How to find a therapist when you don’t know where to start

When I first considered therapy, I had no clue where to start. I went on Psychology Today. Then I employed the same search strategy I use on Yelp—look up the nearest options available and go down the list. This brilliant strategy resulted in meetings with the following therapists:

• A conservative woman who could not fathom why any woman would not want to get married. I never told her about my tattoos.
• A holistic healer who predicted my future using ancient Norse rune stones and I Ching. The forecast was grim.
• An awful person who insisted that I was living under a cloud of shame, brought upon by my upbringing and that I needed to ‘wake up.’ I almost gave up on therapy right then and there.

Erica Woodland is a licensed clinical social worker and founder of the National Queer & Trans Therapist of Color Network, a resource for queer and trans people of color (QTPoC) seeking mental health rooted in social justice. She says the most important thing to consider when getting started is to understand the lay of the land. “What particular training does the therapist have? Do they have a background in social work?” Woodland says. “From there, I talk to people about their rights. Interview multiple people to see if they’re a good fit. Schedule appointments with several folks. It’s not a decision you should take lightly.” Play the field, set boundaries, and trust your instincts. Remember: you’re paying for a professional service, so don’t be afraid to ask lots of questions.

Therapy can be expensive. If you have insurance, your plan may cover mental and behavioral health. That said, most therapists operate out of network due to paperwork and low reimbursements. Most therapists do offer free intake sessions, as well as sliding scale rates, so it doesn’t hurt to ask. If you live near a school that specializes in social work, Woodland recommends therapist interns who are still earning their credentials. Interns are able to provide access to services at a lower cost, and what they may lack in clinical experience, they often make up for in a genuine desire to connect with their communities.

Therapy has come a long way since Rorschach tests. I’ve never laid down on a couch and dished on my freaky dreams (although it sounds kinda fun). There are now a number of approaches to talk therapy, some of them more widely practiced than others. Most therapists will utilize multiple modalities throughout their practice, depending on what you might need. Some of these include:

• Psychodynamic therapy - This is the traditional, Freudian talk therapy most are familiar with, where unconscious thoughts and feelings are addressed.
• Client-centered therapy - Here, the patient takes control of the conversation, while the therapist takes a more hands-off, empathetic role.
• Existential therapy - What if you’ve experienced trauma and can’t shake the pervasive feeling that nothing matters? There’s a shrink for that. Existential therapy is rooted in the search for meaning and authenticity.
• Gestalt therapy - Gestalt focuses on the here and the now, using environment as a conduit for new forms of meaning. Expect lots of role-play exercises, such as the infamous empty chair technique.
• Cognitive behavioral therapy - CBT seeks to change negative thought patterns, which, in turn, changes negative emotions and behaviors. If you enjoy homework and worksheets, then this approach might be for you.

More importantly, however, is the relationship you have with your therapist. “A lot of research has found that the modality is not the most important thing,” Woodland says. “If you have a strong therapeutic alliance, then it means you’re attuned to what your client needs—no matter what.”

For the longest time, I struggled to feel a genuine connection with my therapists. It wasn’t until I started seeking therapists who fit exactly what I was looking for—someone who actually made me feel validated and seen—did I really start to let my guard down throughout my sessions. Lucy Nguyen, a marriage and family therapist intern in Los Angeles, says that it’s essential to “find somebody who feels curious about you, rather than somebody who’s analyzing you.” “If the relationship feels genuine, then that gives you space to be authentic yourself,” Nguyen says. “That’s the basis of healing.”