Finding and Hiring The Right Mental Health Professional
The MedCircle Guide To Finding the Right Mental Health Professional
Mental health education is critical in reaching your next level of overall health and wellness. Getting the right education not only helps you live better, but also improves your ability to properly support those you care about. MedCircle is dedicated to providing you with this life-changing, paradigm-shifting education.
Working with the right mental health professional can make a profound difference in your emotional well-being, relationships, and quality of life. But finding that person isn’t always easy, and the search process can often feel overwhelming and even discouraging.
This guide will overview everything you need to know to find the proper support. It will review pertinent topics about:
- Knowing when to seek support
- The differences between typical mental health providers
- First steps towards finding a new provider
- Getting ready for your first session
- Encouraging a loved one to seek support
- Talking about your treatment with loved ones
Keep in mind that there isn’t a one-size-fits-all approach to finding mental health treatment. What works well for someone may not yield the same results for someone else. Sometimes, finding the right provider can be a trial-and-error process, and it’s vital to remain open-minded.
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Rising Trends in Mental Health
Research shows that nearly one in five American adults lives with a mental illness, like depression or anxiety. (1) Mental illness can range in severity, and symptoms often ebb and flow based on current circumstances.
Today, nearly 10% of children in the US meet the criteria for severe depression. Among adults, suicidal and self-harm ideation has continued to rise every year. (2)
Fortunately, we’re becoming societally more aware of the implications of mental illness. More and more people are taking mental health screening questionnaires, which can provide preventative and proactive support. As of 2019, nearly 20% of U.S adults reported receiving mental health treatment, such as therapy or medication, during that year. (3)
Nevertheless, many people encounter difficulties when trying to seek treatment. Common barriers include financial constraints, lack of accessibility, fear of stigma, and limited insight into the best care options.
Is It Time for Professional Support?
Subsequently, even if things seem to be going well, speaking with a mental health professional can still be beneficial. Mental health treatment offers invaluable support, insight, and guidance into helping you live a healthy life. Having an impartial opinion can be advantageous in making good decisions.
Keep in mind that many people seek support at different points in their lives. Even if you’ve had negative experiences in the past, there are many good providers out there. It’s almost always worth giving treatment another chance.
“Therapy can open a new story about yourself – one that you may not have known existed.
That’s the kind of magic that can happen in therapy.”
Even when it may not feel like the perfect time to seek mental health treatment, you may benefit if:
- You continue feeling sad, angry, or guilty.
- You find yourself feeling indecisive about important life decisions.
- You’re struggling with a significant life transition.
- You feel disappointed or stressed by your relationships.
- You’re struggling with a specific mental health condition.
- You don’t feel like you have anyone who can help you.
- You want support and reassurance as you navigate new changes.
Understanding the Differences Between Mental Health Professionals
If the letters behind the professional’s name confuse you, you aren’t alone. You will learn there are many different kinds of providers, and many of them share numerous overlaps.
Below is an overview of different professionals, their education, and what they typically treat.
Psychiatrists are specialized medical doctors who can prescribe medication. They have the letters, MD or DO, behind their name.4
Psychiatrists will conduct an initial assessment to review medication and treatment options. They may order or conduct various laboratory or psychological tests. These tests help them understand your current psychological state.
They will also meet with you periodically to review medication effectiveness and overall treatment progress. In some cases, they will also offer psychotherapy. However, it’s uncommon to meet with a psychiatrist primarily for that reason.
Psychiatrists typically prescribe the following medications to clients:
Antidepressants primarily treat depression, but they can also be prescribed for people struggling with anxiety, eating disorders, substance use disorders, and other mental health conditions.
Selective serotonin reuptake inhibitors (SSRIs), such as Paxil, Zoloft, Prozac, or Celexa, are the most common type of antidepressant. These medications work by impacting the levels of serotonin in the brain. Serotonin is responsible for many essential functions, including mood, emotional regulation, sleep, and appetite.
It’s important you and the prescribing doctor are fully aware of the benefits and risks of putting a child on an antidepressant.
Antipsychotics, such as Abilify, Latuda, Risperdal, and Seroquel, treat psychotic symptoms associated with delusions, hallucinations, paranoia, and other disorganized functioning. These medications primarily impact dopamine, serotonin, and noradrenaline.5
Anti-anxiety medications, such as Xanax, Klonopin, and Valium, help slow down the central nervous system and reduce anxiety symptoms. Benzodiazepines are the most common type of anti-anxiety medication. They increase the effects of GABA within the body, coinciding with more relaxation and sedation.
It’s possible to build a tolerance to benzodiazepines. Tolerance can foster dependency. Benzodiazepines are classified as controlled substances, meaning they have the potential for abuse. For this reason, psychiatrists prescribe them for short-term, moderated use.
Psychiatrists may prescribe stimulants, such as Ritalin, Adderall, or Vyvanse, for people diagnosed with ADHD. In rarer cases, they may prescribe these medications for narcolepsy or treatment-resistant depression.
Stimulants work by increasing dopamine levels. This effect can help boost concentration while decreasing hyperactivity or inattentiveness.6
Mood stabilizers, such as Lithium and Depakote, work by decreasing irregular activity levels in the brain. They essentially ‘stabilize’ neurotransmitter functioning, reducing symptoms of mania, depression, and mood swings.7
Psychologists have doctorate degrees in mental health specialties and comprehensive clinical training. They may identify as either a Ph.D. or PsyD. They may also identify as an LP (licensed psychologist). If they have an ABPP, it means they are nationally board-certified.
Clinical psychologists often provide therapy. In this setting, they can work with individuals, families, couples, and groups. Psychologists cannot prescribe medication in most states. However, in Louisiana, New Mexico, Illinois, Iowa, and Idaho, qualified psychologists may have prescribing rights.
Psychologists often provide psychological assessments, and they may conduct research and testing. Below are some common assessments psychologists administer:
Assessment of Intellectual Functioning (IQ)
IQ tests help assess an individual’s cognitive and intellectual abilities. IQ test results serve numerous benefits, and they can be used for:
- Educational placement and planning for children
- Screening intellectual disabilities
- Evaluation for potential job placements
Most experts agree that both genetic and environmental factors shape individual personality. Personality assessments offer insight into specific strengths, weaknesses, preferences, and patterns. Common personality assessments include:
- Minnesota Multiphasic Personality Inventory (MMP-2)
- Millon Clinical Multiaxial Inventory-III (MCMI-III)
- Rorschach Inkblot Test
- Thematic Apperception Test (TAT)
Other Types of Psychologists
Having a psychologist title isn’t inherently correlated with providing clinical treatment. In fact, there are many psychologist subtypes, including:
- Forensic psychologists work with criminal justice and legal teams to assist and advise in cases.
- Educational psychologists improve learning and academic outcomes in schools.
- Health psychologists focus on treating specific health issues.
- Industrial-organizational psychologists improve productivity and growth within corporate settings
- School psychologists promote safety and well-being for students in school settings.
- Social psychologists work to understand specific human behaviors within a greater social construct.
The term psychotherapist is the overarching umbrella term for mental health professionals who offer therapy. Psychotherapists may include:
- Licensed psychologists (LPs)
- Licensed marriage and family therapists (LMFTs)
- Licensed clinical social workers (LCSWs)
- Licensed professional clinical counselors (LCCPs)
- Licensed mental health counselors (LMHCs)
All licensed psychotherapists must have at least a master’s level degree of education. They must also complete thousands of hours of clinical experience and pass state board exams.
If someone identifies as an intern, associate, or trainee, it means they are not yet licensed. Instead, they work under a licensed provider while accruing relevant experience. These professionals may be finishing graduate school.
Psychotherapists tend to primarily offer therapy and other clinical services. Like psychologists, they can work with individuals, families, couples, and groups.
Case managers can help provide wraparound services for mental health care. They may facilitate referrals for housing, jobs, or financial support. Additionally, they can also offer counseling services for clients.
Case managers have varying degrees of education and experience. Certified case managers (CMCCs) receive specialized education and training within case management. Many case managers receive their CADC, which is specialized training in drug and alcohol counseling.
Case managers tend to work in managed care settings, such as hospitals, nonprofit facilities, prisons, mental health organizations, and schools.
Psychiatric nurses are specialized registered nurses who focus on psychological well-being. They have the letters ANCC or PNCB (for pediatrics) behind their names. In addition to becoming a registered nurse, psychiatric nurses must complete at least a certain number of hours working in psychiatric care.
They can provide psychoeducation, support crisis management, and offer basic counseling. Most psychiatric nurses work with other healthcare professionals in hospitals, rehabilitation facilities, doctor’s offices, and assisted living facilities.
Life Coaches or Self-Help Gurus
In general, it’s essential to be cautious and avoid working with anyone who makes bold, grandiose claims or promises to have a cure.
There has been a recent influx of unlicensed professionals touting their abilities to treat mental health issues. These gurus usually become well-known through social media, self-help books, or expensive coaching programs.
Often (although not always), they lack essential education and training. Or, they may have degrees in other fields, but they do not have specific certification in mental health.
Non-credentialed providers can be harmful to your well-being. That’s because these providers do not necessarily subscribe to a specific code of laws and ethics. They may also not have the appropriate experience in treating mental health conditions. In other words, you may risk investing time, money, and emotional energy into someone lacking professional expertise.
Of course, many people have experienced success and reported improvement after working with this type of individual. It will be important to research the person you are hiring, ask the right questions, and fully understand their qualifications and certifications.
Which Mental Health Professional is Right for You?
Do you want to review medication options?
If so, you will likely need to meet with a psychiatrist or a psychiatric-mental health nurse practitioner. In some cases, your primary care physician will prescribe psychiatric medication and certain psychologists in specific states may have prescribing ability. Additionally, many physicians and psychiatrists work in tandem to provide wraparound care.
Do you want support for a specific mental health issue or emotional concern?
If so, you will likely benefit from meeting with a psychologist or psychotherapist. Some psychologists provide advanced testing, which can be beneficial if you want specific diagnostics in topics like neurofeedback. Psychologists may charge more for their sessions than master’s-level therapists.
Do you need comprehensive care for a severe issue?
If you’re struggling with an acute severe mental illness or substance use disorder, you may need more intensive services like inpatient or partial hospitalization care. Consider speaking with your primary care physician to review options.
Are you the parent of a child struggling?
Do you want to complete a specific assessment?
Understanding Your Payment Options
Once you decide it’s time to start looking for potential candidates, you need to begin your search. At first, it may feel overwhelming.
Mental health treatment can undoubtedly be a financial investment. But no matter your budget, some qualified professionals can help you. It’s important to learn the various payment options available.
You can organize your process by following the next steps.
Free or Low-Cost Services
You may be able to obtain free or low-cost care through your local community. If paying for therapy is a concern, start with these resources.
Many universities with therapist graduate programs offer low-cost treatment in exchange for meeting with a graduate student. These services are often open to the public.
Additionally, if you are an enrolled college student, you might have access to a university clinic with a campus therapist or psychologist. You might also have access to free or low-cost psychiatrists who can prescribe medication.
University-based therapy tends to be short-term. You may only have a designated number of sessions with a therapist (such as meeting once a week for one semester).
Employee Assistance Program (EAP)
Many companies offer employee assistance programs, which can qualify you for a certain number of free therapy sessions. Even though this contract is through your work, the nature of your sessions will remain confidential.
If you aren’t sure if your company provides EAP, ask your human resources representative.
Nonprofit Mental Health Facilities
Most cities and counties contract with nonprofit mental health facilities to provide low-cost treatment. Guidestar provides an extensive directory of more than 15,000 mental health and crisis services in the US.
If you aren’t sure about the local resources in your area, you can start by calling 211. 211 acts as a springboard in helping connect people with treatment options.
If you receive Medicare, you may acquire complete mental health coverage for free or subsidized costs. This coverage usually entails mental health screenings, counseling, psychiatric evaluations, and diagnostic tests.
You can search for Medicare providers using the Medicare website comparison tool or by calling them directly at (888) 904-4702.
The Affordable Care Act requires that insurance companies provide coverage and access to mental health resources. Today, many clients use their health insurance to receive subsidized treatment.
If you opt to use insurance, it’s important to remember that there are inherent limitations. For instance, insurance companies will only pay for services rendered ‘medically necessary.’ To prove this medical necessity, your provider must give you a mental health diagnosis.
Keep in mind it can be challenging to receive any coverage for services like couples or family therapy. Furthermore, you may run the risk of only having a few providers within your area. Waitlists can be long, which can make accessing care even more challenging.
If you want to try to use your insurance, consider taking the following steps:
- Determine what coverage is available by calling your insurance company directly.
- Calculate the costs associated with deductibles and copays.
- Ask for a list of in-network mental health providers.
- Contact these providers and ensure they still take this insurance.
To continue receiving coverage, your provider must regularly update your insurance company with your progress. You will need to provide consent to let them share your records. Your insurance has the final say in determining if they will authorize payment.
What’s a Superbill?
Sometimes, out-of-network providers offer superbills. A superbill is a detailed invoice that provides an itemized list of the services you receive. It will contain pertinent diagnostic and treatment information.
In the case of a superbill reimbursement, the money goes directly to you rather than your therapist. However, there is no guarantee of payment.
If you change insurance during the year, this may impact your mental health treatment. Your deductible or copays may increase or decrease. Similarly, your provider may not be in-network with your insurance.
Sliding Scale/Pro Bono Services
Many providers offer a sliding scale for clients facing financial hardship. Similarly, some therapists provide a few free, pro bono slots within their practice. You can always ask if this option is available.
Some providers will indicate their sliding scale explicitly on their websites or intake forms. Sometimes, the sliding scale rates are provided. Most of the time, however, you will need to inquire directly.
When making that first contact, it’s a good idea to say something along the following lines:
I’m interested in seeking treatment for _____. My budget is tight. Do you offer any sort of discount or sliding scale for clients in my position?
From there, the provider may indicate how they reduce costs. For example, they might ask you about your annual salary or specific budget concerns. Providers offering a sliding scale may provide a cheaper rate with the agreement that you two will revisit the topic every month or so.
If they cannot accommodate your budget, they will provide you with appropriate referrals for other providers.
Private pay may be the best option for clients who:
- Do not wish to use their insurance to fund treatment
- Do not meet criteria for a specific mental health diagnosis
- Want to work with one particular specialist who may not take insurance
- Do not have financial constraints regarding payment
Private pay costs vary depending on the provider’s experience, location, and type of services conducted. If you pay privately, your provider will handle payment directly. You will either keep a credit card on file or pay with cash or a check during each session.
Meeting with a Therapist or Psychologist
Typical costs for therapy range anywhere between $75-$250 per session. (8) For example, the average therapist in Atlanta, Georgia charges $125 per session, whereas the average therapist in Miami, Florida charges $200. In metropolitan areas or with highly-specialized professionals, the fee can be much higher.
Most therapists meet with clients once per week for about forty-five minutes to one hour. Psychologists charge similar rates, although they tend to cost more than the average therapist. Expect to pay extra for psychological testing or assessments. Psychologists may charge an hourly or flat-rate (around $125-$200 per hour). Full assessments, which may require several sessions, can cost anywhere from $1000-$3500. (9)
Meeting with a Psychiatrist
Psychiatrists may charge up to $500 for the initial intake and anywhere from $100-$300 for follow-up sessions. The intake can take up to 1-2 hours. Subsequent sessions tend to be much shorter unless your psychiatrist provides talk therapy.
Meeting with a Life Coach or Non-Credentialed Provider
Life coaching and non-credentialed services exclusively require private pay. Insurance does not currently subsidize these services. Most coaches charge between $75-$200 per hour.
Monthly Subscription Services
Some telehealth services offer subscription services for flat-rate fees. These services may include ongoing messaging support and designated sessions.
The company will charge your card on file once per month. You can choose to cancel or suspend your account at any time.
Different Types of Clinical Therapy Treatment
Many proviers are systematically trained, which means they work with indiviuduals, families, couples, and groups. There are various benefits associated with each model.
Individual therapy can provide guidance, support, and practical coping skills for people struggling with various mental health issues. In individual therapy, you focus exclusively on yourself and your specific needs.
Many people combine different treatment methods as part of their care. For example, a woman struggling with her husband’s infidelity might attend individual therapy and couples therapy. A man recovering from depression may participate in a mental health support group and take antidepressants.
In many cases, different treatment providers will work together to coordinate care. At any given time, a treatment time may consist of various professionals, including:
- Social workers
- Primary care physicians
- Case managers
- Probation officers
Combining treatments tends to be very common in managed care settings. Comprehensive care helps ensure that clients receive wraparound treatment addressing multiple needs simultaneously.
What About Alternative Treatments?
Alternative or holistic approaches can also be useful in mental health treatment. Many people use them as coping strategies to support overall emotional well-being.
Some common recommendations include:
- Mindfulness and meditation
- Diet and exercise
- Natural supplements
Your provider may recommend some of these approaches as part of your treatment plan. If you decide to engage in any of these strategies on your own, it’s a good idea to let them know.
Different Levels of Care
Every type of treatment falls under a different level of care (LOC). These levels of care range in severity.
Hospitalization may be necessary for immediate stabilization. This might be recommended in the following events:
- Active psychosis
- Danger of hurting self or others
- A recent suicide attempt
- Severe intoxication or issues with active substance use disorders
- Severe malnutrition or medical issues associated with an eating disorder
Hospitalization tends to be brief, although some people are hospitalized several times during their lives. It is not considered adequate treatment- hospital staff will provide appropriate referrals for the next phase of care.
Inpatient or Residential Treatment
Inpatient or residential treatment offers 24/7 supervision and support. Clients live in a monitored facility and receive several hours of clinical services each day.
The length of treatment varies, but it usually averages between 30-90 days. This is considered the highest level of clinical care. It is typically recommended for severe mental health conditions, substance use disorders, or after a period of hospitalization.
Partial Hospitalization Treatment
Partial hospitalization treatment is similar to inpatient treatment, but clients do not live on-site. Instead, they come to a center 5-6 days per week for clinical services.
Many times, clients receiving residential treatment transition into a partial hospitalization level of care. Some people start at this level- this way, they can still stay home with their families or go to work.
Intensive Outpatient Treatment/Outpatient Treatment (IOP/OP)
IOP/OP levels of care range from receiving clinical services a few times a week to about once a week. In general, private mental health providers offer this type of treatment.
This care is best for clients who can adequately demonstrate some coping skills and the ability to live independently. This treatment can last for a few months to several years.
Finding and Interviewing Your Provider
How do you know if someone is qualified to help you? What should you be searching for when narrowing down providers?
In general, expertise refers to having adequate knowledge and experience in a particular field of interest. While all mental health professionals receive graduate-level education and complete relevant internships, each provider has different focus areas.
To discern one’s expertise, consider asking the following questions:
- What specific training do you have in treating ____?
- What therapeutic modality do you follow?
- What kind of results should I expect?
- How long have you been treating ____?
Unfortunately, there isn’t a universal standard “guaranteeing” one’s expertise. Ethical providers stay abreast in their field by attending workshops, gaining certifications, and keeping track of current research. You might want to spend some time researching different clinical treatments and determine which ones appeal to you.
It should be noted that expertise alone doesn’t guarantee a good fit. Even if someone has ample experience in a specific niche, it doesn’t mean you two will automatically connect.
That said, experts can offer an essential starting point for ensuring you’re on the right track. If you have a rare condition or specific need, expertise can be invaluable, as you want to work with someone who understands appropriate treatment.
Finding a Provider Online
Type “therapist near me” in Google, and you will be inundated with millions of search results. The sheer volume of these responses can be overwhelming, and it’s crucial to know how to parse out all the excess information.
Several mainstream directories help you screen multiple providers. These directories are free, convenient, and widely used among both clients and professionals. You can add filters related to specific specialties, treatment methods, location, and religious backgrounds.
After finding a potential provider, you can usually contact them through the directory or call their provided work phone number. The directory may also link their website, giving you more information about their practice and contact information.
Psychology Today advertises itself as the largest therapist directory. After indicating your city, you can narrow down your search by selecting therapists who:
- Accept your insurance policy
- Treat your specific issue
- Specialize in a specific sexuality
- Specialize in a specific age group
- Speak certain languages
- Practice specific types of therapy.
Good Therapy is another extensive directory that helps you locate providers in your area. You can narrow down your search by:
- Pricing (can filter out which therapists offer free consultations and sliding scales)
- Common specialties
- Types of therapy services
- Types of insurance accepted
- Availability (i.e., weekends and evening)
TherapyTribe starts by having you select your location and indicate a specific area of focus, such as chronic pain, eating disorders, or divorce. From there, your search results will list specialists who can treat that issue.
Open Path Collective
OpenPath Collective is a nonprofit organization that connects clients with local sliding scale therapists. This program is designed for clients with high insurance deductibles or who otherwise cannot afford full-fee therapy.
To join, prospective clients can obtain a lifetime membership for $59. From there, you will have access to a directory of therapists who provide services for no more than $60 per individual session or $80 per couples or family session.
APA Psychologist Locator
The APA Psychologist Locator connects clients with local psychologists, making this an attractive option if you want to work with a psychologist (instead of a master’s-level therapist).
You can refine your search by:
- Practice area
- Insurance accepted
- Treatment methods
- Age group specialization
- Nationality specialization
- Languages spoken
What About Telehealth Directories?
Telehealth has surged in popularity in recent years and this trend will likely continue as more people rely on technology as part of their daily routine.
When searching for a provider, you will likely stumble upon mainstream sites like BetterHelp or Talkspace. These sites advertise offering low-cost telehealth services. Telehealth refers to virtual healthcare, which means you will interact with your provider via video chat, texting, or email.
Pros of telehealth
- Flexible scheduling
- Access to more therapists, particularly in rural areas
- Convenience (can meet with a therapist in the comfort of your own home)
- Services that meet every budget point
- Discreet services
Cons of telehealth
- Some sites have very high turnover rates
- Privacy issues (if you do not live alone or do not have a confidential space)
- Virtual support may feel more impersonal
- Technological difficulties that can interfere with treatment
Some agencies and therapists also offer telehealth options as part of their general practice. Usually, they charge the same rate for telehealth as they do for in-person sessions.
Should You Consider Telehealth?
Telehealth is relatively similar to in-person treatment. You will still meet with your provider regularly, work towards meeting specific goals, and share your thoughts and feelings each week. However, because it is a fairly new concept, research on the efficacy remains limited.
Emerging studies show promising results. More than 75% of clinicians in a particular study indicated that telehealth allowed them to offer quality care during the COVID-19 pandemic. Over half of those participants indicated that telehealth has improved the health of their clients. (10)
Telehealth may be the best option for people who:
- Lack reliable transportation.
- Have extremely busy schedules and are constantly on the go.
- Desire discreet services without any chance of running into others in a waiting room.
- Want to work with a specialized provider in a rural area.
Benefits of Telehealth in “Medical Deserts”
A medical desert refers to a specific region located at least more than an hour away from the nearest hospital. In other words, these areas lack adequate access to treatment. Nearly 80% of rural America meets the criteria for being medically underserved. (11)
It’s no secret that accessible mental health treatment remains an ongoing problem. Just like lack of hospital services can create issues, a lack of sufficient therapy can also affect a community’s well-being. While metropolitan regions may be saturated with providers, remote areas may only have one or two clinicians. If those clinicians have full schedules, what options do you have?
Telehealth can help bridge the gap in areas where treatment is scant or nonexistent. Therapists must be licensed to work in the state they provide services. However, this rule means they can treat any client within the state. Similarly, it’s not uncommon for therapists to become licensed in multiple states.
Best Practices When Reviewing Providers Online
When scrolling through limitless providers, what distinguishes a good match? While there isn’t a perfect answer, here are some considerations.
Be Careful Of Too Many Specialties
If a provider reports to treat seemingly every diagnosis or issue, it means they aren’t a specialist. True specialists hone in on their niche- they may only work with a few populations or conditions.
Beware of Reviews
Online reviews is a tricky space – while they can provide great insight into a company, they can also paint a false picture. When was the last time you left a review? Were you upset with a service? When people do leave reviews about a certain company or service, it can be out of spite, anger, or other, unrelated issues. That said, if someone has several negative reviews, this could be a red flag. It means enough people felt harmed or upset in treatment. Furthermore, due to the stigma around mental health, satisified patients may not leave a public review online.
You should also be mindful if a provider has too many positive reviews. For instance, if other local therapists have 5-10 reviews, but one person has 50+, this may mean they paid for fraudulent reviews or acquired them through some other suspicious activity.
Professional Online Presence
Most providers have a business website with professional headshots. They may also have a LinkedIn page or published articles. Likewise, if they have public social media pages, the information should be professional without being overly revealing. For example, you shouldn’t see pictures of a potential therapist out at a bar with friends!
Responsive, Up-To-Date Information
Does their website load quickly? Does their information seem relevant and current? Therapists who take their practice seriously take pride in their online presence. In doing this, their websites often look polished and professional, their articles are recent, and they are responsive when answering inquiries.
Getting Ready For Your First Session
You’ve finally found some providers, and you’re getting ready to make the initial point of contact. This step can feel frightening, but you’re on the right track! Here are some tips to ensure the process goes smoothly and effectively.
Determine How They Want to Be Contacted
Most providers list their direct contact information on their website. They may have a specific contact form to answer a few questions and wait for them to reach out to you. If you’re using a directory, you can contact them through that specific site.
Some providers might indicate they prefer phone calls. In some cases, the phone call will direct you to a reception line. In other cases, you will be prompted to leave a message in their confidential voicemail box. You can use the following script when leaving a message:
Hi, my name is ____. I found you through (name of website or referral). I am interested in meeting with you, and I was wondering if you are currently accepting new clients. You can call me back at ____. I am usually available at (these times). Thanks!
If you really want to work with a provider, don’t be afraid to follow up after a few days. After giving it two tries, however, it’s probably best to move onto someone else.
Inquire About an Initial Consultation
Many providers offer complimentary consultations to discuss your treatment needs and goals. Consultations may be done in-person, over the phone, or via videoconferencing. These consultations are typically about 10-20 minutes, and they can help a potential provider determine if they are an appropriate fit.
Remember that ‘appropriate fit’ is a two-way street. You should use this time to gauge how comfortable you feel talking to them. Feel free to ask any questions that come to mind. You may want to write down a list of items to discuss ahead of time.
During the initial consultation, they will likely review:
- How they can help treat specific issues
- Payment and scheduling
- What to expect during your first session together
If you need immediate support, let your provider know this ahead of time. Some professionals with full practices may have waitlists spanning for several weeks or months. If this is the case, ask if they can provide you with other referrals.
Sign Release of Information Forms (If Applicable)
As part of their legal and ethical requirements, mental health professionals must maintain confidentiality about your care. Confidentiality means that your treatment remains private.
That said, you may wish for certain past or current providers to coordinate care. For example, if you spent years working with one therapist, you may want them to provide your new therapist with an overview of your treatment. Or, if you’re meeting with a psychiatrist, you may want them to share relevant updates with your therapist.
For them to share records, you must sign legal consent forms. On these forms, you can specify what you permit the provider to disclose. Beyond mandated reporting, consent always belongs to you, meaning you can change or withdraw your terms at any time.
Arrive a Few Minutes Early
Try your best to arrive early for your first appointment. This ensures that you have enough time to fill out extra paperwork.
You may feel nervous while you wait. You might also feel somewhat awkward or uncomfortable around your provider for the first time. This feeling is normal! Just like with any relationship, things will ideally feel more comfortable as time goes on.
What Happens During An Intake?
Your first session primarily includes completing an intake. You won’t dive right into the clinical work- your provider needs background details about your life first.
An intake consists of a comprehensive questionnaire about your physical and mental health. You may complete this intake over the phone or in person. Some providers will provide you with forms to complete for them to review.
You will likely answer questions about:
- Why you’re seeking treatment
- Basic demographic details (age, culture, career, socioeconomic status)
- Your family history and current family dynamics
- Current medical issues
- Previous history with treatment
- Your existing support system
This intake provides your provider with an overview of your treatment needs. They will use this information to help shape your treatment plan.
Try to be as specific as you can in explaining why you’re seeking treatment. For example, you might be feeling depressed. But it’s helpful to indicate your specific symptoms, their impact on your life, and what you’re hoping therapy can do to help.
That said, if you don’t have overly specific goals, that’s okay, too. Instead, try to describe (to the best of your ability) what’s going on in your life. If you feel upset, sad, or worried about something, that’s important to share.
During intake, your provider will also review the limits of confidentiality and specific expectations for treatment. You will discuss fees, scheduling needs, and other administrative details.
Recommended Questions to Ask a Mental Health Professional
As a prospective client, you are entitled to ask a mental health professional questions about their practice and approach. Keep in mind that most providers will avoid or limit answers about their personal life. However, you always have the right to inquire.
As a caveat, if you want to work with a provider who shares something in common with you (i.e, the same religion, political beliefs, sexual orientation, ethnicity), it’s reasonable to ask about this ahead of time. Some providers will readily offer this information. Others will remain more private.
If you know you would feel more comfortable with someone who relates to a specific issue, let a potential provider know. If they aren’t the right fit, they should have other referrals.
Below are some other, helpful questions to consider asking ahead of time.
"Where did you attend school or receive your training?"
Remember that you can also look up any state licenses online. There isn’t a universal method for doing this, as each license and state has different boards. A quick Google search with the terms “look up therapist/psychologist/social worker license in ___ (name of state)” should bring you to the appropriate website.
"How frequently will we meet?"
Most therapists meet with clients once a week for about 45-50 minutes. However, some therapists will meet with clients as infrequently as once per month or as often as twice a week. In hospital or residential settings, you may even meet with a provider everyday. The frequency typically depends on the severity of your presenting issue. Psychiatrists often meet with clients less often than therapists. Subsequently, case managers may meet clients only at specific, appointed times.
"When will I see results from therapy?"
Most therapists will not be able to provide you with an exact answer. It’s challenging to put a specific timeline on treatment. However, some therapists specialize in brief therapy (just a few sessions), whereas others focus on more long-term work. There is no right-or-wrong treatment, but your therapist should be able to give you a general idea of what to expect.
"How will we review our progress?"
There isn’t a one-size-fits-all answer for reviewing progress. For example, some will have you fill out a survey after each session. Others may check-in every month or so. It’s a good idea to ask the provider exactly how frequently you will revisit this topic.
"What would you like me to do before our first session?"
"What are the risks of therapy?"
"What are the risks/side effects of this medication?"
Red Flags in a Potential Provider
Unfortunately, not all providers are created equally. Be mindful of the following warning signs when meeting with someone new.
Therapists must adhere to specific laws and ethics with their clients. Unprofessional conduct can include:
- Asking you to help with specific favors
- Overly self-disclosing about their personal life
- Touching you inappropriately
- Entering a romantic relationship, friendship, or working relationship
- Frequently giving unsolicited advice
- Breaking your confidentiality
- Acting out of scope (i.e., giving you direct financial, medical, or legal advice)
Therapists help support your mental health treatment. For this reason, your relationship must remain professional. Anything that deviates beyond that standard could be a serious concern.
It’s a misconception that therapists just “tell you what to do.” In fact, good therapy offers very little advice- instead, therapists help you come to your own conclusions about living an ideal life. In some cases, they will offer suggestions and feedback worth trying. However, ethical providers won’t push you to do something you don’t want to do.
In general, treatment should focus exclusively on you and your needs. If it feels like they’re making their work too much about them, it’s a red flag.
Lack of Empathy or Compassion
It’s vital that your provider displays a genuine interest in your growth. Empathy and compassion means:
- Praising your successes and positive attributes
- Validating your emotions
- Gently confronting discrepancies or issues without shaming you
- Remembering important details about your life
- Genuinely appearing to enjoy the time you spend together
If they appear bored, restless, or angry with you, that’s a concern. Feeling judged can stunt your progress, and it can affect your ability to express your feelings. An ethical provider will never criticize you or call you names.
I saw a psychiatrist once a week for years. During which time, he dozed off in his chair while I was speaking no less than ten times. I never brought it up. And neither did he. Looking back, I should have said something. today, I hold my providers to the same standards I hold myself. If I am showing up, ready to work – I exepct my provier to show up and be ready to work as well.
Moving Too Quickly
Trust takes time, and that’s why the rapport-building stage is so crucial. You need to feel like treatment is progressing at the appropriate speed.
Some mental health treatment can feel uncomfortable, but you shouldn’t feel rushed to talk about or do something that doesn’t feel right. For example, you shouldn’t feel pressured to spill intimate details of a past trauma during your first session!
Ethical providers respect your privacy and vulnerability. If you don’t want to talk about a particular topic at the moment, they will respect your need.
In general, providers should be consistent with their behavior. This consistency provides a sense of familiarity and safety.
The opposite is also true. If your provider seems to change their expectations frequently, it can feel awkward and uncomfortable. Some examples of confusing boundaries include:
- Letting sessions frequently end late.
- Being unclear about how and when you can contact them in between sessions.
- Changing the way they conduct therapy each week.
- Failing to provide you with essential information about payment or scheduling.
While it’s normal to feel attached to your provider, excess dependency is dangerous. This is why it’s your provider’s job to uphold professional boundaries. They should be encouraging you to make independent choices- not reinforcing you to rely on them for critical decision-making.
Your Intuition Tells You Something Feels Wrong
If you immediately experience an adverse reaction to a provider, pay attention to that feeling! Your body might be subconsciously picking up on something concerning.
Therapy is a unique relationship, and even if someone appears excellent on paper, it doesn’t mean they are a great choice for you. If something doesn’t feel right, it’s perfectly reasonable to move on. You can explain your rationale, but you are not under obligation to do so.
How to Encourage a Loved One to Seek Help
If you’re concerned about a loved one, it’s important to be patient and mindful of their feelings. Mental health tends to be a complicated subject- it can trigger immense shame, fear, and discomfort for people.
When encouraging a loved one to seek help, it can be helpful to prepare in advance. You may need to organize your thoughts and rehearse what you want to say beforehand. Here are some beneficial tips.
Do Share Your Specific Concerns
Stick with facts and use I-statements when asserting how you feel. An I-statement typically adheres to the format, I feel ___ when you ____.
For example, you might start by saying, I felt worried when you stopped showing up to work last week. Or, I felt hurt when you stole money from me.
By expressing your feelings calmly, you raise awareness of how their actions affect you. At the same time, you aren’t accusing or attacking them. You’re simply conveying how you felt.
Do Convey Your Love
Let your loved one know how important they are to you. Share your gratitude for your relationship and emphasize that you believe in them. Try to convey that you’re speaking to them because you care about their well-being and your relationship.
Do Pick The Appropriate Time and Place
Unless you plan on staging an intervention (which requires preparation), do not involve other people in this conversation. Having others around can make your loved one feel uncomfortable or defensive.
If you don’t know the best time, consider asking what works best for them. For example, I want to talk to you about something important. What time is good for you? Can we schedule it?
Of course, this direct question may prompt them to immediately ask you what’s wrong. If that’s the case, simply reinforce that you want to make sure you’re both in the right headspace.
Do Anticipate Defensiveness
Your loved one may feel like a burden. They may assume you’re overreacting or jumping to conclusions. Try to prepare for these reactions- and try to avoid getting defensive yourself.
Do Set Boundaries
Regardless of your loved one’s mental health, you deserve to be treated with respect and dignity. You will not be helping anyone if you allow others to take advantage of you.
Your boundaries will vary depending on your relationship, but they may include:
- Refusing to provide financial support until they seek appropriate treatment
- Prohibiting them from criticizing or calling you names in your home
- Asking them to contribute around the house or take care of certain tasks
Requiring them to use respectful language around you
- Setting limits around what you choose to disclose around them
Do Not Use Stigmatizing Language
Instead of saying, “You’re crazy or mentally ill!”
Identify your feelings and say, “I am concerned about your behavior. I have observed ___ (these symptoms), and they worry me.
Instead of making assumptions about diagnoses and saying, “You have bipolar disorder!”
Use I-statements and say, “I am concerned about ____ (these symptoms). I think it would be helpful to speak with a therapist or psychiatrist about what’s going on. Maybe they will have a better understanding.
Instead of saying, “Are you seeing your shrink this week?”
Use the appropriate terms and say, “When are you meeting with your therapist next?
Instead of using psychiatric terms when describing situations like, “The weather is so psychotic today!”
Use non-psychiatric terms and say, “Wow, we’ve been having such unpredictable weather lately!
Instead of making mental health sound like it’s always negative like, “She’s suffering from depression.”
Use neutral language and say, “She has been diagnosed with depression.”
How to Talk to Your Child about Their Mental Health
Do Model Sharing Your Own Feelings
As a parent, you can positively influence sharing your own feelings in front of your children. For example, you might say, I am feeling upset right now. I know I won’t feel this way forever, but I am a little sad. With young children, you can practice asking how you believe certain fiction or television characters may feel at a given time.
Modeling these statements demonstrates your willingness to attune to your feelings. If children grow up in a home where it’s okay to talk about emotions, they may feel more apt to share them with you.
Do Reach Out To Other Adults
Often, if a child struggles with their mental health, the difficulties can bleed into areas beyond the home. For instance, they might start acting out in the classroom. Or, they may change peer groups suddenly.
Set up a conference with other adults to get on the same page. Intervention may require several trusted influences in your child’s life- having more people on your side increases your chances of providing support.
Do Discuss Healthy Coping Strategies
You should try your best to limit or avoid negative coping skills in front of your child. If they regularly observe you trying to escape your emotions (i.e., by drinking, smoking, overeating, watching TV), they may start replicating your patterns.
Do Not Assume It’s a Phase
Many adults wrongfully assume that childhood struggles are fleeting and temporary. Unfortunately, this isn’t always the case. The average onset of most mental illnesses starts in adolescence, and many children experience depression and anxiety symptoms at a young age. (12)
The following behaviors are a sign for concern:
- Jokes or ongoing conversation about suicide
- Sudden decline in school performance
- Withdrawal from friends, family, or usual interests
- Frequent somatic complaints (headaches, stomach problems)
- Noticeable, rapid weight changes or evidence of disordered eating
- Suspicious of substance use
- Increased symptoms of anxiety or depression
Don’t dismiss these symptoms as rebellious or hormonal- even if they are temporary, they still deserve attention.
Do Not Force Them To Go To Therapy
Some children will resist therapy. They may think it’s ineffective, awkward, or otherwise unhelpful. Instead of disregarding their concerns, ask them to collaborate with you. Would they like to choose another provider? Would they feel better if you attended a session with them?
Remember that therapy can represent a trial-and-error process. Validate your child’s concerns while also emphasizing your feelings. For example, you can say, I know you didn’t like meeting with ____. I’m sorry it wasn’t a good experience. You deserve to feel respected in those sessions. I want you to feel safe and comfortable- how can I support you in making sure that happens?
How to Talk about Your Mental Health with Others
Your decision to seek mental health treatment is personal and can be completely private. You don’t owe anyone an explanation. However, you may want to confide in your choice with trusted loved ones. For example, if you have a standing appointment each week, it’s usually helpful to share where you’re going! Here are some tips for having this important conversation.
Consider What You Want to Disclose
If you choose to share your mental health with others, remember that you don’t have to reveal everything. It’s up to you to decide how much you wish to disclose.
Some people find it beneficial to start by telling just a few details. They gauge the other person’s reaction first before deciding if they want to share more. This strategy can help determine who is and isn’t safe for expressing such vulnerability.
It’s unrealistic to assume that everyone will understand your mental health concerns. Some people will inherently judge, ask inappropriate questions, or react negatively. You may wish to be more discreet around those individuals.
Choose the Right Time
The National Alliance on Mental Health (NAMI) recommends using the following criteria when opening up about your mental health: (13)
- Find a time when your emotions feel stable: If you’re in the middle of a crisis, you risk losing objectivity and becoming highly reactive to other people. Instead, try to find a calmer time to disclose. This ensures that you will be more receptive to feedback.
- Have a purpose in mind: It’s important to consider why you’re choosing to disclose about your mental health. What do you hope to achieve from this admission? For instance, do you want to give your mother an explanation why you didn’t show up to the family reunion? Do you want to ask your partner if they will seek marital counseling with you? Consider this purpose before spilling your story. It will help you remain organized and cohesive in your discussion.
- Wait until you feel ready: Once the truth is out there, it’s out there, and you can’t take it back. You might want to practice expressing your feelings beforehand with a therapist or trusted loved one.
Avoid Any Blaming
Some people may become reactive when they discover that you’re struggling or seeking mental health treatment.
Why would you need to talk to someone else when you have me? Are you going to complain about me the whole time? Isn’t therapy for crazy people- you’re not crazy! You shouldn’t feel depressed when your life is this good.
These statements may come from a place of good intentions. But they can feel cruel and attacking. Instead of becoming defensive, take a deep breath. Remind yourself that mental illness comes with many stigmas, and it’s not your responsibility to “make” other people understand what you’re experiencing.
Focus on Your Progress
After starting treatment, you might notice that you suddenly want your spouse or parent or friend to get help. After all, if it’s benefiting you, why wouldn’t it benefit them? And so, you may begin dropping subtle (or not-so-subtle hints) about why you think they should seek support.
Be careful with this kind of behavior. Your treatment should reflect on your thoughts, feelings, and behaviors. It’s not about changing other people. If your loved ones decide they want to seek help, that needs to be their choice.
Other people might become impatient or nosy about your treatment. Remember that this journey is about you, not about appeasing them. Let them know that you are continuing to work on yourself and that you will reach out if you need more specific support.
4. American Psychiatric Association