Whether you’ve been in counseling before or are giving it a try for the first time, finding a therapist is an important decision. Opening up to a stranger about your most personal issues makes most people feel vulnerable. And if you’re not feeling your emotional best, it’s important to find someone with whom you feel comfortable and confident as soon as possible. Below are some things to consider when looking for a psychotherapist.

To Go With Insurance or Not?

The healthcare landscape is changing quickly and most insurance plans offer at least some coverage for mental health services. One key phrase here is “some coverage.” If you’re hoping to go the insurance route, find out if there is a limit to how many visits you are allowed annually. If you need to get “pre-authorized,” ask about how to do this. It may require a referral from your primary care physician. If you run out of visits, but want to continue therapy, can you get more? Some companies require that your psychotherapist send information about your condition and treatment in order to pre-authorize or allow extra sessions. This may not matter to you. Others want a greater degree of confidentiality.

Saving money is the most typical reason for using insurance to see a psychotherapist. Find out how much your copay will be. I’ve seen it range from $10 to $50. Most therapists will want to see you weekly, so even with insurance, your treatment is an investment.

However, say you find a fantastic therapist who does not accept your insurance. Some insurance plans will reimburse out-of-network, typically some percentage (up to a capped amount) of a therapist’s rate. You pay up front, and most psychotherapists will provide you with the information (something called a “superbill”) for you to get partially reimbursed by your insurance company.

Finally, for a variety of reasons, some choose not to involve their insurance companies at all. Some people want to keep their mental health treatment separate from their medical record. Others don’t want to be limited to the therapists who take their insurance or find, when they call, that these practices are already full.

MFT, LPC, LCSW, Psychologist, Psychiatrist…Aren’t They All Therapists?

Do an internet search to find a therapist and you will stumble over an array of lettered degrees after people’s names. For example, I am one of a dwindling number of therapists in Phoenix, AZ who is well-trained in psychodynamic methods, and you could find me listed as a therapist, counselor, psychologist, psychotherapist, and Psy.D.

In general, there are five groups of professionals trained to provide mental health services. (I am not including here “coaching” or “life coach” professionals. So far, this is a fairly unregulated profession and even “certified” coaches may have vastly different levels of training and expertise.)

• LCSWs (Licensed Clinical Social Workers) have at least a master’s degree. They are a subset of the social work profession that is trained to work with mental health issues.
• LPCs (Licensed Professional Counselors)  have at least a master’s degree and work with people either as mental health generalists or have trained in a niche specialty.
• MFTs (Marriage and Family Therapists) have at least a master’s degree. Their emphasis is most commonly on couples and family systems, but many also work with individuals.
• Psychiatrists are medical doctors (M.D.s) with a specialization in mental health. While some psychiatrists can and do provide psychotherapy, the majority focus on diagnosis and treatment of mental health issues with psychiatric medications.
• Psychologists are doctoral-level professionals with a variety of specialties. In searching for a psychologist, you will want to look for a Psy.D. degree (someone whose focus in school was clinical, i.e., extensive training in direct work with people) or Ph.D. (someone whose focus in school was on research, but who will also have the necessary clinical experience to get licensed).

The kind of professional you choose depends on you and your needs. There are well-trained, helpful people in all of these professions. It never hurts to speak with psychotherapists with different degrees to get a sense of who might best help.

Interview – or at Least Call – Several

It rarely dawns on most people to interview a doctor. However, speaking with a few psychotherapists can give you a lot of information about who will be the best fit for you. First, try calling and give a brief overview of your situation and needs. Does the person on the other end of the line respond in a way that makes you feel understood? You can ask about anything that seems important for you to make a decision. Maybe education-level or number of years in practice is important to you. Or perhaps you want to know about the psychotherapist’s treatment philosophy. While a psychotherapist cannot provide treatment or give advice by phone, she/he should be willing to take 10 minutes to respond to your most important questions.

Second, if the phone conversation feels comfortable enough, see if the therapist is willing to meet with you to see if it’s a good mutual fit. This can take up to a few sessions to establish. If you experience some early benefit, go ahead and give the relationship a shot. Remember, therapy is a process, and most treatments require more than a few sessions. If, on the other hand, you’re still unsure about your psychotherapist after a few sessions, it’s all right to move on. In fact, continuing your search for a better match makes sense before you invest any more time and money into the process.

Ultimately, studies show that the effect of helpful psychotherapy is about 30% due to a positive relationship with the psychotherapist. So, keep shopping until you find the right one.

Some Resources to Help In Your Search for a Therapist

• Psychology Today
• Psychologist Locator
• The National Register for Health Psychologists
• Your state associations for counselors, social workers, psychologists and psychiatrists will likely have professional directories.
• Word of mouth is a great way to find out about psychotherapists with good reputations.
• Call your insurance company for a list of therapists on their panel.

In my twenties, I wanted to be Lucy Lippard. She’s this feminist art historian who breaks all the rules in her books by creating a collage of text, photographs, art, and journal entries scrolling like a news ticker across the top of the page. In The Lure of the Local, Lippard writes about place so evocatively, I’ve thought about just her first sentence for over a decade:

Place for me is the locus of desire.

That line alone holds so much truth and mystery. Place. What place? For me, it’s the idea of “home” I’ve been chasing, researching, trying to interpret. Locus. It means location, but hints at a more internal quality, something imbued with meaning, than a spot on a map. Desire. Standing alone, it’s a sensual word, hinting at something nearly forbidden. And yet, we all have desires, things for which we long.

As a psychologist, I’m in the business of listening for longings. Though not taught in psychology school, places are as much a part of our psyches and relationships as people. Lippard continues:

Places have influenced my life as much, perhaps more than, people. I fall for (or into) places faster and less conditionally than I do for people (p.4).

Psychology describes the mother-infant duo as the first symbiotic place-relationship. The second is the family home, explored tentatively, at first, by a toddler, by crawling, touching, taste and smell. The child then moves outward into the world….

However out of fashion romanticism and nostalgia may be, I can’t write about places without occasionally sinking into their seductive embrace (p.5)

We learn to soothe our upsets and anxieties first in the embrace of a guardian. That is our first home. Later, the dwellings we call home can serve a similar function. Home gives us a place to belong.

Home is embedded in our personal and national psyches. “There’s no place like home.” “Home is where the heart is.” “Home sweet home.” If you listen, it’s found throughout pop songs and commercials. Advertisers use it to sell all the fixings and a plane ride to a perfect home for the holidays. Owning a home is central to the “American dream.”

Home is more than shelter. It is part of our identity and self-expression. Home reflects our cultural history, even if the original functions of its construct are forgotten.

Home is a bookend, the place from which we start and end our days. And all the homes we’ve ever had, particularly the childhood home, keep memories and dreams (good and bad) safe, in place.

As I follow the labyrinthine diversity of personal geography, lived experience grounded in nature, culture and history, forming landscape and place, I have to dream a little… (p.5).

This is the first post in a series about the psychological significance of home and place and the locus of desire that resides in everyone. What first inspired me about Lucy Lippard was her ability to blend things that seemingly don’t mix—place, art, politics, history, academics, personal reflection and dreams—into gorgeous, chaotic sense. Isn’t that, after all, the beauty of the human mind?

Dr. Amra Stafford
Psychologist – Phoenix AZ