How to find a therapist

Deciding to talk with a therapist is a big step. Finding one can feel like a second hurdle. Lists are long, words like "in-network" are confusing, and the first person you call may not have an opening.

This page walks you through it in order: where to look, how to check cost, what to ask, and when to move on. If you are not sure what kind of professional you need, start with Starting therapy: a beginner's guide.

Step 1: Know where to look

You do not have to search alone. Here are the places most people find a therapist:⁵

• Your primary care doctor. Doctors can check you for common problems like depression and anxiety. They can refer you to a psychologist, social worker or psychiatrist. Many know local therapists by name.
• Your insurance company. Call the number on your card or use the plan's website or app. Ask for a list of in-network mental health providers (people who have a contract with your plan). Seeing someone in-network usually costs much less.
• Government search tools. FindTreatment.gov is a free, confidential locator run by SAMHSA (the federal mental health and substance use agency). It lists state-licensed programs for mental health and substance use near you.⁷ Medicare and the VA also have their own search tools.⁵
• Professional groups. The American Psychological Association runs a free Psychologist Locator. Your state psychological association, a nearby university psychology department or a community mental health center can also point you to someone.⁶
• Your job. Ask your human resources office if you have an Employee Assistance Program (EAP). An EAP is a free, private benefit that often includes a few counseling sessions.⁵
• Friends and family. A trusted person's suggestion is a fine place to start. You still need to check the license and fit.⁶

Private websites that list therapists can also help. Many let you filter by location, insurance, language and topic. Treat them as a starting list, not a guarantee. Always check the license yourself (see Step 4).

Step 2: Check what your coverage pays

Cost is one of the first questions to settle. This section gives the basics. Our page on paying for therapy goes deeper into insurance rules, Medicaid and help from your employer.

If you have Medicare

Medicare Part B covers outpatient therapy from several kinds of licensed professionals:²

• Psychiatrists and other doctors
• Clinical psychologists
• Clinical social workers
• Nurse practitioners, clinical nurse specialists and physician assistants
• Marriage and family therapists (MFTs)
• Mental health counselors (MHCs)

The last two are new. Starting January 1, 2024, MFTs and MHCs could enroll in Medicare and bill it directly. To qualify, they need a master's or doctoral degree, a state license, and at least 2 years or 3,000 hours of supervised work after their degree. Licensed professional counselors (LPCs) count as mental health counselors for this purpose. So do addiction counselors who meet the same rules.¹ This gives people with Medicare more choices.

After you meet the yearly Part B deductible, you usually pay 20% of the Medicare-approved amount for each visit. A hospital clinic may add its own charge.² For the full picture, see What Medicare covers for mental health.

Ask one key question when you call: "Do you accept Medicare assignment?" A provider who accepts assignment takes Medicare's approved amount as full payment. That is usually your cheapest choice. Some therapists have "opted out" of Medicare. If you see one of them, Medicare pays nothing and you pay the whole bill yourself, even for care Medicare would normally cover.⁴ If someone asks you to sign a private contract, you can call your State Health Insurance Assistance Program (SHIP) for free advice first.⁴

If you have a Medicare Advantage plan, check the plan's own list of in-network therapists.

If you have private insurance or Medicaid

Ask your plan these questions:

• Which therapists near me are in-network?
• Do I need a referral from my doctor first?
• What is my copay or coinsurance per visit?
• Is there a limit on the number of visits?
• Do you cover video or phone sessions?

If money is tight or you have no insurance

You still have options:

• Sliding scale fees. Many therapists lower their fee based on your income. You have to ask. The APA suggests asking about this when you first call.⁶
• Community health centers. These federally funded clinics adjust their fees based on income and family size. Many offer mental health counseling. They will not turn you away if you cannot pay.⁹
• Virginia Community Services Boards (CSBs). Virginia has about 40 local public CSBs. They offer outpatient mental health care, case management and crisis help. The state describes them as a safety net for care regardless of ability to pay.¹⁰ They mainly serve people with little or no insurance or with Medicaid.
• University training clinics. Some universities run clinics where advanced students see clients under close supervision, often for lower fees.⁶
• Veterans. VA medical centers offer same-day mental health help. Vet Centers offer free counseling to many veterans, even without VA health care enrollment.¹⁴ See PTSD in older adults and veterans.

Step 3: Think about what fits you

Type of help

Some therapists focus on certain problems, like grief, trauma, couples issues or caring for a parent with dementia. Some focus on certain methods, like cognitive behavioral therapy (CBT) or problem-solving therapy. If you are an older adult, ask if they often work with people your age. For specialized later-life care, see Finding geriatric mental health care.

In person, video or phone

Video and phone visits can save a long drive. They can also help if you have trouble walking, do not drive, or care for someone who cannot be left alone.

Medicare covers telehealth, including therapy, from anywhere in the United States, including your home. Under current law, this coverage runs through December 31, 2027.³ Rules like these can change, so check again if you are reading this later.

One thing to know: a therapist generally must be licensed in the state where you are during the session, not just where they live.¹³ So if you live in Virginia, look for someone licensed in Virginia. For apps and online companies, read Online therapy and mental health apps.

Language and culture

It is easier to talk about feelings in the language you think in. Many directories let you search for a therapist who speaks your language. Some people also want a therapist who shares or understands their culture, faith or background. It is fine to ask about this.

If you cannot find a therapist who speaks your language, you can ask for an interpreter. Under federal civil rights law, health programs that get federal money, such as those paid by Medicare or Medicaid, must offer language help, like an interpreter, at no cost to you.¹² You do not have to rely on a family member, or a child, to interpret private matters.

Step 4: Check the license

Before your first visit, make sure the person is licensed. In Virginia, the Department of Health Professions has a free online License Lookup. It shows the license number, the dates and whether the license is active.¹¹ Other states have similar tools through their licensing boards.

Common license letters include:

The beginner's guide explains what each kind of professional does.

Step 5: Ask questions before you commit

Many therapists offer a short free phone call first. Use it. Here are questions the NIMH and APA suggest:^5,6

1. "Are you licensed, and how long have you practiced?"
2. "Have you helped people with problems like mine?"
3. "What kind of therapy do you use, and does research show it works for this?"
4. "How long does treatment usually last?"
5. "Do you take my insurance or Medicare? What will I pay? Do you have a sliding scale?"
6. "Do you offer video or phone sessions?"

Do not be discouraged if the first few people are full. Leave a short message with your name, your number, your insurance and the best time to reach you. Then keep going down your list.

Step 6: Watch for red flags

Most therapists are caring and ethical. Still, it helps to know what is not okay. In Virginia, counselors must follow clear rules.⁸ A good therapist will:

• Explain the goals, methods, risks and benefits of therapy at the start.
• Tell you the fees and how billing works.
• Explain what stays private and the few times they might have to share information, such as to keep someone safe.
• Keep your records secure and share them only with your written permission, except where the law requires.

These are serious red flags:⁸

• Any romantic or sexual contact, or hints at it. This is never allowed, even if you agree or start it.
• Asking you to go into business with them, lend them money, trade services or become close friends.
• Not telling you what treatment costs.

Other warning signs to trust your gut on:

• They promise a quick cure or say therapy will fix everything.
• They tell you to stop taking a medicine. Only your prescriber should guide that. Talk with your doctor or pharmacist before changing anything.
• They dismiss your culture, faith or values.
• They often cancel, show up late or seem distracted.
• They talk mostly about themselves.

You have the right to report a mental health provider who acts in an unethical or unprofessional way to the Virginia Department of Health Professions.⁸

Is this the right therapist?

Therapy works best when you have a good relationship with your therapist.⁵ Give it a few sessions. It is normal to feel nervous at first.

Early on, agree on your goals and about when you should expect to notice progress.⁶ Feeling a bit of relief or hope is a good sign. If you still feel unheard or stuck after several visits, say so. A good therapist will welcome the talk and may adjust the plan. If it still is not working, it is okay to try someone else.⁵ You do not owe anyone an explanation for switching.

If you take medicine for your mood, keep taking it while you look for a new therapist. Do not stop any treatment without talking with your provider first.⁵

Therapy is not the only kind of help. Groups can also help. See Support groups and peer support.

How long does it take to get a first appointment?

Wait times vary a lot by area and by insurance. Call several places at once, ask to be put on a cancellation list, and ask your doctor for help if you are waiting too long.

Do I need a referral from my doctor?

Some plans require one and some do not. Call your plan to check before your first visit. Your doctor can also suggest names, which can save time.⁵

Can I find a therapist for my parent who has dementia?

Yes. Look for someone who works with older adults or people with memory loss. You can help with calls and paperwork, but include your parent in choices as much as possible. See Finding geriatric mental health care.

What if I feel worse while I am waiting?

Use the 988 Suicide & Crisis Lifeline by call or text, any time. If someone is in immediate danger, call 911.⁵ You can also make a safety plan or try our calm plan while you wait.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.