Stepping into a therapist’s office for the first time can be nerve-racking. But when you find the right therapist—someone who listens, is respectful and is someone you trust—the partnership can be beneficial not only for your mental and emotional health but for your life overall.
The question is, how do you find a good match? Burton Hutto, MD, professor of psychiatry at the UNC School of Medicine, offers this advice.
1. Decide whether you’re going to use insurance.
If you have health insurance, you’ll want to determine what is covered for mental health services. Coverage for therapy services can vary greatly, so it’s important to understand your benefits. For example, some plans might cover only a specific number of therapy sessions, whereas other plans’ coverage depends on whether your therapist is in or out of network.
If you can use health insurance to cover your therapy, your copay is likely to be lower than if you pay out of pocket, but the options for therapists you can see might be limited. “If you plan to go with in-network providers, finding that list is not always easy, and it’s often outdated or inaccurate,” Dr. Hutto says. “Call someone at the insurance company and ask to be directed to the most-updated list of providers in your area.” Insurance plans vary on what they pay, or if they pay at all, for out-of-network providers.
If you decide not to use your insurance, you’ll likely have a lot more options for therapists available in your community. But you might also have to pay more per session; some therapists do work on sliding scales based on income.
2. Do your research.
Once you decide on insurance, it’s time to do your research on therapists. Dr. Hutto recommends contacting the referral service of the Psychoanalytic Center of the Carolinas, which will work with you to find a local counselor who fits your needs, or consulting Psychology Today’s “Find a Therapist” tool.
“There are a wide range of types of therapy, and you’re looking for someone who is also a match for your problem,” Dr. Hutto says. Divorce counseling, for example, will look a lot different than therapy for someone who’s experiencing depression, so you’ll want to find someone who specializes in the type of counseling you’re looking for.
“If you have someone in mind that you’d like to see, call them and ask questions before making an appointment,” Dr. Hutto says.
Questions such as, “What types of therapy do you offer, or what disorders do you specialize in?” can lead you in the right direction. The focus should be on finding a counselor that has experience dealing with the issue you are dealing with, be it trauma, anxiety, relationships or something else.
A preliminary phone consultation can be helpful in determining whether you and your potential therapist are a personality match, but Dr. Hutto warns that a perfect connection is not always conducive to effective therapy. Being able to talk about difficult topics together is more important than simply finding that person nice or friendly. You want to feel heard and respected, but sometimes you might be challenged.
“For therapy to be effective, it’s going to be uncomfortable at times,” Dr. Hutto says. “The therapist you need is someone who you’re able to open up to, not necessarily someone you want to hang out with.”
3. Make an appointment and try it out.
When you’ve found a therapist who seems like a good fit, make an appointment—or two, or three or four. It’s important to give the therapeutic relationship a chance, even if at first it doesn’t seem ideal. At the same time, it’s good to trust your gut if the fit seems problematic.
“There’s no perfect answer for how long you should see someone before trying someone new,” Dr. Hutto says. “Obviously, if you feel disrespected, you might not see that person again. But you also have to realize that people often feel worse before it gets better.”
In your sessions, be honest with your therapist about how you’re feeling, and if you feel like nothing has changed, talk about that, too. “It’s an important discussion to say, ‘Let’s talk more about what we’re doing here and how this is supposed to work,’” Dr. Hutto says. “I think it’s fair to be challenging to your therapist in that way, and they should be able to handle that, and that discussion of the relationship should be part of therapy. At some point, if you can’t get on the same page, you’re free to walk away. But I think you need to give it all you’ve got before that point.”
4. Keep going.
Progress happens when you go to therapy regularly, but it also happens on an individual level. “Most progress doesn’t happen as quickly as people hope, especially when you’re talking about making an important change in the way that you operate in the world,” Dr. Hutto says. “If you went to a weight-loss center to lose 50 pounds, you’re not going to lose all 50 pounds in the first month. But if you stick with it, over time, you see the benefit.”
To get the most out of therapy, Dr. Hutto recommends going weekly. “Once a week is baseline. Anything less than that, and you’re going to limit the impact,” he says. “I personally think that, all things being equal, the more therapy, the better.”
It’s important to know that seeing a therapist more than once a week isn’t a sign that you’re “sicker” than someone who doesn’t, Dr. Hutto adds.
“I think of it like piano lessons. If you’re learning and moving forward quickly, the piano teacher is going to ask the good students to come twice a week to sharpen their skills,” he says. “The advantage of going more than once a week is there’s more immersion in the process and deeper work.”
If you think therapy might be right for you, talk to your doctor. If you don’t have one, find a doctor near you.