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  • Susan Bush, PsyD, LCP

Thinking of Seeing a Therapist? 4 Questions to Consider

Updated: 2 days ago


1. How will I pay for it?

Let’s just get this one out of the way as it can be the most important. Therapy can be expensive, but it’s an investment into your wellbeing and overall happiness. Therapists differ in regard to which, if any, insurance plans they take. If you would like to use your insurance, make sure the therapist takes your plan. There is a difference between PPO (Preferred Provider Organization), HMO (Health Maintenance Organization), and EPO (Exclusive Provider Organization) plans, so be certain to check that your plan matches what your therapist takes.

It is strongly encouraged to contact your insurance carrier beforeyour first session to understand any co-payments and co-insurance for which you may be responsible. It’s unwise to rely on your therapist to inform you of this information as it’s your responsibility to understand your benefits. Sessions may be covered in full or part by your particular plan. Additionally, you may have a co-payment (typically $10-$40 per session) or co-insurance, which is a percentage of the visit cost. If you have a deductible, you are expected to pay out-of-pocket until that deductible amount is met. It’s essential to know this information as a deductible can range from a few hundred dollars to thousands of dollars. To check this information, you can call the customer service number on the back of your insurance card and ask the following questions:

What are my mental health benefits?

What are my co-pay and co-insurance amounts (if any)?

What is my deductible and has it been met?

How many sessions per year does my insurance cover?

What monetary amount is covered per session?

Do I need a prior authorization from my primary care physician?

If you have insurance with a company that your therapist does not take, often times you can pay out-of-pocket for your sessions, and then the therapist can provide a statement or “superbill” that you can submit to your insurance company. Be mindful that your insurance carrier may only reimburse you for some of the session cost. This is called “out-of-network benefits,” and your insurance company may not reimburse any of the cost.

If you do not have insurance, some therapists might offer you a fee on a “sliding scale.” This is a reduced rate that you and therapist may agree upon.

It is always important to fully understand your therapist’s insurance and payment policies before you start therapy. Most therapists will charge a full session fee for “no-shows” or appointments cancelled less than 24-48 hours of the session. Your insurance company will not cover this cost.

2. What am I looking for in a therapist?

A client-therapist relationship is a relationship.You will be working with this person anywhere from a few months to several years, so make sure that you’ve found a good match. Therapy can be uncomfortable at times but you should always feel that it’s a safe space. Moreover, feeling that you can be open and honest with your therapist is essential for a healthy working relationship.

Spend some time thinking about what is important for you. Do you prefer a certain gender? Age? Years in practice? What about their philosophy of psychology and wellness? Do you want a therapist that will be very direct and firm or someone more relaxed and flexible? If you attend a session and decide that it is not a good fit, you can either work through this with your therapist or find another one. It’s not helping anyone if you feel miserable in sessions.

Working with a therapist can be all about finding a good fit, and each therapist will vary a little bit in regards to education, clinical background, experience, and treatments or methods used. In regards to education, therapists either have a doctorate (PsyD, PhD) or master’s degree (MSW, MA). If it’s important to you, before you set up an appointment, ask the therapist about education and background. Ask about the treatments used and the theoretical framework from which the therapist operates.

Speaking with a therapist is different than talking to a friend. Therapists aren’t meant to tell you what to do or provide inspiration. They are to help guide you, treat mental illness and its symptoms, and to get unstuck. They can give you strategies and help lead you in a direction, but good therapists will not be espousing advice throughout the session.

Boundaries are another consideration. It will be helpful to familiarize yourself with your therapists email/texting policy. Most therapists do not engage in texting and have specific policies about what they will communicate via email. Moreover, some therapists have policies about communication outside of therapy. It’s important for you to understand and be comfortable with your therapists as well as yourpersonal boundaries regarding contact outside of the therapy session.

A common mistake we all make in every day life is assuming people “just know” how we feel or what we think. Just as this is a fallacy in your personal life, it is also a fallacy in therapy. Your therapist might not know you’re feeling uncomfortable or lost, or that therapy isn’t helping unless you share this information with him or her. If you do not feel like therapy is useful or you are confused, do speak up and address this with your therapist.

3. What are my goals and expectations?

In the first few sessions of your treatment, have the “goals and expectations” conversation with your therapist. What are you hoping to get out of therapy and want do you want from your therapist? Discuss your expectations with your therapist. It is understandable that you want to feel better right away and get a quick fix, and therapists understand that, but change doesn’t happen overnight. Putting in the work will yield more benefits.

Talk to your therapist about what progress looks like and find a way to track and monitor it. You may even want to take notes in session. You and your therapist might want to regularly check-in during each session to make sure you are working towards your stated goal.

4. What are you willing to do?

Are you willing to put in some work? Are you willing to feel worse before you feel better? You need to actively participate in therapy. It can be uncomfortable at times. You might want to quit when it gets hard. This is totally normal and might be a good time to lean into this discomfort and embrace the experience. Feeling worse before you feel better might happen. This is normal and not a sign that you are regressing or doing anything wrong. You are growing.

Your therapist might assign you “homework” or activities to try or things to think about outside of your sessions. Much of the work in therapy does happen outside of the session. Additionally, your therapist might suggest that you see other professionals in conjunction with your therapy. These could include a psychiatrist (for medication management), medical specialist, acupuncturist, or nutritionist.

Finally, therapy doesn’t “work” if you are not honest with your therapist. Trust me, they've heard it all. Their job is not to judge you or make you feel shamed; their job is to help you work through the conflicts in your life. They cannot do that if you do not share your truth with them.

Most often you will see your therapist every week, at least in the beginning. As you make progress, you may drop down to every other week or possibly once per month for “check-ups.” Again, therapy is an investment into your wellbeing so think about your willingness to commit.

Moreover, a therapist does not have infinite amounts of time. When you don’t show up to an appointment or cancel last minute, you might be taking away that time from another client who needs the hour. Understand and respect your therapist’s cancellation policy.

To find a Chicago therapist call your insurance company for referrals or head to psychologytoday.com

For more information on how to choose a therapist go to:

http://www.apa.org/helpcenter/choose-therapist.aspx

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