But deciding what type of therapy you want, finding a provider, and paying for it can all be major obstacles to getting good care. Let’s walk through what you need to know. Some common research-backed approaches you’ll come across may include:
Supportive psychotherapy This is one of the most common types of talk therapy clinicians employ. It aims to relieve emotional distress and symptoms by emphasizing reassurance, reeducation, advice, and encouragement of desirable behavior, according to the APA’s definition.It often combines some of the following therapeutic strategies.Cognitive behavioral therapy (CBT) CBT is a common type of talk therapy that focuses on helping you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a healthier way, according to the Mayo Clinic.“Its premise is to understand how our thoughts are connected to our emotions and how our emotions are connected to our behaviors. The idea of CBT is to understand our thought patterns and detach our thoughts from our behaviors and actions,” says Christine Crawford, MD, MPH, an adult and child psychiatrist and an assistant professor of psychiatry at Boston University School of Medicine, who is also the associate medical director at the National Alliance on Mental Illness (NAMI). Often, therapists will give their clients homework between sessions to practice behaviors or new ways of thinking about whatever they are struggling with.Psychodynamic psychotherapy In psychodynamic therapy, therapist and client talk about negative patterns of behavior and feelings that are rooted in past experiences with the goal of resolving them.Through deep exploration of their past and present lives, the client will learn (with the help of their therapist) to analyze their unconscious emotions and motivations and how they shape their thoughts and actions, according to Mental Health America.Your therapist is helping you understand how your subconscious thoughts are affecting your conscious thoughts and behaviors, Dr. Crawford says. “You’re piecing together how past experiences influence your life today.”Dialectical behavior therapy (DBT) DBT is heavily based on CBT with a few distinctions. CBT emphasizes understanding the link between thoughts, feelings and behaviors, while DBT emphasizes managing uncomfortable or distressing thoughts and feelings. It also has more of an emphasis on behavioral change, or working on skills to improve negative behavior patterns. It’s currently used to help people with various mental illnesses, and often those with borderline personality disorder as a primary diagnosis, according to NAMI.“It’s really helpful for individuals who when faced with a major stressor may experience intense emotions and who can have thoughts of self-harm,” Crawford says. In this approach, patients see therapists regularly. Homework between sessions is usually part of therapy.Exposure therapy Exposure therapy is another subset of CBT that’s most frequently used to treat obsessive-compulsive disorder, panic disorder, social anxiety disorder, PTSD, and phobias, such as fear of leaving the home or fear of flying. During treatment, patients work with a therapist to identify their triggers and learn techniques to overcome their fears via gradual exposure to them in a controlled environment. Exposure could consist of imagining the feared stimuli, virtual reality simulations, or directly facing fears in real life, according to the APA.“Your therapist will work with you to expose you to the things that bring on the most anxiety to you, so you become desensitized with repeated exposure to it,” Crawford says.Mindfulness-based therapy (MBT) MBT helps patients prioritize their present thoughts, feelings, bodily sensations, and surrounding environment with the aim of being mindful, open, curious, accepting, and compassionate. A review published in 2021 found MBT can be effective in helping people with depression, anxiety, stress, insomnia, addiction, and psychosis.“It’s about helping a client stay focused and aware of their feelings, and narrowing down their emotions,” says Liz Morrison, LCSW, a New York City–based psychotherapist and the owner of Liz Morrison Therapy. In one MBT exercise she uses, she asks a patient to put a raisin in their mouth to slow down and focus on the “nitty gritty details” like the texture, the taste, what it reminds them of, and any other sensations they experience.Eye movement desensitization and reprocessing therapy (EMDR) EMDR is used to treat PTSD, with research suggesting it can significantly reduce the emotional distress stemming from traumatic memories, according to NAMI. In this case, EMDR replaces negative emotional reactions to difficult memories with less-charged reactions and beliefs.During this therapy, patients stimulate the brain with back-and-forth eye movements while recalling traumatic events.Family or couples therapy Family therapy is a type of counseling that can help family members improve communication and resolve conflicts. It’s often short-term, provided by a psychologist, clinical social worker, or licensed therapist; the provider is often credentialed by the American Association for Marriage and Family Therapy (AAMFT).Through this therapy, families learn skills to deepen connections, get through stressful times, and improve troubled relationships between partners, parents and children, or siblings. It can include multiple family members, or just those who are willing to participate.Transcranial magnetic stimulation (TMS) TMS is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. During a session, an electromagnetic coil is placed against your scalp or near your forehead to deliver a magnetic pulse that stimulates nerve cells in the region of the brain involved in mood control. It’s typically used when other depression treatments haven’t been effective.
Learn More About Types of Mental Health Expert
Therapy can help people with their emotional and mental health (whether they have a clinical diagnosis or not) because it addresses ways of thinking, past traumas, and habits they want to change, Bufka says. It’s through therapy that patients learn healthy coping strategies and feel empowered to take control of their lives — but it requires active participation and some work at learning new skills.
“Some people go into therapy not because they have a diagnosed disorder, but because they want to make changes in their life, and they want to do that with the assistance of a mental health professional,” Dr. Linde explains. A person may seek help because they want to communicate better, improve their relationships, become more self-aware, overcome a fear, or pursue some other avenue of personal growth. “Therapy is for everybody, and counselors work with people all along the continuum of emotional difficulty,” Linde says. She says she thinks the pandemic has removed some hesitancies and negative stigma about professional mental health treatment for many people. People stopped, in many cases, seeing therapy as a sign of weakness; instead people recognized that our day-to-day lives are emotionally challenging, and that taking steps to learn how to cope better keeps you well and makes you stronger. “I hope that continues,” she says. “When someone seeks therapy, they’re doing something positive for themselves and we shouldn’t look at it like there’s something wrong with them.”
Chronic illness, death, or bereavement in the familyFinancial issues, job loss, or problems in the workplaceRelationship stress, including trying to make a marriage work, caring for young children or aging parents, and managing friendshipsDaily stressors that are overwhelming you or throwing your life out of balanceRecovering from physical or sexual abuse or witnessing violence or a traumatic eventCope with sexual problems, whether they’re due to a physical or psychological cause
Feel stronger in the face of challengesChange behaviors that are holding them backLook at ways of thinking that affect how they feel or behaveHeal pain from the pastBuild relationship skillsFigure out goalsStrengthen their self-confidenceBetter handle strong emotions like fear, grief, or angerEnhance their problem-solving skills
Therapy can be helpful for anyone who is feeling like they are struggling to cope with life’s stressors on their own, Linde says. Therapy can be an appropriate first step if emotional worries or struggles are interfering significantly (and in an ongoing way) with day-to-day routines and tasks, like work, school, or household responsibilities.
Feeling down, even if you are still able to keep up with work, school, or houseworkDifficulty sleepingAppetite changes that result in unwanted weight changesInability to perform usual daily functions and responsibilitiesThoughts of death or self-harmSocial withdrawal and disengagement from family members
Learn More About Signs You May Need Therapy Online therapy, also known as e-therapy or teletherapy, can include:
Videoconferencing using Zoom or FaceTime for your “in-person” therapy sessionsEngaging with your therapist solely via phone conversationsOnline chats, texts, and voice messaging, in which conversations are often stored so you can reread the transcriptApps that include mood and symptom tracking and therapy-based exercises
For Americans living in remote or rural areas, and those with tight schedules, online therapy can be a great way to access care on your computer, tablet, or smartphone wherever you have a steady internet connection. Like traditional therapy, research suggests online therapy, specifically videoconferencing and phone therapy, is effective at improving mental health and alleviating symptoms of depression, anxiety, and stress. “We know every client is different, but overall we can say there isn’t any reason why we shouldn’t use [online therapy], especially if getting therapy or getting an evaluation is more difficult because of accessibility,” says the study’s lead author, Ashley Batastini, PhD, an assistant professor of counseling, educational psychology, and research at the University of Memphis in Tennessee. There’s less evidence that apps offering therapy via text message, chat rooms, email, or other formats where you’re not one-on-one with the same provider from session to session are effective, says Bufka. Consider using them to complement, rather than replace, traditional therapy, she says. Learn More About Online Therapy There are different types of mental health providers, each with their distinct training and approaches to therapy. Your first step will be familiarizing yourself with the different types of providers and what type you wish to see for therapy. You can start your search by:
Getting a referral Talk to your family doctor about your symptoms as a starting point. They can refer you to a specialist or provide you with other resources.Using a reliable online database Several mental health organizations have up-to-date databases of licensed therapists in your neighborhood. With these tools, you can filter therapists based on your zip code, city or state, and filter based on other parameters, such as whether you want a male or female therapist, or one who provides telemedicine or in-person counseling. Some large databases include:American Psychological Association Psychologist LocatorAmerican Association for Marriage and Family Therapy Therapist LocatorMental Health America Affiliate Resource CenterPsychology Today Therapy DirectoryNational Association of Social Workers HelpPRO Therapist FinderAsking your insurance company for a mental health provider list If you have private health insurance, Medicaid or coverage provided through your job, call your insurer’s information number to connect with therapists in your area who accept your insurance plan.
What about finding a culturally competent therapist? Mental health providers are trained to provide care to people from all backgrounds. But if you prefer to find a therapist who is the same ethnicity, sexual orientation, or gender, or who have specific expertise in helping people with a disability or illness you have as, try using databases designed to help you connect with these providers, Crawford says. Innopsych, for example, is a database that allows users to filter therapists by ethnicity. The Association of LGBTQ+ Psychiatrists Online Referral System or the Gay and Lesbian Medical Association can help you connect with a therapist who is LGBTQ+. Learn More About How to Find a Therapist Who’s Right for You
Variables That Can Affect Cost of Therapy
Instead, your job is to shop around, request quotes, and look at therapists’ fees on their website. You’ll notice price points will vary depending on factors such as:
Location Expect higher fees if your therapist practices in a city with higher living costs than in smaller towns, Morrison says.Experience Veteran therapists with extensive training or niche areas of specialization may charge more for counseling than their counterparts who are establishing their practice and clientele.Platform If you’re working directly with a therapist in private practice or someone affiliated with a nearby medical center, you may encounter higher price points than when you use subscription virtual services like BetterHelp or Talkspace.
Does Insurance Cover Therapy?
Does my plan cover mental health services?Do I have a choice about what kind of mental health professionals I can see? What kind of treatment does my plan cover or exclude?Is there a deductible?What is my copayment for a therapy session?Is there a limit to the number of sessions?
Learn More About the Cost of Therapy
Treat each session like a medical appointment. Bufka urges those starting counseling to “treat it as seriously as any other healthcare.” Even if you’re taking the online therapy route, don’t turn up in your pajamas, don’t have happy hour right before meeting your therapist, and come prepared with notes on topics you may want to address.Do your homework between sessions. As your sessions progress, you may be asked to document your thoughts, take up journaling, or make a list of your triggers. Follow through on the exercises your therapist assigns you — typically, they’ll add to what you’re learning in your sessions, Linde says.Be open and honest. Your success depends on your willingness to share your thoughts, open up, and provide feedback on what’s working and what needs to change with your therapist’s approach. Building rapport won’t happen immediately — it’s common to feel uncomfortable in your first therapy session. But within your first few sessions, you’ll be able to gauge your level of comfort with your therapist, Linde says.Make sure you have a private space. If you’re taking the online therapy route, make sure you’re conducting your sessions in a private place in your home where you can talk openly. If you have family members, roommates, or friends within an earshot, you may be holding back, Crawford notes.Trust the process. Linde says that therapy can be emotionally exhausting as you broach sensitive topics in your life. “You might feel worse before you feel better, but that’s okay,” she says. Don’t expect instant results, and stick to your treatment plan.
American Psychological Association (APA) The APA is the professional organization representing psychologists from across the country. Its site includes tips on emotional health, depression, PTSD and addictions, and provides a Psychologist Locator, which connects Americans to therapists based on their zip code. The APA also lists several crisis hotlines and resources for confidential telephone counseling. National Alliance on Mental Illness (NAMI) NAMI’s website includes blogs and articles on topics like warning signs of mental illness, common mental health conditions, treatment options, and how to find treatment. It also has a help line that’s staffed Monday to Friday until 10 p.m., which provides advice on what to do in an emergency and how to navigate a mental health crisis. You can contact the help line through chat, phone, or email. Mental Health America (MHA) The MHA says it’s dedicated to promoting mental health and preventing mental illness through education, research and advocacy work. Its website includes resources for Americans, such as mental health screening tools, advice on mental health treatment options, and how to make the most of your therapy sessions. It’s also connected to more than 200 community-based mental health organizations, including support groups for various mental illnesses. American Counseling Association (ACA) Whether you’re encountering feelings of depression, bereavement, grief and loss, or trauma, the ACA provides a list of mental health resources on its website. It has a Therapy Directory maintained by Psychology Today, which can help you find a counselor based on your zip code and whether you’re looking for a therapist of a particular gender, ethnicity, religion, or other characteristics. Innopsych If you’re seeking a BIPOC (Black, Indigenous, or Person of Color) therapist, experts recommend Innopsych, which is a database that helps users filter their therapists according to ethnicity. Its mission is to “change the face and feel of therapy” by making therapists of color more visible in the community, and to make it faster and easier for people of color to match with a therapist of color. You can also seek referrals from organizations like the Association of Black Psychologists, the Black Mental Health Alliance, which maintains a directory of African American psychiatrists, the Asian Mental Health Collective, or the Hispanic Access Foundation. Anxiety and Depression Association of America (ADAA) The ADAA has a wealth of resources for Americans, including explainers on depression, generalized anxiety disorder, OCD, PTSD, and BPD. It also has a library of educational resources like blog posts, videos, podcasts, and webinars to help everyday Americans better understand their symptoms and treatment options. Depression and Bipolar Support Alliance (DBSA) The DBSA provides symptom screening tools for depression and anxiety in adults and adolescents. It also has resources on treatment options, how to find a healthcare provider, and how to find local and online support groups. If you have a loved one living with a mental illness, it has articles on how to help family members, caregivers and friends going through a difficult time. Mental Health Is Health This initiative aims to normalize conversations about mental health, and it helps people learn more about feelings and experiences such as loneliness, hopelessness, and stress. It was launched by MTV Entertainment Group in partnership with the Trevor Project, the American Foundation for Suicide Prevention, NAMI, the National Council for Mental Wellbeing, and others. If you are actively in crisis and need immediate support, call 911. You can also call the National Suicide Prevention Lifeline at 800-273-8255, or text 741-741 to reach a trainer counselor with Crisis Text Line.
