It's been noted by some people that I am an extrovert who will, given the moment, talk to just about anybody about just about anything. This is largely because I have very little shame. (I think this is a good thing.)
Maybe that's why I wind up talking about therapy a fair amount. Also, saying things like, "Yeah, I was talking to this completely not-an-educated professional about just this issue the other day," can get creepy after a while.
The other day, therapy came up in conversation, as it tends to do. But then something new happened. The person I was talking to asked me, "How do you even find a good therapist anyway?"
Y'all, after all my years of therapy, I have some opinions on this. I shall present them to you in an ordered list. This has worked for me for the past 21 years.
1. Start your search before you reach a crisis point. (If you are looking for a therapist while in crisis, I have some tips on that later). As with any other kind of medical professional, it's a lot less overwhelming to start sorting through the muck of it all when you aren't desperate for it. It's like that old saw about how you'll find love when you aren't looking for it. Except you will still have to be looking for a therapist.
2. Organize a list of things you'd like from a therapist. It helps if you have some idea of what you're looking for before you start a search. I know, when I go looking for a therapist, I need someone who is not going to suggest weight loss as a cure for my mental ills. I need someone who is not going to be judgy about alternate lifestyles. I prefer therapists who have some experience with adoption issues and also with LGBT issues.
Make a list of must-haves (like, "poly-friendly" or "easy to get to on the bus" or "experienced with disability issues") and nice-to-haves (something you'd prefer but that isn't a deal breaker -- like "is a woman" or whatever). Some people's must-haves will be other people's nice-to-haves and vice versa. I don't need my therapist to be a member of my culture, but you might. That is a completely valid concern and you should respect your own needs enough to take it seriously.
3. Ask around for recommendations.
If you have a safe environment in which to do so. This can actually work even if you think you don't know anyone in therapy. They just might not talk about it publicly, but have a fantastic person they can suggest. Not everyone can do this (you may be in a workplace, for example, where it would be held against you if it was know you were seeking mental health counseling), but if you can, then you might easily find someone worth calling for an initial consult.
4. Use the power of the Internet.
With great connection speed comes great research responsibility -- and you can usually find a list of local therapists simply by Googling for "*insert your area here* area therapists." That specific search string will generally pull up not only web sites of individual therapists, but any listings that group therapists by region.
A lot of major organizations do this, and it's a handy thing to access. I prefer to search via the Internet rather than ask, like, other medical professionals for references because they aren't usually looking for the same characteristics in a therapist as I am. You can also consult the lists provided by the National Coalition for Sexual Freedom. Even if you aren't into kink yourself, having a therapist who is more familiar with the diversity of human sexuality can make people feel more comfortable.
5. Once you have some names, return to the Internet.
Search specifically for each individual therapist. If the individual is savvy, they'll have a website. When I was looking for my last therapist, I didn't bother with anyone who didn't have a website. This was less an Internet snobbery thing and more that, because I spend a lot of time involved in social justice communities (and other communities) online, I needed someone with at least a rudimentary understanding of how the Internet works.
The stuff that goes on here is just as much a part of my real life as anything else. I don't need to set myself up for failure by going to a therapist who doesn't understand that, you know? Similarly, an individual website will list specialties. This is how I weed out some of my must-haves -- I don't see therapists specializing in Christian therapy or bariatric counseling. There is a decent list of types of therapy approaches here.
6. Review not only individual websites but also online review sites.
There are a LOT of sites that list information for therapists and also include a little review area for patients to fill out. You might not find any info, and that is not in and of itself a red flag. But if you see a lot of negative reviews, you might want to give that person a miss. Google the name of the individual therapist and "reviews" to find those results.
7. Start calling therapists who look like they may be a good fit.
You can call them one at a time or, depending on how booked they are, you can set up consults with more than one. When you call, ask for an initial consult meeting. It's a chance to meet the therapist and get a good feel for them. Most therapists will still charge for this -- which is why the research behind it is so important. If you find someone quickly, remember to cancel any other appointments you may have made.
8. Prepare some personal information.
When I started with my current therapist, I took her what was basically a file folder of info on me. I made a list of significant events over the previous three years. I wrote a letter that explained my history with therapy, issues I had addressed with previous therapists, and -- perhaps most importantly -- I spelled out why I was seeking a return to therapy.
I also brought a copy of my book to give her. It seems like overkill in some ways, but it smoothed the road and made our sessions more productive. She's not trying to work on issues I've got a decent handle on and she knows what my specific reasons are for being there.
9. Go in with the knowledge that you are interviewing the therapist.
You don't work for them -- they work for you. Doctors have a lot of power and authority, and they deserve a lot of respect for that. But they don't get to treat you poorly. If you do not think you are a good fit with a therapist, you are not obligated to spend a full hour with them. You can leave at any point.
10. Remember that you can ask the therapist questions.
While they cannot reveal much about their patients -- confidentiality being of the highest order -- you CAN ask them if they have ever treated anyone with XYZ issues or ABC identity. You can ask them about their experiences and their approaches to various issues.
In this way, it really IS like a job interview for them. Ask them about the things that are important to you. Take as many notes as you want. Pay attention to how patient they are with the process and your questions.
How do you know you'll be able to work with someone? That is such a personal and individual thing -- and a lot of it depends on knowing yourself. I actually kind of like the slightly older man therapist -- it's comforting with the right person. Other people might want to avoid that like a house on fire because of Reasons and Things. All of which is completely valid.
Your issues are real and your own and your mental health professional should understand that. Your therapist is not supposed to be your best friend -- but you shouldn't be afraid of them.
Sometimes, circumstances don't allow for a research-driven approach to finding a therapist. The above 10 steps really can be time consuming. If you're in crisis, you might not have the time and you probably won't have the energy. I've been there and still managed to find a therapist that worked for me -- it started with calling a mental health hotline and asking for suggestions.
A lot of workplaces, even ones that don't offer regular insurance, will offer an emergency hotline for mental health issues. Take advantage of them if you need it.
In the U.S., you can call the Boys Town Suicide and Crisis Line (800-448-3000) (TDD: 800-448-1833) or the Covenant House Hotline (800-999-9999). You can also find other crisis lines, like this list for nationwide resources or this one for NYC-specific hotlines. The Trevor Project also has a lifeline specifically for LGBT youth (866-488-7386). In the UK, you can access this list of helplines.
You will have to call people -- be honest and tell them that, yes, actually, this is something that can't really wait. You don't want to tell them it's an emergency -- mental health professionals take that very seriously and if you are not at risk of suicide, you might think their response is overboard. Ask them to keep your number in case there are any cancellations. A lot of therapists operate with set appointments, so nothing can be scheduled, but cancellations are not uncommon.
Many therapists will work on a sliding payment scale with people who have income but not insurance. Many local government health services will also provide low- or no-cost therapy. It's harder to be picky when you have fewer options -- but even if you're at the free health clinic (especially on campus), you can request someone different if you just aren't meshing.
There are also some therapists who will provide counseling services over Skype -- they're harder to track down, though, and I don't have a comprehensive list. It's a fairly new thing.
A good therapist can save you a lot of pain -- or save your life. Finding one that works for you is worth the effort.