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The Process of Therapy: How to Get Connected

 Talk therapy has many different practitioners, offering different styles of help.
Talk therapy has many different practitioners, offering different styles of help.
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Ambrophoto / Shutterstock

NEW YORK — So you’re ready to give therapy a try. You have decided on the kind of therapist and therapy approach you feel the most comfortable with.

Now, how do you get connected with a therapist?

In the third part of DNAinfo New York’s multi-part series on understanding the process of therapy, we looked at who therapists are and what kinds of therapy they offer. For this installment, let’s take a look at how you get connected to a therapist, and the costs you can expect. Of course, there are many different options, and some of the choices will be dictated by your financial situation.

Here are some suggestions on how to find a therapist:

Your Friends, Family and Acquaintances

Maybe you know someone close to you who is in therapy. Maybe you don’t. While stigma and stereotypes still remain about therapy, it’s safe to say New York is the therapy capital of the world.  I guarantee you that someone in your social network has attended, or is currently attending, therapy. 

Often times, I receive referrals from past or present clients. For many people, this is how they decide on a therapist: someone else’s recommendation. For the most part, this is no different than asking someone for a referral for a doctor, dry cleaner or contractor.

There are pros and cons of going through personal connections to find a therapist. If you don’t want anyone you know to know that you plan to seek therapy, it may not be the best avenue to pursue. On the other hand, if you have a friend or acquaintance or relative who has spoken about positive experiences with therapy and you trust them, you may want to go with the opinion you know.

If you decide to ask someone you know for a referral, do not feel pressured to discuss every little detail of what’s bringing you to therapy. You don’t even need to discuss it all. Feel free to say things like, “Have you been to therapy before? Can you recommend a good therapist?”

If you feel like you want to share a little, you can speak in generalities, using a line like, “I have some unresolved stuff from my childhood I’d like help with.” Or, “I’m under a lot of stress right now and need some support.”

If you do not want people to know that you are seeking out a therapist, include a line like, “Please, let’s keep this between us, as I don’t want the whole world to know I’m looking for a therapist,” or, “I would appreciate it if this conversation was kept confidential.” This is especially important if you are asking a work colleague/friend.

Your HMO’s Behavioral Health Plan

If you have health insurance, this will most likely be the most affordable option for therapy. Whether you have the name of a therapist from a friend, or are picking a name from a provider listing, it’s smart to check with your health insurance. Keep in mind coverage varies widely and most, if not all, plans require a co-payment for each session attended. 

Most plans will only cover 20 to 40 sessions per year. Many plans require prior authorization to begin or continue therapy, and patients may be denied coverage for additional sessions because the HMO determined that the diagnosis given by the therapist is not severe enough to warrant more therapy. Again, health insurance plans vary widely, and this is not everyone’s experience.

Many private-practice therapists do not accept health insurance plans, and I am in this category. However, many HMO’s reimburse for “out-of-network” services. If your insurance offers this option, you generally pay the therapist out-of-pocket, and then submit HMO paperwork for reimbursement. The reimbursement percentage also varies, but standard reimbursement is anywhere between 50 percent and 80 percent.  Submitting paperwork usually occurs on a monthly basis, and your therapist can fill in the appropriate codes for you prior to submittal.

A therapist’s decision to apply to be on insurance panels (in order to accept insurance coverage) is a personal one for them. Many therapists I know feel that the combination of coverage denials, additional paperwork, and low reimbursement rates make accepting insurance more trouble than it’s worth for both client and therapist.  Keep in mind that while a therapist’s fee per session might be $175, the HMO’s rate will be far lower, about half that for the therapist (including the co-payment).

 A woman in need of help.
A woman in need of help.
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Oleg Golovnev / Shutterstock

“Find a Therapist” Online

There are many different ways of finding a therapist, and like most information in the 21st century, the Internet is an extremely powerful tool. Websites like Psychology Today or goodtherapy.org are jam-packed with thousands of therapists, each with their own webpage describing their counseling philosophy, office location and contact information. Please note that therapists must pay to be on these listings, and have editorial control over the content you see on their webpages.

Another way to find a therapist is to search using a very specific therapy modality. Feel like working with a Gestalt therapist? Look at the gestalttherapy.net’s therapist listing. Have unresolved trauma or Post-Traumatic Stress Disorder, and want a therapist that specializes in EMDR? Try emdria.org’s listing. As we discussed in part two of this series, there are an endless number of modalities and sub-specialties to choose and search from.

I’d like to point out that there are many generic therapy websites that aggregate therapists’ information and credentials and sometimes reviews into a single search engine. These sites do not have the permission or authority of the people listed on them to include the information, and, much in the way people-searching sites pull your address or phone information from a host of old databases, these sites tend to be chock full of misinformation. I advise against using those generic sites, in favor of verified sites like the ones previously discussed.

Low-Cost Therapy Options

If you do not have health insurance, are unemployed, or are financially struggling, there are a few affordable options to be aware of that offer solid therapy.

Community Mental Health Clinics are usually nonprofit or not-for-profit organizations that specialize in providing therapeutic options at low to moderate prices. These agencies also accept most health insurance, and usually accept Medicaid (which is a good option if you qualify for coverage). There are many fine therapists who work on a “fee-for-service” basis at these clinics. These tend to be the best options for low-income patients.

Another popular moderate-priced option is therapy at a training institute. There are dozens of training institutes in New York, and performing an Internet search will give you a good idea of the range of options. At a training institute, you will work with a therapist who is in post-graduate training. These therapists-in-training are being supervised by a seasoned therapist well-trained in the institute’s specialization. There are many institutes that specialize in family and couples therapy, and most institutes offer group sessions as well.

Making Your Decision

In therapy, you will be discussing personal feelings and experiences, thoughts, reflections and behaviors that you may not have shared with anyone. As previously discussed, it’s important for you to feel comfortable enough to trust your therapist.  But how do you know if a therapist is the right person for you, before you attend therapy?

The short answer is: you don’t.

But that’s OK. 

Deciding on a therapist is an inexact science, and it may take a little trial and error before you decide to commit to one. Therapists understand this, and most offer a free phone consultation in order to better understand what you want to work on, and also for the therapist and client to feel each other out.  If you decide to schedule a consultation, be as upfront as you can about the fact that you are “shopping around" for a therapist, as this will help both you and the therapist.