How to Start Therapy

I get questions about this all the time! How do I start therapy? How do I find a therapist? How much does it cost? What happens in therapy? Finding a therapist that is a good fit and starting therapy can be an overwhelming and intimidating experience, particularly if this is your first time doing so. Like so many things, the first steps in this process can be some of the hardest (although therapy is often hard work, too).  Here are some basic steps to keep in mind if you are interested in starting therapy!

1.     How will you be paying?

The two primary payment options are via insurance or paying privately. In the case of using your insurance, you will pay a co-payment directly to your therapist and your therapist bill your insurance. Depending on your plan, you may not have a co-payment and may instead be responsible for 100% of the cost until you meet your deductible. The ins and outs of insurance are incredibly nuanced and complicated (or is it just me?), so I really encourage you to contact your insurance and get clear on your benefits before beginning.

Private pay is pretty straight forward. You are responsible for payment of services to your therapist. Insurance is not billed, or involved in any other way.

A couple brief notes related to insurance. If you are utilizing your insurance, your therapist is required to submit information to said insurance for reimbursement. Typically, these are things like session date, length of session, type of session, and diagnosis. Most insurance (in my experience) requires a mental health diagnosis; this in and of itself may exclude you from using your insurance, as not all individuals who would benefit from therapy will necessarily meet the criteria for a mental health diagnosis. Additionally, an insurance company may limit the number of sessions and types of sessions (in my experience, may insurance companies do not cover couples therapy).

If you are not able to, or do not want to, use insurance, but are unable to afford the full fee of a therapist, you can ask if a therapist provides any sliding scale options. This will vary from therapist to therapist, and is important to ask upfront.

2.     How will you find a therapist?

An easy place to start can be to ask people around you for recommendations. If that is not possible or not something you are comfortable with, move to the next option.

Another jumping off point is the website Psychology Today. Psychology Today allows you to search by area, and then also narrow results based on what you are looking for (specialty, insurance coverage, etc.). A therapist’s profile will include basic information related to their training, education, and approach; many will also provide a link to their own website. I really encourage people to look through a potential therapist’s website (if available)- I try to present information on my own website in a way that is very congruent with who I am as a therapist in the room with a client. This can sometimes help you get a feel for whether a particular therapist might be a good fit with you and what you are wanting.

If you are planning on utilizing insurance, it is important to remember that not all therapists accept insurance; the insurance companies that a therapist is contracted with, if any, will also vary. You can typically obtain a list of in-network therapists from your insurance; many people have access to an online insurance portal where you can search for providers in your area. You can also search by insurance coverage via Psychology Today.

If you are a student at a college or university, many schools have a mental health center that provides services to students. Additionally, if you are near a university that has graduate programs in psychology, services may be available with supervised graduate students at a reduced fee (even for non-students). This can be a great option!

Many cities also have community mental health centers that can offer services at a reduced fee.

3.     How do you contact a therapist?

Reach out to the therapist(s) that you identified as being a possible good fit. You can do this by either telephone or, if a therapist provides one, email. I have also come across therapists who indicate that potential clients can contact them via text. Keep in mind that emails and texts have the potential to be sent to or read by someone other than the intended recipient (for example, emails sent from a work email may be subject to internal monitoring by the company)- just something to keep in mind!

Now the next part of the process likely varies in one way or another from therapist to therapist, so I will tell you what my process is. When I am contacted by a potential client by either phone or email, I will confirm a couple pieces of information right at the start. I do not contract with insurance companies, so I ensure that clients understand this and are able to pay for services without insurance. Second, I will give clients the days/times of my available sessions to confirm whether one of these would fit their schedule should they decide to move forward in scheduling a session with me. The reason that I like to start with these two business items is that I want to avoid a client engaging in an initial phone consultation, sharing personal information and beginning to form a therapeutic relationship with me, only for them to find out that they will not be able to move forward with therapy because of an insurance or scheduling conflict.

I schedule a 15-minute initial phone consultation with prospective clients. During this call I invite individuals to share their current reasons for seeking therapy; I assess for any mental health history and possible high-risk factors; I share my approach to therapy; and I welcome any questions that individuals have. If, at the end of the call, clients would like to move forward in scheduling a session, we will do so. I encourage clients to take any time to consult with other therapists or think about how they would like to move forward- no pressure to schedule a session at that moment! If it becomes evident during the call that I will not be an appropriate fit for a client, I offer to provide referrals to other colleagues.

I hope this information is helpful- what are your questions about starting therapy?!

To learn more or to book an appointment, contact me via telephone or email.

Brenna Burke, LMFT is a licensed marriage and family therapist in private practice in Valencia, CA. She provides individual psychotherapy and couples counseling. Information provided through this website is for informational purposes only. It does not create a therapist-client relationship and does not replace clinical assessment or professional consultation.