Navigating the Gauntlet of Getting Started with Therapy
How to Get Started with Therapy
You are finally ready. To seek the support you are missing in your everyday life, to take stock of your patterns of showing up in the world that used to work just fine and now….well kind of, don’t. To change your relationship to your life experiences by honoring your resiliency and letting go of what no longer serves you in that story.
But where to begin on this newfound enthusiasm to heal and find a therapist? It can be daunting, overwhelming, and just plain frustrating to get help and support once you’ve decided you would benefit from it.
Things you may want to consider are:
What training and education a therapist you are interested in has had
What your goals are for therapy
Whether you have a preference for in-person or virtual therapy
Who can you see for therapy?
Mental health therapists come to the work of supporting folks in outpatient mental health via a variety of avenues. In the medical world, a family practice doctor, pediatrician, or primary care doctor each have a unique lens they view their patients. Just like choosing a physician, it is important to consider a therapist’s schooling or education, their perspective of a client’s struggles, obstacles, and successes. Additionally, how a therapist approaches providing support and facilitates healing within therapy (including what therapeutic tools they regularly use to facilitate healing) are important considerations.
Below are some of the acronyms you may see behind therapist names and what they mean (but TLDR - social workers, psychologists, counselors and family therapists are all qualified to support you on a journey for outpatient mental health!)
Social Workers
Social workers often see mental health symptoms as connected to a person’s environment (family, culture, race, trauma history, social systems and access to resources). There is often a strong lens focused on systemic barriers, life stressors and injustice. Social workers navigate healing by helping clients build coping skills, strengthen relationships, increase self-awareness and navigate life stressors. They emphasize empowerment and resilience.
Licensed Independent Clinical Social Worker (LICSW):
A mental health therapist who has advanced training and full licensure to diagnose and treat mental health conditions. They can work independently and provide ongoing therapy.Licensed General Social Worker (LGSW - Provisionally Licensed):
A social worker who has completed their master’s degree and is working under supervision toward full licensure (LICSW). They can provide therapy but aren't fully independent yet
Psychologists
Psychologists tend to look for patterns of client thinking, behaviors or emotional processing. They may explore early childhood experiences, present day stressors and work to understand how a client’s thoughts influence their emotions and actions. Some psychologists provide research based therapies such as CBT, trauma modalities while others may perform psychological testing to clarify a diagnosis. Psychologists often emphasize insight and sometimes deep self-exploration.
Psychologist (PhD, PsyD, EdD):
A mental health provider with a doctoral degree. Psychologists do therapy, testing, and evaluations. They typically do not prescribe medication.Licensed Psychologist (LP):
A psychologist who has completed all licensing requirements and can independently provide psychological services, including therapy and assessments.
Counselors
Counselors often focus on current life stressors, emotions, relationships and how the past shapes the present. They may view client struggles as challenges in emotional or behavioral regulation. Counselors help clients to understand themselves, develop new tools for managing emotions and make meaning of difficult life circumstances.
MA Counseling:
A therapist who has completed their master’s degree and is on the path towards licensure (either LPC or LPCC). They are early in their career and receiving supervision to gain hours toward full licensure but have all of the tools necessary to support clients.Licensed Professional Counselor (LPC):
A therapist who has a master’s degree and is provisionally licensed. They are often early in their career and working under supervision to gain hours toward full licensure.Licensed Professional Clinical Counselor (LPCC):
A fully licensed mental health counselor who can work independently with clients and diagnose and treat mental health concerns.
Family Therapists
Family therapists see symptoms as part of the interplay within relationships. That is, issues are not just focused on an individual. They believe problems are rooted in communication patterns, generational dynamics or unmet relational needs. They work to strengthen client interpersonal relationships and disrupt unhealthy patterns of communication. Not all family therapists treat families or partners!
Licensed Associate Marriage and Family Therapist (LAMFT):
A therapist who has completed their master’s degree and is on the path towards licensure. They have already filed their intention to become independently licensed with the board. They are early in their career and receiving supervision to gain hours toward full licensure but have all of the tools necessary to support clients.
Licensed Marriage and Family Therapist (LMFT):
A licensed therapist who specializes in working with couples, families, and individuals—especially when relationship dynamics are involved. They have a master’s degree and clinical training focused on relationships
Prescribers (Medical Doctor, Nursing)
Prescribers use a medical model to explain symptoms a client may be experiencing. They focus on brain chemistry as well as physical health and biological and genetic factors to gain understanding of what could be helpful. They prescribe medications to support mental health with a goal to reduce symptoms. They may offer brief therapy support or refer to a therapist to assist with balancing the mind and body needs. Clinical Nurse Specialists or Nurse Practitioners often take a more holistic or integrative approach to the work while still working within the medical model and tending to whole-person wellness.
Psychiatrist (M.D. or D.O.):
A medical doctor who specializes in mental health. Psychiatrists can prescribe medications and may also offer therapy, though many focus mainly on managing medications.
Clinical Nurse Specialist in Mental Health (CNS) or Psychiatric Mental Health Nurse Practitioner (PMHNP): A registered nurse with advanced training in mental health. They may offer therapy, coordinate care, and sometimes prescribe medication depending on state laws and credentials.
How do you FIND a therapist?
When looking for a therapist, it can be difficult to marry the many external factors most clients need to prioritize including scheduling limitations, necessity of accepting insurance or other financial considerations and finding someone who offers therapeutic modalities that match your presenting issues or concerns.
While there are so many ways to get started searching for a therapist, it's important to understand just how important a good fit of a therapist-client relationship is to healing work. Research has shown again and again that a strong alliance between a therapist and client is directly correlated to a successful outcome in therapy. This means it may be the most important aspect of getting good care! Take your time and if things aren’t going as you expected, it is ok to speak with your therapist about it and potentially even make a switch to someone new after a few sessions.
Many folks find success using online directories to search to assist with incorporating some of the above factors. Most therapists have an online presence where you can learn more about their offerings, style and more. It is ok to reach out to several therapists at once to find out about availability or one at a time, depending on how you best work. However, once you find one person, it is good to give them some time to work with you before you decide to work with someone else. Word of mouth referrals are another avenue many folks find success with getting started.
Online:
There is no shortage of places to search for a therapist, below are some trusted directories that can assist you with a search. They often have filters you can add such as presenting concerns, insurance, availability and much more!
Word of Mouth:
Sometimes the best matches for therapy can come from trusted individuals in your life. Consider contacting a friend or two, family or healthcare professional such as a primary care doctor for a recommendation.
By the Concern(s) you Wish to Address:
Some folks prefer to focus on finding someone who has additional training or focus on their biggest area of concern. If you are looking for support navigating interpersonal relationships, you may want to find someone with that focus or a specific way they will approach that with you. If you have experienced trauma or difficult circumstances, you may wish to find someone who can support you in trauma work such as EMDR, brainspotting or more!
What to Expect with the First Few Sessions
Your first sessions with a new therapist may feel like the uphill climb of a large rollercoaster. You may feel nervous you will be asked to recount difficult experiences or relieved you finally have someone who will truly listen to the struggles you’ve faced. However you are feeling, it is ok to share with your therapist where you are at and go at the pace your mind, body, and spirit indicate is tolerable for you. Therapists have a lengthy list of questions that are usually required to be completed within the first three sessions, but are also willing to do their very best to meet you where you are at and will likely encourage you to only share what you feel comfortable in those initial meetings.
After a few sessions, you and your therapist will likely discuss where you want to go with therapy (also known as treatment planning or setting goals) and then you may even get started with some interventions or actions you take inside and outside of session to begin to incorporate skills to help you live your best life or process difficult or traumatic past circumstances. Along the way, it is always ok to come back to those conversations with your therapist about how they view your issues, how they can best be of help and what the work in the therapy room and real world will look like for you.
