How to Find the Right Therapist

Finding a counselor is more of a personal process than finding any other healthcare provider. Whether you are looking for a relationship or individual therapist, knowing how to go about finding the best one for you can be confusing. Taking the time to do it right and knowing what to look for means that you won’t waste time and money and be frustrated with the outcome.

Here are my 6 suggestions to help you through:

1)    More than with doctors or dentists, clients tend to pick therapists based on the personal recommendations of friends and family. When someone that you trust has had a positive counseling experience with a therapist, they are more likely to be a good match. Also, since your family and friends know your personal style, they can steer you towards a therapist that is more likely to connect with YOU. Therapeutic alliance, which is the professional connection you feel with your therapist, is generally regarded as one of the most important aspects for successful counseling. It is imperative that you feel heard, seen and accepted from the first time that you meet.

2)    Don’t go on one recommendation alone. Get 3-5 recommendations, if possible, and then look at each therapist’s website and get a feel for them. Many therapists have blogs (like this one) in addition to their profile, so that you have a chance to know what they’re all about. Counseling is largely centered around personal values. Although a good therapist can meet you where you’re at, regardless of their own personal beliefs, it can be helpful to see a therapist that already understands the world you live in. As a therapist that works with a lot of open relationships, I frequently see the damage done by other well meaning counselors who know nothing about open relationship dynamics and have worked with poly clients anyway. The same can be true for religious or political orientations, knowledge about kids or blended families, or any other cornerstone to your existence that might come up in the therapeutic process.

3)    Think about insurance. If you have great mental health coverage (which is rare) it makes sense that you want to see an in-network clinician instead of paying out of pocket. I encourage you to research exactly what that means:

a.     What will you actually pay? Find out what your copay is, whether you have to meet a deductible first, and if there is a limit to how many sessions you are approved for. If you are trying to see a therapist out-of-network and have it partially covered by insurance, find out exactly what they will pay. Often, insurance companies will say they pay 60%, but what that actually means is that they will reimburse 60% of the $60 they would pay a provider, not 60% of the $175 your provider charges.

b.    Does your insurance require a diagnosis and, if so, are you okay with having that in your medical record? A DSM5 diagnosis can potentially raise your health insurance and life insurance premiums. If you aren’t seeking insurance coverage, clinicians rarely put a diagnosis in your file (and no one would be privy to it if they did.)

c.     How many hours does your in-network therapist work? Insurance companies pay therapists terribly. A typical rate of reimbursement is $60/50 min, which is less than half of what an experienced therapist’s rate should be and requires additional hours of paperwork. This means clinicians who accept insurance often have to see twice the clients in order to make the same pay and they end up overworked. Full time for a therapist is considered 20 client hours a week. In-network therapists often see 40-60 clients a week, in addition to the extra paperwork, and are therefore less available to you, both for session flexibility and after hours consultation.

4)    Consider education and experience level. You may be tempted to go with a therapist that has half the rate as the other ones you’ve been considering and seems perfectly nice. However, you will get more for your time and money if you see someone that has been practicing awhile. Most of how we learn as therapists is by doing the work, so it takes a few years to be our most confident and competent selves. Here’s what to look for:

a.     Look for a date that a therapist began practicing. If their profile or website only contains vague sentences about how long they’ve been doing this work, ask them directly.

b.    If their rate is below $120/50 min (in Denver, CO – this varies widely based on location) then they are likely to be either new to the field or seriously undervalue their work.

c.     Look at their licensure. Those are the myriad of cryptic letters after their name. I’ll tell you what they each mean. Buckle up, because it’s quite a list!

·         LPC – Licensed Professional Counselor. This is perhaps the most common set of letters you will see. They have a minimum of 2000 hours and 2 years of experience post-graduation. They are likely to be well trained in all aspects of individual counseling. If you are looking for a relationship counselor, however, look at their profile to make sure that they have received additional post-graduate training or certifications. While LPCs can practice relational therapy, their education does not require comprehensive training in relational work or family dynamics.

·         LPCC – Licensed Professional Counselor Candidate. This means they have completed their Master’s degree, however they have not yet completed the 2000 supervised hours required to become fully licensed.

·         LCSW – Licensed Clinical Social Worker. Also a very common set of letters. Social work programs tend to be only 2 years (as opposed to the 3-4 years for an LPC or LMFT program) and only 1 of those years is clinical (the other is macro level social work). If they have LCSW after their name, that means they have completed the 3360 supervised hours required (only half of which are client hours, so about the same as an LPC or LMFT). However, because of their minimal amount of initial clinical training, you definitely want to see additional post-graduate work or certifications in their profile in order to see them for individual or relational counseling.

·         LSW – Licensed Social Worker. This means they have not yet completed their initial 3360 supervised hours and are not fully licensed as a clinician, although they are licensed as a social worker (they have completed their required coursework and have taken the exam).

·         LMFT- Licensed Marriage and Family Therapist. There are less of us than the others in this alphabet soup; however LMFTs are the gold standard for relationship therapy. Don’t let the conservative sounding vernacular throw you off; marriage and family therapy education means that we are comprehensively trained in relationship dynamics in addition to individual therapy. In the state of Colorado, trained LMFTs can also apply for their LPC, but not the other way around. LMFT means we have had a minimum of 2000 supervised hours and 2 years in the field.

·         MFTC – Marriage and Family Therapist Candidate. This means they have completed their Master’s degree, however they have not yet completed the 2000 supervised hours required to become fully licensed.

·         CST – Certified Sex Therapist. Because “sex therapy” is not a protected term, anyone can call themselves a sex therapist and we cannot technically be licensed as sex therapists. However, the letters CST denote that the American Association of Sexuality Educators Counselors and Therapists (AASECT) has certified this person as a sex therapist. This means they have completed a post-graduate education that is 1-2 years in addition to graduate school, as well as 300 additional supervised client hours. At the moment there are only 25 of us in Colorado (compared to over 10,000 social workers).

·         LAC – Licensed Addiction Counselor. This is a Master’s level addiction counselor who has received additional post-graduate training and completed between 3000-5000 supervised hours, depending on how they progressed through the levels of addiction counseling. CACI, CACII and CACIII are lower levels of addiction counseling that do not require a Master’s degree. This is relevant if substance use or addiction is a subject of your treatment or your couples counseling. (Please note that “sex addiction” is not actually an addiction and therefore addiction counselors do not receive training in compulsive sexual behavior, only certified sex therapists do.)

·         PsyD – Doctorate in Psychology aka Psychologist. Not all PsyD holders go into the field of therapy. Many go into academia or testing for measurable mental health issues, such as ADHD or learning disabilities, since much of their training is more quantitative or research based. Clinical training and supervised hour requirements are actually less than with LMFT/LPC/LCSW at 1500 hours. Despite being doctors, they cannot prescribe medications (that’s a psychiatrist.)

·         PhD - Doctorate in Psychology. A PhD can indicate a wide range of educational backgrounds, too varied to expand on in this brief forum. Usually you will see a PhD listed with other credentials on this list in order to provide clinical work. (Like practitioners with a PsyD, these doctors also cannot prescribe medication.)

·         NLC - Registered Psychotherapist. This is an older term meaning that someone is practicing but not yet fully licensed. You will still see it listed sometimes.

·         An “S” at the end of any of this lettering – Supervisor. For example, an LMFT-S supervises MFTCs while they work on their hours. Supervisors have acquired additional training, supervision and years in the field in order to become supervisors (requirements differ depending on the license). They are often great therapists with a lot of experience.

·         An “A” at the end of any of this lettering – Associate. For example, an LMFT-A means they are newer in the field and are working underneath a more experienced clinician, although they may have completed enough hours for licensure.

5)    Logistical aspects such as location and hours that your therapist offers sessions are important factors to consider. Therapy is most successful if it is consistent and ongoing, which means that making sure you have a certain level of convenience is more important than with your primary care doctor, who most people only see a few times a year. Not all therapists offer evening and weekend appointments, which can be helpful for those who don’t work from home or have an atypical work schedule. Many therapists ask their clients to keep a consistent appointment time on a weekly basis and don’t have much flexibility for changing days or coming in less frequently. Make sure to ask any logistical questions during your new client consultations so you have all the information you need to pick the right provider. At Mile High Psychotherapy, we do offer evening and weekend appointments, as well as flexible scheduling.

6)    After you have narrowed your list down to 2-3 therapists, schedule a phone or in person consultation with each of them, if possible. Most therapists offer one or both of these options. If they don’t, be willing to do a first session without fully committing to working together. Although it can be tempting to go with the first therapist that sounds awesome, that would be like picking only one online dating profile to find a relationship. Sometimes a therapist seems like a perfect fit in theory, but as soon as you get to know them directly it doesn’t feel quite right.

I hope this list has helped you understand the process of finding a therapist better! If you have any other questions, feel free to reach out: indigo@milehighpsychotherapy.com.