaid client for such services is considered fraud.
Even if your search for the right therapist takes time, keep your long-term goal in mind: emotional and relational wellbeing. The value of exploring your story is staggering; it's worth it to take the time to find the right person to help you get there.