How to Find Therapy & Counselling

Here’s what you need to know about how to find therapy or counseling.

Key takeaways

• Therapy and counseling are very similar. They both involve working with a trained professional to help you overcome problems you are currently facing

• There are many different types of therapy to choose from, but finding a therapist you trust and feel safe with is the most important factor

• People starting therapy can often feel worse before they feel better, but it’s important that you feel supported throughout

Finding therapy and counselling in your area

Consistency is important in both therapy and counseling, so it’s important to find a therapist you trust and who is accessible to you. Therapy and counseling can be offered either face-to-face or online, meaning that your practitioner doesn’t necessarily have to be based in your area. Most practitioners can’t work across state lines or internationally, however, so you will need to find someone who is licensed to practice in your state.

To find the right professional for you, it’s helpful to check online databases of counselors and therapists, read practitioners’ descriptions of their work, and create a shortlist of people you would like to consider.

You might also use the International Therapist Directory or the Inclusive Therapists Directory, if those better suit your needs.

The difference between therapy and counseling

Many people use these terms interchangeably, and in some countries such as the UK, they are identical. In the US, however, counseling usually refers to short-term, goal-oriented help with specific problems, such as grief or addiction counseling.

Therapy usually refers to longer-term treatment, including for complex issues and mental health diagnoses. This can include resolving childhood abuse or trauma, as well as treating disorders such as bipolar disorder or schizophrenia. Although these are often severe illnesses, the difference between counselors and therapists is in the complexity of the issues they deal with, not the severity.

Both counselors and therapists have received specialized training and should be registered or licensed according the the rules within their local area. They are different from coaches, who typically do not have advanced qualifications and are unregulated. Coaches can be helpful in some circumstances, but are not qualified to work with clients on mental health problems.

Questions to ask before seeking therapy or counselling

Before seeking therapy, it’s useful to ask yourself a few questions. This can help you find the right practitioner for your needs.

Do you know what you want out of therapy?

You’re not expected to show up to therapy or counseling with all of the answers, but it is helpful if you have a clear understanding of what you are hoping to achieve or the problem you would like to resolve. This can be more important in counseling, as this is usually short-term, and the counselor will need to understand your goals to help you achieve them.

In longer-term therapeutic relationships, it’s common for your needs to change over time. New problems may appear, or you may come to identify past difficulties that have not been resolved. Even so, it is valuable to think about why you are trying to find therapy, as this may guide your choice of practitioner.

Do you have a diagnosed condition that needs treatment?

If you have a diagnosed mental health condition that you need help with, it’s important to find a therapist who is experienced in treating that condition. Most counselors and therapists will list their specialisms and areas of expertise. Look for someone who has a strong track record in the area you need help with.

Do you require medication?

If you require medication, your therapist or counselor will almost certainly not be able to prescribe that for you. Prescribing medication for mental health conditions is usually restricted to a psychiatrist, who is a medical doctor specializing in mental health conditions, or your doctor.

In most cases, medications for mental health conditions are more effective when combined with therapy.^[1][2] You should talk to both your doctor and therapist about all aspects of your treatment, as they must work together.^[3]

Do you know what type of therapy or counselling you want?

Sometimes, it is very easy to know which type of therapy or counseling is appropriate for your problems. For example, if you are facing problems in your marriage, you would normally look for a marriage therapist.

In other circumstances, another healthcare professional might recommend a specific type of therapy or counseling because it is known to be effective for your condition. For example, dialectical behavior therapy (DBT) was developed to help people with borderline personality disorder (BPD) and is often recommended as the first type of therapy for people with this condition to try.^[4]

If you know which type of therapy you are looking for, this can reduce the number of therapists you need to look through.

Have you had therapy or counseling before?

If you have had therapy or counseling before, you might have strong feelings about what you want based on whether your last experience was positive or negative. Try to remember that each therapist will have a different way of working, even within the same therapy modality.

Try to keep an open mind about new therapists and consider whether their way of working might offer you something new and different.

Questions to ask a counselor or therapist

Questions you might want to ask of a therapist or counselor before beginning work include

• What qualifications do they hold?

• Which governing or regulatory bodies are they a part of?

• What approaches or modalities do they have experience in?

• How much do sessions cost, and is the therapy covered by insurance?

• Are sessions online, face-to-face, or do they offer both?

• How long do they expect treatment to take?

• How well do they understand your community or culture? This is especially important for people of color and members of the LGBTQ+ community

• What should you expect in your first session?

How do I know what type of therapy is best for me?

There are many different types of therapy, and it can be difficult to know which approach will be most appropriate for you. Luckily, most therapists today are at least somewhat integrative, including several approaches in their work.

The type of therapy can be affected by the problem you are trying to solve and your personal preferences and experiences. It’s helpful to remember that the exact type of therapy used is probably less important than having a great relationship between you and your therapist.^[5]

The main branches of therapy are cognitive-behavioral therapy (CBT), psychodynamic therapy, and humanistic or person-centred therapy. There are hundreds of approaches, most of which draw significantly from one or more of these three.^[6]

CBT

CBT emphasizes the way that a client’s thoughts, feelings, and behaviors influence each other. The therapist encourages clients to explore ways in which their thoughts may be limiting them and to explore new ways of thinking, feeling, and reacting.

Psychodynamic

Psychodynamic therapy aims to help clients understand their conscious and unconscious processes. This gives the client insight into the underlying problems, which they can then work with the therapist to resolve.

Humanistic/person-centred

Person-centred therapy focuses on creating a safe space in which the client can explore their thoughts and feelings without judgment. Within this space, the client can recognize the roots of their problems and see ways to resolve them.

Finding help in a crisis

Counseling and therapy aren’t quick fixes. In a crisis, you won’t have time to find a therapist and build the relationship you need to begin treatment. During a crisis, it’s important to know where to turn.

Your existing therapist

If you already have a therapist, they can be an essential resource during a crisis. Reach out as soon as possible, explain the situation, and ask for help. You can do this as well as seeking crisis support from other sources.

Crisis helplines

There are crisis helplines available both at the state level and nationally. Some are for specific situations or disorders, while others are more general. You can also find text or online chat helplines, which can be especially helpful for those in domestic violence situations or who struggle with telephone calls.

National helplines aimed at supporting people experiencing mental health crises include

• 988 - The National Suicide and Crisis Lifeline is available for anyone experiencing a mental health crisis. You can also visit https://988lifeline.org for online chat services

• 1-800-950-NAMI (6264) - The National Alliance on Mental Illness helpline

Emergency services

If your mental health situation leaves you feeling that you cannot keep yourself or others safe, it is an emergency. Call 911 immediately or attend the emergency room.

What to do if therapy isn’t helping

It’s not uncommon for people to feel as though therapy isn’t working for them. Sometimes this is a sign that you need to look for a different therapist or treatment modality, but other times it can be a natural part of the process.

• Don’t give up. If therapy isn’t working for you, it’s not your fault, and it doesn’t mean that therapy won’t work for you.

• Talk to your therapist about how you feel. Ask whether they would have expected to see more progress.

• People often feel worse for a while after starting therapy before they feel better. Consider whether this may be the case for you.

• Therapy relies on the relationship between you and your therapist. If you don’t feel entirely comfortable, you can try a different therapist. If the way of approaching your problems didn’t feel right for you, you can also try a different modality.

• In some cases, medication alongside your therapy might be helpful. Talk to your therapist and your doctor to discuss whether this is appropriate for you.

Final thought

With the right practitioner, therapy or counseling can be life-changing, helping you overcome problems and address even deep-seated issues. Take the time to find the right therapist or counselor for you, and don’t be afraid to keep looking if you’re not comfortable with the first few people you try.