These days the world feels especially scary. Our rights are attacked on national television, masked men take people off of the streets, and the job market is in free fall. If you’re struggling more than usual right now, you’re not alone. LGBTQ+ folks are more than twice as likely to experience a mental health condition than their heterosexual counterparts. For trans members of our community, that number jumps to four times as likely to experience mental health conditions than their cisgender counterparts.
Looking for help can feel daunting: Where do you start? How do you ensure your safety? How will you pay for it? This article will walk you step-by-step through the process of seeking professional help, so you can fill your cup and face the world with a bit more inner peace.
STEP 1: Get clear on what you’re looking for.
When people talk about seeking therapy, they’re usually referring to care from a psychiatrist, a psychologist, or a licensed clinical social worker. Here’s what each one of these professions do:
- A psychiatrist is a medical doctor. They typically take on patients with more serious and complex mental illnesses that require medication. Schizophrenia and bipolar disorder are just two examples of mental health issues that a psychiatrist would typically treat.
- A psychologist is specially trained to diagnose and treat mental illness through talk therapy. While they are not medical doctors, they are trained at a doctoral level to treat mental illness. In most states, a psychologist cannot prescribe medication (but if you need medication in addition to talk therapy, they can work with a psychiatrist or general practitioner to help you get the medication you need.)
- A licensed clinical social worker (LCSW) is a social worker licensed by the state to provide mental therapy. They undergo extensive training and often take a holistic approach to talk therapy, considering the community and environment in which their patients live. They cannot prescribe medication but, like psychologists, they can work with a psychiatrist or general practitioner if medication is needed.
STEP 2: Know your options.
Therapy can be expensive, but there are options no matter your budget.
If you have insurance: Grab your insurance card and call the number on the back to get help finding a practitioner. You’re going to ask for a few questions:
- Are mental health therapies covered by your insurance?
- What is the co-pay?
- Is there a limit to how many sessions you can have?
Next, ask for a list of practitioners in your area. You’ll provide your zip code, the type of therapist you’re looking for (psychologist, psychiatrist, licensed clinical social worker), whether you prefer a specific gender practitioner, and any specialties you may need the therapist to have (trauma, LGBTQ+ friendly, PTSD, etc.)
If you don’t have insurance: It’s time to look for resources that can help you access therapy at low or no cost. Start off by searching “free therapy in [your city].” A lot of LGBTQ+ centers offer free or low-cost therapy, so don’t forget to check your local center. Sometimes free therapy is only available in a group counseling setting, but that can still be incredibly helpful as it connects you with other people going through similar experiences as you.
Another way to look for affordable care is to search for organizations that provide therapy to any specific groups you might be a part of. There are therapy funds and free options for LGBTQ+ folks, queer and trans folks of color, Black women and girls, and veterans, just to name a few.
You can also look for a therapist who offers therapy on a sliding scale, charging based on your income. If that’s not an option, keep in mind that some therapists reserve a number of pro bono spots to treat patients who cannot otherwise afford therapy. If you find a therapist who seems like a good match, there’s no harm in calling and asking. A sample script: Hi, I’m calling to ask if you have any pro bono therapy spots available. I’m ready to get help and work through my problems, but money is a barrier to treatment. Is this something you can help with? It could take some time to find a therapist who says yes, so keep trying and be patient.
STEP 3: Research. Research. Research.
Now it’s time to put the skills you’ve honed looking up your exes on social media to good use. Take the list of potential therapists you’ve compiled, or received from your insurance company, and start looking them up. My favorite site for reading about therapists is Psychology Today. The profiles on this site can tell you any specialties the therapist has, reveal their rates, mention whether or not they are sliding scale, and explain the best ways to reach out. Also, these profiles usually provide a picture of the therapist. The goal is to find someone you feel comfortable talking to, so a therapist who looks like your favorite aunt might be helpful, while one that looks like your asshole boss might not.
If you can’t find a potential therapist on Psychology Today, no worries. Just Google them. Many therapists have their own pages or social media accounts which can tell you more about their practice and philosophies.
By the end of the research phase, your goal is to have 10-15 therapists you can call. I know that sounds like a lot, but you won’t hear back from everyone and many of the people you call will have a full calendar. You’ve got to weed through the unavailable therapists to find one who can help you.
STEP 4: Start making phone calls.
If you’re anything like me, the idea of calling 15 therapists turns your stomach into knots. I get it. I got through it by writing out what exactly what to say if I needed to leave a message (which was the case 95% of the time) and what to say if a person answered the phone. Below are the scripts I used. Make sure to adjust them to your specific needs before calling!
- If leaving a message: Hi, I’m Jane Doe and I’m looking for a therapist who specializes in treating trauma and accepts Anthem health insurance. Are you accepting new patients? Please call me back at 123–456–7890 so we can talk further. I look forward to speaking with you soon. Bye!
- If a person picks up: Hi! I’m looking for a trauma specialist who’s comfortable with LGBTQ+ patients and discussing mental health as it relates to racial identity. Are you accepting new patients? Do you accept Anthem insurance?
Keep your list of potential therapists nearby and take notes as needed! If you’re still anxious about calling, keep in mind that most therapists are seeing patients during the day and don’t answer the phones when the office is closed, so nine times out of ten, you’ll be leaving a message.
STEP 5: Answer your phone.
As we discussed above, you’ll leave messages for most of the practitioners that you call. At some point, they are going to call you back, so be ready! Create a script similar to the one above for talking to a person so you don’t forget any of your questions. Keep your list of potential therapists somewhere you can find it easily (like in your notes app) so you can mark off who calls back. Some therapists won’t be a good match or they may not be accepting new patients, so make sure to update your list.
STEP 6: Ask questions.
Once you find a therapist who is taking new clients, they’ll want to chat about if you two are a good match to work together. This only takes a few minutes and may take place when they return your message. They may also work with you to arrange a time for a short phone conversation. Usually, they’ll explain their methods for treatment and ask what you’re looking for. Be prepared to explain why you’re interested in starting therapy. Then you’ll ask any questions you have.
For guidance on what a consultation might look like, Tagg spoke to Deanna Aliperti, LCSW, a queer EMDR-trained therapist in New York. “During consult calls, I like to keep my questions to a minimum, I just want to know the basics… I try to leave the rest of the time for people to ask questions about me.” she says.
And what should we be asking our potential therapists? “I always encourage people to ask what kind of experience the therapist has working with people who have the same issues they do,” she says. Aliperti also encourages asking deeper questions. “My hot take is that you can ask what that person’s identifiers are—meaning if you are queer and you need to have a queer therapist, that is a valid thing to ask somebody.”
Another big topic Aliperti advocates for is asking a therapist about their political affiliation. The goal of therapy is to get support from someone you feel safe talking to and for many queer folks that means not working with someone who votes against their rights. “Therapy doesn’t exist in a bubble and you deserve to know those things,” she says. Of course, therapists have a right not to answer any question, but Aliperti says it’s a good sign if your potential therapist is comfortable and open with answering these deeper questions.
Other questions you have may be more practical:
- Does this therapist see clients in person or via telehealth?
- How does scheduling work?
- What do they charge per session?
It’s totally okay to have a consultation and realize that this therapist is not the right match for you. Keep looking. It might take time to find someone you’re comfortable with, but don’t give up!
STEP 7: Take stock.
Once you’ve shopped around and found a therapist you think is a good fit, you’ll start meeting with them as a client. Aliperti suggests attending a few sessions before deciding whether you two are a solid match. “The first session is more like an intake, so the therapist is going to ask a bunch of questions. It isn’t the best gauge of what therapy with them will be like,” she says.
However, she acknowledges that sometimes you know right away if things aren’t going to work. “At the end of the first session, I will always tell somebody, ‘Hey, now that we’ve met, if you are thinking I can’t stand Deanna and I never want to speak to her again, then that’s okay and you can let me know,” she says. Not every therapist gives such a clear opening to leave if you aren’t feeling the match, and Aliperti encourages clients to end the working relationship in whatever way is most comfortable to them. This can be done face-to-face, in a virtual meeting, via email, or even via text. Keep it simple. “Just say, ‘Hey, this isn’t working out and I don’t want to move forward,’” she says.
If your first “match” doesn’t work out, keep moving down your lists of potential therapists until you find one that does.
STEP 8: Do the work.
Once a few sessions have gone by and you’re happy with your therapist, it’s time to start the real work. Digging deep isn’t always easy, but you’ve already accomplished so much by getting to this point. You’ve got it from here.