I’m Maureen Fernandez and I’m the content director here at Momentous Institute. My role includes many things – such as writing the content on this blog. If you’ve read our posts on mental health, you’ve likely seen that we often include something along the lines of, “If you find that you need additional support, consider reaching out to a professional.”

However recently that line has been nagging at me. Finding a therapist is often easier said than done. We’ve mentioned that people should reach out when they need to… but where do you even start? How do you find the person who is the right fit for you?

To help answer these questions, and much more, I spoke with Dr. Laura Vogel, the director of our therapeutic services program at Momentous Institute.

One thing before we go on: Momentous is a mental health clinic that provides therapy to children ages 0-15 and their families in-person in Dallas and online. The advice offered here is to support you in finding a licensed therapist that is a fit for your needs and will provide general counsel no matter your circumstance or location. However, if you are in looking for a licensed professional in Texas and want to know if Momentous Institute will work for you, you can read more here.

Below is a summary of our conversation. In this post, we’ll talk about narrowing your search and finding the right type of therapist for you. In part two, we’ll talk about consultations and determine which therapist is a fit.

When you start the process of finding a therapist, what is the first thing you should do?

Often the first thing I recommend people do is think about what they want in a therapist. It’s important to narrow down your search so you spend less time sorting through therapists and can get in to see someone sooner. A few things you might want to consider include:

- Does the race, age or gender of the therapist matter to you?

- Do you care how many years of experience the therapist has? Is it important to you that the therapist has been practicing a long time, or does the idea of a newer therapist appeal to you? Are you open to newly licensed or even supervised interns?

- Are you looking for a specialty, such as someone who specializes in LGBT issues, single parenting, divorce, attachment issues, parenting a child with special needs, intimacy issues, depression, etc.?

- Does their approach matter? Do you want someone who can do art therapy, play therapy for your child or Cognitive Behavioral Therapy?

One point I’d make here is that the therapist doesn’t necessarily have to have the same lived experience as you to be able to support you in your journey. If you’re seeking counseling for parenting, or past trauma, just as an example, you don’t necessarily need to ensure that the therapist is a parent or has personally experienced the same kind of trauma. More important is whether they have experience working with that population or presenting concern.

Often people want someone who shares their identity in certain categories such as race or gender – and this makes perfect sense.

There was an episode of This is Us where the character Randall, who is Black, tells his White therapist that he needs to switch therapists because he needs someone who is Black who can understand the nuance of being a Black man and what that experience is like for him.

Yes, I saw that! I think that was a great example from popular culture of what we’re talking about. Sometimes a therapist can treat someone effectively despite not sharing the lived experience, and sometimes that shared experience is really essential to understanding and healing. And that will differ for each person, so it’s important to really think through what will make you feel comfortable being vulnerable and sharing your story with another person.

Let’s talk about licensing types. I know there are lots of types of therapists with different letters after their names. What are the different areas of mental health experts, and what should someone know about the difference between them?

All licenses have training to do therapy, however different disciplines focus on different issues, so a quick understanding of the licenses can help you narrow your search. While training for different licenses has some similarities, there are also key differences between them. These are the common types:

LPC: Licensed Professional Counselor. An LPC requires a master’s degree and training is typically focused on treating the individual, but you can find LPCs who have specialized in treating couples or families.

- If you see LPC-S, this means the therapist has been licensed long enough and completed additional training to supervise others working to get their LPC license.

- LPC-A is an “associate” who is under the supervision of another LPC.

LMFT: Licensed Marriage and Family Therapist. An LMFT requires a master’s degree. LMFT training is typically focused on treating the entire family and/or couples. You may also see the S or A at the end, and these mean the same thing as they do for an LPC.

LCSW or MSW: Licensed Clinical Social Worker. These require a master’s degree. Social workers’ training tends to focus on the impact of larger systems (communities) on the individual and supporting the individual to connect to both internal/personal resources as well as those offered in the community. A Licensed CLINICAL Social Worker differs from a social worker because they have completed additional training to focus on providing therapy.

Licensed Psychologist: Licensed Psychologists must have a doctoral degree. They are prepared to do a variety of therapy interventions but can also do psychological testing to evaluate a variety of concerns; both emotional, developmental or academic.

Psychiatrist: Psychiatrists are medical professionals who have gone to medical school. They can prescribe medication and specialize in understanding medications used to treat mental health needs. In most states, they are the only mental health providers who can prescribe medication.

Regardless of license, finding the right fit for your needs and personality is the most important thing.

Tell me about the different setting options for therapy. So I know Momentous Institute is a clinic, for example, and there are many therapists on staff. There are also private practice clinicians who are a one-person operation, and there are probably other options in between. What are the different types of places you might receive therapy?

That’s right. Clinics are generally made up of a team of practitioners, sometimes it’s a neighborhood clinic with a couple of therapists sharing an office, sometimes it’s a low-cost clinic or focused around a particular need. Momentous Institute is an example of a clinic. We are a nonprofit that believes that high-quality mental health should be accessible to everyone so we aim to provide mental health to populations who may not have the financial resources to afford it. Others may be clinics for certain populations, such as teenagers, or LGBT populations. And then, like you said, there are private practices. Private practices can vary in size. Sometimes you might find just one therapist who handles all of the scheduling and billing, and other times you might find a group that shares an office manager who handles appointments and billing. The size of the practice is not necessarily reflective of the quality of the service or goodness of fit for your needs. And then I should mention that there’s TeleHealth (or video therapy), which is of course growing in popularity since the start of the Covid pandemic. People who practice TeleHealth may be in any of these settings.

I want to ask a little about TeleHealth. Is there something special about TeleHealth practioners – is there some kind of license or designation that you get with TeleHealth? Anything you should be looking for if you’re going that route?

There’s not really a special designation, like a license or certain letters after a person’s name that indicate that they are qualified to offer TeleHealth therapy, although ethically someone who practices TeleHealth should have some additional training. Some insurance panels might require additional training and some ethical codes say TeleHealth therapists should get more training, but there is not some kind of universal certification. What I would encourage is to ask a potential therapist how long he/she has been offering TeleHealth to give you a sense of their comfort and familiarity with the nuances of video therapy.

One thing to think about before deciding if TeleHealth is right for you is whether you have consistent internet connections and a private space for your sessions. TeleHealth has many benefits - like not having to travel for an appointment - and can be just as effective as in-person therapy. However, for some, going to a different environment and interacting with your therapist in person is important. Be sure you ask your therapist if they do both in-person and TeleHealth. It will be important to understand if you have options to change how you see your therapist if the need arises.

Okay so once you have your wish list of the type of therapist you’re looking for, and you’ve considered whether there’s a specific clinic or practice that is right for you, then you have to think about how you’ll pay for it. I know this has a lot of layers. What can you tell us about the cost/payment side of therapy?

There are a lot of considerations when it comes to the financial side of this. First, there’s insurance. The insurance process can definitely be daunting. Many insurance policies will cover some mental health services, but often include a copay and a deductible, meaning you’re paying something at each visit, or even paying the full amount until you reach a limit. Just like with other specialists, some therapists are “in network” and others are “out of network” which can affect the cost to you. I encourage you to contact your insurance company and get clarity around what they cover.

There’s also an option to seek therapy without using insurance, for those who don’t have insurance, whose policies don’t cover what you need, or for those who have a therapist they’d like to see who doesn’t take insurance. In these cases, you can pay the therapist directly. Many people in private practice post their rates on their site or on listing/directory sites. Of course, you can contact someone directly to find out their rates if they’re not listed. Some people offer sliding scale fees. And some people won’t necessarily advertise that they take payment on a sliding scale, but it never hurts to ask. Another option to explore is whether you need to attend therapy weekly, or perhaps an every-other-week appointment would meet your needs and reduce your costs. And as I mentioned before, there may be a low-cost or free clinic in your community that is an option as well.

So if I had to sum up what we’ve covered so far, I would say your advice is: determine what type of therapist you would like to work with, determine if you want a clinic or private practice, figure out how you plan to pay for therapy. This is all helpful to do before you even start the search. In part two, we’ll talk about that process – finding a therapist, meeting with them for a consultation, and ultimately determining if the relationship is working. Any other thoughts on this process we’ve covered so far?

The only thing I would add is that this is a lot of work to think through all of these questions. If you or your child or loved one is in crisis, there are some more immediate steps you can take to make sure you have the support you need. Hopefully once the crisis is more resolved, you can pursue these steps for mental health support as ongoing maintenance. Crisis response could be its own separate post, so just briefly I would suggest that people in immediate danger either call 911, go to an emergency room, or call a 24-hour crisis line. The Suicide and Crisis Lifeline is 988 and can be reached by call or text. 

Thanks so much for all this insight! We’ll share more in part two.