An acquaintance recently described a multi-year therapy relationship that she hadn’t enjoyed because she felt judged by her therapist. While therapists are supposed to provide empathy, a set of professional skills, questions that lead to reflection, and a kind support system on your life’s journey, judgment shouldn’t be in the room. I’m not going to claim that sessions are a totally judgment free zone, since therapists are people too, but (at least in my opinion) clients should experience thoughtful kindness 99% of the time.
If you consistently feel judged by your therapist, that person is probably not the right therapist for you.
So how do you go about picking a therapist?
Where to look. First, start by looking on Psychology Today (or another directory site) for a therapist in your area code who treats your concern. (Psychology Today is the yellow book of therapists, it has most everybody. There are other competing websites, and they have their own listings.) You can filter by insurance taken, specialties in certain mental health issues, type of therapy provided and therapy identity. When you send a message to a therapist, it’s helpful if you mention what insurance you have if you hope to use it, whether you have a flexible schedule or need an appointment at a specific time, and what concern is bringing you to therapy.
Finances. You’ll notice that many therapists do not take insurance, and you will need to use your out of network benefits if you have PPO insurance, or pay out of pocket (depending on what fee you can afford). You can use your HSA to cover your therapy. And if you spend more than 10% of your income on medical costs, you might be able to take it as a tax deduction.
In my experience, scheduling and payment are the two administrative issues that pose the largest obstacle to therapy. Prepare yourself for a minimum of six months of treatment–can you afford this on a weekly basis for six months?
Your needs. You might also want to search specific terms in your browser just to see what comes up. In my case I specialize in highly sensitive people, healers, artists, and activists. If the therapists have websites, take a look and see if you like their style and approach.
How many to contact. Second, I recommend you contact at least five different therapists. Hopefully, three of the therapists you reach out to will get back to you. Two will have openings at a time that works with your schedule and hopefully will have a fee that works with your budget.
Third, meet at least two therapists in person. There are a variety of treatment approaches and personal styles, and you will probably have a preference. Decide who is the right therapist for you.
It’s a unique fit. Every therapist works better with certain people than others, and mismatches can be a little idiosyncratic. In my case, I’m not great at working with people who have long thoughtful pauses in their speech, though I hope I might get better at working with that population in the future.
If you do not have insurance, and are limited in your financial means, you have a few options. The major advantage of seeing someone in private practice and paying out of pocket is that they are a more stable provider: they are usually fully licensed and will not change employers. Paying out of pocket if you chose not to use your insurance will also give you more privacy: Just you and your therapist will know your diagnosis and no information about your treatment will be shared with your insurance.
If private pay is not an option for you, here are some low fee options in the Philadelphia area. If you are in crisis, here are some places that can help. If you cannot keep yourself safe, please go to your nearest emergency room to be evaluated.