So you’re ready to go to therapy. First off: Bravo for deciding to support your mental health in this way! The next important step? Figuring out how to find a therapist you can actually afford—and that you click with.
That’s no small task. People have to do “a lot of legwork to find the right care for themselves,” C. Vaile Wright, PhD, senior director of health care innovation at the American Psychological Association (APA), tells SELF. “And that can be discouraging.”
If you’re looking for a therapist while managing a condition like depression or anxiety, the mental energy that’s required during your search can be especially overwhelming, Dr. Vaile Wright adds. Working within the constraints of a limited budget and health insurance red tape can also be tricky and frustrating.
Not to mention, you don’t just need a good therapist; you need the right therapist for you. It’s essential that you trust this person enough to open up to them and work together toward your mental health goals, Theresa Nguyen, LCSW, chief research officer at Mental Health America (MHA), tells SELF.
Despite these obstacles, therapy doesn’t have to be as prohibitively expensive and exclusive as it may seem, Dr. Vaile Wright says. To help you through this process, we asked a few experts how to find a therapist who is not only in your price range but also fits your unique needs and preferences. Here’s their best advice:
1. Start by asking your insurance provider what they’ll cover.
Mental health services are one of the 10 essential benefits that the Affordable Care Act requires individual (as in, you bought it yourself) and small group (through an employer) insurance plans to cover, according to the US Department of Health and Human Services (HHS). All Medicaid plans and most large employers cover at least a portion of mental health care, too, according to the APA. (If you don’t have insurance, don’t worry—we have options for you below.)
Thanks to federal and state parity laws, most insurance companies can’t charge you a much higher co-pay to see a therapist than to see a medical doctor, like a primary care physician or ob-gyn, the HHS explains. But beyond that, the coverage specifics vary from plan to plan.
These details should be included in the information you received when you first enrolled—but frankly, those documents can be nearly impossible to understand. To get more clarity, call your insurance’s member services number (found on the back of your member card or on the website) and ask questions like:
- What is my co-pay for therapy visits?
- Does my plan require referrals or preapprovals for mental health care?
- Is there any coverage for out-of-network therapists?
- If so, how much, and what’s the process for getting reimbursed?
- Does my plan cover some kinds of mental health professionals and not others?
- Does my plan cover teletherapy options? Is there a reduced rate for these?
Here are more questions you might want to consider asking.
2. Explore your insurer’s directory of in-network therapists first, then browse online databases.
With many plans, staying in-network is easier on your wallet. You can peruse your insurance company’s online directory to start, or call them directly and ask them to send you a list of in-network therapists in your area. “Tell them exactly what you need,” Ken Duckworth, MD, chief medical officer of the National Alliance on Mental Illness (NAMI), tells SELF. “You’re paying them, and [helping you find a provider] is part of their obligation.”
Still, “it can be really hard to find somebody in-network,” Dr. Vaile Wright adds (especially a therapist who’s the right fit). Clunky insurance websites, reams of names with no personal details, and long hold times can be a pain in the ass.
Fortunately, there are lots of online therapy directories that are easier to navigate and allow you to get super specific while you search. Many of them let you filter for a potential therapist based not only on the insurance they accept (if any) but on other important factors that can help you better decide if they seem like a good match. (More on that below.)
Consider resources like Psychology Today, GoodTherapy, Therapy Den, and thero.org. If finding a therapist of a certain identity is particularly important to you, try a specialized directory like Inclusive Therapists, InnoPsych, Therapy for Black Girls, Melanin and Mental Health, Alma, Latinx Therapy, the Asian Mental Health Collective, or the National Queer & Trans Therapists of Color Network.
You’ve definitely got more options if you’re lucky enough to have out-of-network insurance coverage—though it can still cost you. You may have to meet a deductible before that coverage kicks in, the amount covered may be minimal, and you often have to pay for sessions upfront and get reimbursed by insurance later, Dr. Vaile Wright says. Then there’s the admin headache: Seeing an out-of-network therapist may require submitting insurance claims yourself.
3. Decide what’s most important to you and interview your potential therapist.
Regardless of how—or where—you conduct your search, it’s helpful to strike a balance between knowing what you’re looking for in a therapist and remaining open-minded. First, consider what qualities are most important to you. Maybe you prefer to see someone who shares a certain element of your identity—sex, race, gender expression, or religion, say—or who specializes in a specific mental health condition or type of therapy. (You could use an online database to search for a Black provider who offers talk therapy to people with borderline personality disorder, for example.) Or perhaps you’re just looking for somebody warmhearted who you vibe with.
No matter how good they look on paper, the truth is that it’s tough to know if you’ll click with a new therapist until you have a consultation or first session. In your initial chat, you can ask questions about how they work, as well as get a feel for their approach, assess their cultural competence, and see how you feel when you’re having a conversation with them. Do they put you at ease and make you feel hopeful about working together? Vetting a therapist in this way can help you quickly figure out if you’re on the same page, Dr. Duckworth says.
4. While you’re at it, ask your potential therapist if they use a sliding scale.
An out-of-pocket therapy session typically costs around $100 to $200, depending on the provider and where you live, Dr. Vaile Wright says. Fortunately, some providers operate on a sliding scale with some or all of their clients. This means that the amount they charge varies based on factors like a person’s income, Dr. Duckworth explains, although how much of a discount they offer is totally up to them. So if you’re drawn to someone you believe is an especially good choice for you but they’re not covered by your insurance, this may be an option.
If the therapist doesn’t indicate online whether they offer fees on a sliding scale, when you speak with them for the first time, it’s perfectly appropriate to ask, “What is your rate?” and “Do you have a sliding scale?” Dr. Duckworth recommends being prepared to tell them how much you make and how much you’re able to pay per session. You should also be ready to explain why you want to see them in particular, Nguyen adds.
5. Get in touch with federally and community-funded health centers.
These facilities offer low-cost, sliding-scale, or even completely free care to people below a certain income threshold. Sometimes they provide both physical and mental health services, Dr. Vaile Wright says, which could make receiving care more seamless.
Try googling your city or county’s mental health authority or department of behavioral health, Nguyen says. These sites typically provide information about these kinds of centers or contact information for someone who can point you in the right direction. You can also search the Health Resources & Services Administration’s database of health centers.
If you’re not sure whether you qualify, Nguyen recommends making a phone call and saying something like, “I’m interested in accessing services. Can you tell me what the criteria are?”
6. Consider seeing a clinician in training at a nearby college or university.
If you’re not set on (or can’t afford) a therapist with years of experience under their belt, consider seeing someone who’s in the process of getting their mental health practitioner degree. Clinicians in training typically charge reduced rates but are under the close supervision of a licensed professional, so you’re still receiving quality care.
“A clinician in training is a really nice option if you know you want someone who has more flexibility in their time, because sometimes [they] can spend more than 50 minutes with you,” Nguyen says. They may also bring extra energy and eagerness to the table. “They’re training to be the best at their job that they can be,” Dr. Vaile Wright says. Plus, these therapists-to-be are often younger than their licensed counterparts, which could be a quality you’re looking for.
If you live near a college or university, call and ask if they have a training clinic open to the public or offer virtual sessions. You can also check out the Association of Psychology Training Clinics’ list here. (By the way: If you’re currently enrolled in school, it’s worth reaching out to your campus health center to see if they offer free or low-cost counseling to students.)
7. Look into your online and app-based therapy options.
Several platforms offer teletherapy via live video sessions and asynchronous messaging. Online and app-based therapy has advantages: It’s typically more convenient than in-person appointments and can be cheaper, too, particularly if you’re paying out of pocket. (It’s only sometimes covered by insurance, so you’ll want to check with your provider.) You might also have access to a wider pool of therapists, especially if you live in a smaller town or rural area.
Online therapy can be as effective as in-person therapy for some people—as long as you’re seeing a licensed mental health provider, Dr. Duckworth says. For instance, in a meta-analysis published in 2021, researchers looked at data on the outcomes of online psychotherapy (from a pool of 56 studies and 1681 people) and how it compared to the in-person version (using data from 47 studies and 3564 people). They found that seeing a therapist virtually was just as effective for treating certain mood disorders (including anxiety, depression, and PTSD).
That said, these platforms aren’t perfect, and they’re not exactly the same as traditional therapy. The field is still relatively new, Dr. Duckworth points out, and isn’t necessarily as tightly regulated as it should be. Some platforms have made headlines for privacy concerns or sneaky fees, for instance—so it’s really important to do your research. Check out the National Institute of Mental Health and the APA for some guidance on finding the most trustworthy teletherapy service possible.
And if you like the idea of virtual sessions but don’t want to go through an app, you can see if an individual therapist in your area offers online therapy (which has become much more common due to the pandemic). Some online databases include this option as a search filter, or you can always reach out directly and ask.
Finding the right fit is equally important with online therapy. It’s a similar process of knowing what you’re looking for, being open-minded, and trial and error. Many platforms allow you to input preferences about what you’re looking for during the initial matching process, and they also let you change therapists if you feel like the one you’re assigned isn’t a good fit.
8. Try group therapy.
There’s no substitute for individual counseling, and baring your soul to a bunch of strangers isn’t for everyone. But group-based mental health treatment, whether in-person or virtual, can be tremendously helpful and cost-effective, if not free.
Group therapy is typically facilitated by a licensed therapist through a large practice, training clinic, or community health center at a reduced cost, Dr. Vaile Wright says. Then there are peer-led support groups, where you can share your experiences in a judgment-free zone with people who can relate to you.
In both scenarios, you also get to listen to other people process what’s going on with them, which can be helpful, Nguyen says. And the built-in social support network can be really valuable for your well-being too.
A few places to start your group therapy search include the National Alliance on Mental Illness, the Anxiety and Depression Association of America, Mental Health America, Psychology Today, and the Depression and Bipolar Support Alliance. (And here are more resources for finding a virtual support group.)
You deserve a qualified therapist you really click with, no matter your budget.
In a perfect world, the process of finding a licensed therapist would always be quick and easy—but it’s totally normal for it to take a little time (and a few tries) to find the right fit.
If you’ve given it an honest go for a few sessions but aren’t feeling it, Dr. Vaile Wright encourages you to bring up your concerns with your clinician. Have a discussion about what to do differently or if it might be time to try someone else; she says: “You shouldn’t ever settle.”
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