How to Find a Licensed Mental Health Therapist

Basic Steps
  1. Check with your insurance to see if you have mental health coverage.

  2. Search for a therapist that meets your criteria and needs.

  3. Prepare for the transition if you are currently seeing another therapist.

  4. Interview the potential therapist(s) over the phone or in person.

  5. Schedule a first meeting to see if it's a good fit.

Ways to Search for a Therapist

Call your Insurance Member Service Representative (If you wish to use insurance and have a diagnosis submitted.)

Ask your insurance company for a list of therapists “Preferred Providers” in your area who are covered by your policy. You can use this list to cross-reference with an online search or list of referrals.

Online Search 

Go to https://www.psychologytoday.com/us/therapists and search for a licensed therapist by city or zip code.

You’ll notice Psychology Today lists therapist bios, specializations, and insurances taken by the therapist. 

Go to https://www.findapsychologist.org/  to search for psychologists based on city or zip code. 

Go to https://locator.apa.org/   to search for a psychologist based on city or zip code.

Ask for Referrals

Some of the best therapists are known through word of mouth.  If you’re comfortable to, ask any friend/family member who is currently in therapy if they would recommend the center/group practice. Most churches have counseling referral lists. If you’re nervous, you can say you are “asking for a friend”. Please note: therapists usually avoid seeing clients from the same family or close friendship circles due to a "conflict of interest".  

His Heart Foundation

His Heart Foundation is a Vancouver non-profit that works diligently to be the bridge between local churches and mental health services. They vet every therapist that they refer to and base their recommendation on your needs. Here is the link to request a counselor https://www.hisheartfoundation.org/request-a-counselor-referral/ .

Insurance Provider
No Insurance Provider

​     You’ll want to contact your insurance provider to see what kind of mental health coverage you have on your plan if you don’t already know. The number is usually listed on the back of the insurance card. Also ask about your deductible, allowed amount, and any copayment or coinsurance. Ask if there is a limit to the number of sessions covered by your insurance.

     For those who don’t have health insurance or who don’t have mental health coverage in their health insurance plan finding a therapist within budget may seem daunting. But there’s still hope! There are many therapists and centers that try to make their costs affordable for this reason. Ask about a reduced rate or a sliding-scale, which is usually based on your income. Some therapists will agree to a certain number of sessions at a reduced price. 

     Check out A New Day Counseling Center. They have student-counselors who rotate  each semester/academic year for $20/session. I recommend this service if you are not in crisis or have a specialized need, but need extra support in a life transition. These counselors are well-supervised and trained in all the basics of counseling. 

http://www.anewdaycounseling.org/contact.html

Average Costs

Average range out-of-pocket cost for an LPC intern or LMHCA is $75-$95

Average range out-of-pocket cost for LPC or LMHC is $125-$150

Average range out-of-pocket cost for a Doctor (Psy.D., or Ph.D)  is $150-$200 depending on specialization. 

(These are rough estimates and depending on

the counselor and organization may be higher or lower.)

Things to Consider when Reviewing a Therapist
  • Is your therapist licensed in your state?

  • Does the therapist use evidenced-based treatments?

  • Different therapists specialize in different areas. Find out if the therapist has experience dealing with your concerns.

  • What are the fees, the charges for missed sessions, and if possible an estimate of how long the therapy might take? 

  • Does the therapist use a sliding-scale? A sliding-scale is where session fees are based on the client’s income or other factors depending on the therapist.

  • Find out where the therapist is located, what hours are available, and if the therapist will see you in an emergency. Consider asking if the therapist is located in a clinic, community mental health agency, medical school, or independent practice. 

  • What is the therapist’s therapeutic approach or orientation? Does this fit your expectations and needs?

  • If seeing a Christian therapist is important to you, let them know that. Considering asking, "How do Christian faith and Biblical truths play out in your therapeutic approach?" 

The Basics of Preparing for Transitioning from One Therapist to Another

​With your current therapist consider discussing these areas:   (take notes when asking these questions!)

  • Consider a release of information (ROI). You may review and sign an ROI for your future therapist to discuss and collaborate care with your past therapist. You may terminate this release at any time.  Many clients dread “starting over again”. An ROI will help your previous therapist collaborate with your new therapist over what you’ve already worked on in therapy.

  • Discuss what has worked for you so far in therapy? Look into therapeutic approach/orientation, style of therapist, and how you knew you could trust your current therapist. 

  • What are your goals and future hopes for therapy? Work with your therapist to identify your objectives.

  • Discuss what your current or potential barriers to seeking another therapist may be? Many times clients feel stable after ending with one therapist, and this may cause them to not continue with their therapeutic goals until they experience a crisis. By starting a relationship with a new therapist you’ll have a foundation started that can boost your likelihood of avoiding preventable issues.

Other Tips & Recommendations
  • Take 2-3 sessions to see if it's a good fit. If by the end of the 3rd session you feel "off" or the relationship feels awkward, try for a new therapist.  If you "just know" by the 1st or 2nd visit that it's not right for you, listen to your gut.  Counselors are trained to not take things personally. Some therapeutic relationships are just not a good fit. IF however, moving onto new therapists becomes a trend you may want to consider yourself as the common denominator.    Lastly, if you can let the therapist know that you're ending sessions with them, even through an email, that would be appropriate. From a therapist's perspective, I do this work to help people, and it's reassuring to know even if the healing doesn't happen with me the client is seeking out different options. Plus, I need honest (and respectful) feedback to grow as a practitioner as well!

  • Insurance companies will most likely require a DSM-IV diagnosis from your licensed therapist in order to bill for the services. In other words, this diagnosis will be documented in your insurance records.

  • By the 4th session your therapist should have a treatment plan created. Ideally, this plan of treatment should be reviewed with you. Being clear about the same goals and direction in therapy is vital to effective change.

  • When dealing with addictions like alcohol, sex/porn, or complex trauma and eating disorders I highly recommend seeking out an experienced therapist who specializes in such areas.

  • In the same way, when dealing with marriage, family, blended-families, or children issues it's best to seek out a therapist who is certified and experienced in these areas.

Articulating my Needs, Issues, and Goals

One of the most common things I hear from those seeking out therapy is, "How do I know what my needs and goals are to see if the therapist is a good fit?" I want to take the pressure off of you. Your needs can be a straight forward as, "I'm just angry all the time and I don't want to be anymore", "I get into these dark lows and I've done everything I can to get out of them." or "I want to know myself better and stop making the same mistakes in life." 

Part of the therapist's job is to do an intake and assess your needs, concerns, and help establish goals with you. (This is also how you can check to see if your therapist is a good fit: did they ask questions and work to gain understanding of your concerns before moving forward to treatment?) That's part of the work. The whole point in seeing a therapist is to have someone who's trained to come along side of you to assist you. So if you know something isn't okay or you want things to be even more okay, because therapy is NOT all about what's wrong with you, be as honest as you can with where you are. You'll better know if it's a good therapeutic alliance if you feel validated with where you are currently at. 

What makes up a good therapist?
Remember to have grace. Therapists are humans too and have off days. Even though they are trained, no one can read your mind, so please speak up as concerns arise. 
  • They help you "feel felt" by being empathetic and active listening. You don't get interrupted or frequently have to repeat what you said. 

  • They have a mutual understanding with their clients but they don't try to be your friend.

  • They understand the direction and goals you want out of therapy, or are able to summarize your concerns into appropriate measurable goals that you agree with. There should be a general roadmap with clear mile-markers and room for flexibility as life happens. 

  • They maintain your confidentiality and you feel like you can trust them by how they run their practice.

  • They check in on your progress and assign homework that challenges you appropriately. It's important to be able to look back over months and sometimes weeks of therapy and see some level of objective change. Sometimes it gets confusing to like your therapist but not have any significant change. This would be something to address. I would HIGHLY recommend having a discussion with your therapist on this before leaving; especially if you have a good relationship with the therapist. 

  • They typically remember key topics and themes you discussed in previous sessions.

  • If any issues occur in the relationship and it's brought to their attention they address it immediately and respectfully. You'll also gain something from a therapist who handles issues that come up in therapy well. 

  • They ask questions that help you gain insight about yourself and the situation you're working through. When you ask them questions they directly respond and make sure it's been answered as well as they can.  

  • They keep appointment times and clearly communicate well in advance any times they will be out of the office. If you are struggling to keep appointment times and are making a pattern of canceling late they address this with you directly and respectfully. 

  • They start and end session at the appropriate times. You may feel initially like this is rigid and sparks some of your potential abandonment issues, but over time, you'll see that clear consistent boundaries provide structure and dependability. 

  • They seem like life-long learners by keeping up with studies in the field and doing their research. You feel like they have sufficient training for what you're needing to work on. 

  • Some therapist strategically share aspects of personal information about themselves as a way to facilitate change for the client. If this ever feels like over-sharing or like they are reversing the roles, this would be something to bring up as a concern. 

  • Some therapists may occasionally tear-up or join you in your anger; however, if you ever feel like they are overly affected by your problems this would be a concern to address.

  • Unwanted romantic feelings in therapy are typically experienced as confusing and uncomfortable. If you see any patterns of your therapist directing romantic passes toward you please listen to your concerns and address this. Any romantic passes or behavior from your therapist is extremely unethical and wrong. With that being said, if you have romantic feelings (whether toward a same gender or opposite gender therapist) please don't run the other direction. This is NOT uncommon, you are not bad, and this is actually a very therapeutic thing to address in session if you're willing. Because of the nature of therapy emotional intimacy may get confused for romantic attraction.  As you can imagine this is a very complex and in-depth topic, so take this note as a simple consideration. 

Terminology 

Those who can practice mental health therapy/psychotherapy:

Psychotherapy, also known as “talk therapy,” is when a person speaks with a trained therapist in a safe and confidential environment to explore and understand feelings and behaviors and gain coping skills.

During individual talk therapy sessions, the conversation is often led by the therapist and can touch on topics such as past or current problems, experiences, thoughts, feelings or relationships experienced by the person while the therapist helps make connections and provide insight.

Counselors, Clinicians, Therapists: Are masters-level (M.S. or M.A.) health care professionals who are trained to assess, diagnose, and treat based on specific training programs. 

Licensure in OR

LPC: ​ Licensed Professional Counselor

LPC Intern: Licensed Professional Counselor Intern. Oregon uses this abbreviation to title a counselor on their way to becoming fully licensed. An LPC Intern is registered with the board and is being supervised by a board approved supervisor. 

Licensure in WA

LMHC: Licensed Mental Health Counselor

LMHCA: Licensed Mental Health Counselor Associate. This means they are meeting WA board requirements  to become fully licensed. They are being supervised by a board approved supervisor and meeting continue education requirements.  

Doctorate Level Therapists

Psychiatrist: Is a medical doctor and specializes in mental health care. They can prescribe medication and some may also do psychotherapy. 

Psychologist: Hold a doctoral degree (Ph.D. or Psy.D.) in clinical psychology, counseling, or education. The psychologist should be licensed by the state.

Other​ (this is not an extensive list)

Clinical Social Worker: Hold a master's degree (MSW) and are trained to assess and treat a person's mental health. Usually they are trained in case management and advocacy services. They should be licensed in the state (LMSW).

LMFTLicensed Marriage and Family Therapist 

Psychiatrist Nurse: AKA Mental Health Nurse Practitioner. They are Registered Nurses who can assess, diagnose, and sometimes provide mental health therapy. They are also qualified to prescribe medications.

See NAMI for more information https://www.nami.org/learn-more/treatment/types-of-mental-health-professionals

Types of Treatment & Approaches to Therapy

Acceptance & Commitment Therapy (ACT)- is a type of psychological intervention that focuses on the development of psychological flexibility, or the ability to contact the present moment and accept negative thoughts without judgment. Created by Steven C. Hayes, Kirk D. Strosahl, and Kelly G. Wilson, ACT focuses on directing behavior in ways that match clients’ core values. Unlike cognitive behavioral therapy, ACT does not stress the importance of controlling thoughts, feelings, or mental health disorder symptoms; instead, ACT therapists encourage their clients to accept their feelings unconditionally, even when those feelings are initially very painful. Therapists using ACT help their clients define a set of core values—goals or states of mind that are important to the client. With these core values in mind, the client commits to acting in ways that reinforce and further these values regardless of the limits and restrictions imposed on them by their condition. The six core principles of ACT are cognitive defusion, acceptance, contact with the present moment, observing the self, values, and committed action. ACT has been proven effective for the treatment of depression, anxiety, stress, addictions, eating disorders, schizophrenia, borderline personality disorder, and myriad other mental health issues.

Attachment Theory- In the counseling world this word attachment is used regularly to refer to the emotional and sometimes physical bonds a person creates with others in his/her life. Back in the late 1960s a British child psychologist John Bowlby coined the term attachment to describe the “lasting psychological connectedness between human beings”.  Attachment theory is a concept in developmental psychology that concerns the importance of "attachment" in regards to personal development. Specifically, it makes the claim that the ability for an individual to form an emotional and physical "attachment" to another person gives a sense of stability and security necessary to take risks, branch out, and grow and develop as a personality. Naturally, attachment theory is a broad idea with many expressions, and the best understanding of it can be had by looking at several of those expressions in turn.

Cognitive Behavioral Therapy (CBT) is a name used for a broad range of psychotherapies that aim to help clients overcome dysfunctional thought patterns and behavioral patterns. These psychotherapies have several characteristics in common, for example, all forms of CBT are based on the idea that thoughts primarily affect our emotions and actions. As a result, CBT focuses on changing and controlling the way the client deals with his or her thoughts. CBT therapists may encourage clients to challenge the damaging beliefs and assumptions they have about themselves and their world. These therapies are popular with therapists and clients because they achieve rapid results and are time-limited. CBT has been proven effective for the treatment of general anxiety disorder, depression, insomnia, schizophrenia, bipolar disorder, post-traumatic stress disorder, and other mental health issues. 

Dialectical Behavioral Therapy (DBT)- is a psychotherapeutic method originally developed by Marsha M. Linehan for the treatment of borderline personality disorder. It has since been successfully adapted for use with other mental health disorders that stem from problems with emotional regulation, such as eating disorders and bipolar disorder. From a position of nonjudgmental acceptance and validation of their feelings, this therapy helps individuals cope with out-of-control emotions by using a set of four practical skills: how to be more effective in interpersonal relationships; how to tolerate and accept distressing situations more easily; how to regulate emotions; and how to use mindfulness-based skills to accomplish any of the preceding tasks.

Emotion Focused Therapy (EFT)-  EFT is a short-term form of therapy that focuses on adult relationships and attachment/bonding. The therapist and clients look at patterns in the relationship and take steps to create a more secure bond and develop more trust to move the relationship in a healthier, more positive direction.  An EFT therapist observes the dynamics between clients in the therapy setting, ties this behavior to the dynamics in their home lives, and helps direct new conversations and interactions based on more honest feelings. To accomplish this, your therapist will encourage you to look at your current emotional issues and then help you discover feelings and emotions that you may not realize you have. You may discover deeper past feelings and vulnerabilities that are blocked by the more immediate emotions you display in your current relationship. You will learn to express these emotions in a way that will help you connect, rather than disconnect with your partner or family member. You will learn new ways to listen and stay attuned to another’s emotions and discover more productive ways to respond to emotional situations.

EMDR- Eye movement desensitization and reprocessing therapy (EMDR) is used to treat PTSD. A number of studies have shown it can reduce the emotional distress resulting from traumatic memories.

EMDR replaces negative emotional reactions to difficult memories with less-charged or positive reactions or beliefs. Performing a series of back and forth, repetitive eye movements for 20-30 seconds can help individuals change these emotional reactions.

Therapists refer to this protocol as "dual stimulation." During the therapy, an individual stimulates the brain with back and forth eye movements (or specific sequences of tapping or musical tones). Simultaneously, the individual stimulates memories by recalling a traumatic event. There is controversy about EMDR—and whether the benefit is from the exposure inherent in the treatment or if movement is an essential aspect of the treatment. 

--When looking for an EMDR therapist I recommend one certified from Dr. Shapiro's EMDR Institute http://www.emdr.com/ 

Interpersonal Therapy- focuses on the relationships a person has with others, with a goal of improving the person’s interpersonal skills. In this form of psychotherapy, the therapist helps people evaluate their social interactions and recognize negative patterns, like social isolation or aggression, and ultimately helps them learn strategies for understanding and interacting positively with others.

Interpersonal therapy is most often used to treat depression, but may be recommended with other mental health conditions.

Psychodynamic Therapy- The goal of psychodynamic therapy is to recognize negative patterns of behavior and feeling that are rooted in past experiences and resolve them. This type of therapy often uses open-ended questions and free association so that people have the opportunity to discuss whatever is on their minds. The therapist then works with the person to sift through these thoughts and identify unconscious patterns of negative behavior or feelings and how they have been caused or influenced by past experiences and unresolved feelings. By bringing these associations to the person’s attention they can learn to overcome the unhelpful behaviors and feelings which they caused.

Psychodynamic therapy is often useful for treating depression, anxiety disorders, borderline personality disorder, and other mental illnesses.

Solution-Focused Brief Therapy- As the name suggests, SFBT is future-focused, goal-directed, and focuses on solutions, rather than on the problems that brought clients to seek therapy. Unlike traditional forms of therapy that take time to analyze problems, pathology and past life events, SFBT concentrates on finding solutions in the present time and exploring one’s hope for the future to find quicker resolution of one’s problems. This method takes the approach that you know what you need to do to improve your own life and, with the appropriate coaching and questioning, are capable of finding the best solutions.

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