TW: depression, anxiety, eating disorders, suicide, self-harm
This is a question I receive a ton on Instagram ever since I started sharing more about my therapy journey. Today, I’m expanding on my experience apart from my occasional updates I share on my “Mental Health” story highlight on Instagram. Therapy is something that’s been monumental for my self-healing journey and something that I recommend to everyone I know.
A common misconception is that you have to be a certain amount of “sad” or “anxious,” or go through a traumatic life experience to warrant therapy or any mental health help. At least that’s what I first thought. But in the same way that you wouldn’t wait for all your tires to be flat, your battery to be dead, your windshield to be cracked before you take your car to be serviced, you shouldn’t wait for x y or z to start prioritizing your mental health. In the same way we take our cars for service appointments with professionals, we should be checking in with ourselves with a professional who can guide us in bettering ourselves. I know I’m not the first one to talk about this, but I hope to be a small part of the movement in destigmatizing the way we talk about mental health.
The beginning is daunting, I know it. I was so nervous because I knew I needed help talking through my thoughts and finding better ways to cope with my emotions and past traumas, but the thought of not having the perfect therapist to start with really bothered me. What if I never find one that I really trust? What if I think I share my entire life story and it’s not a match? I mean- Type A, much? I wanted so much control in what my experience would be like, because this need for control was rooted out of fear. Fear of being judged, fear of imperfection, fear of rejection, fear of change. But I knew it would be worth it, and the sooner I started, the more useful it would be later down the road.
If you’re new here, I started therapy because about a year ago, I through an experience that was really traumatic amidst a really tough season in my life (hello grad school + working nights FT as an RN), and my upbringing wasn’t exactly rainbows and butterflies (hello immigrant Korean parents + being an only child). Looking back, I truly wish I had started prior to even “needing” therapy, because I admit: it is a lot of emotional work sharing your life story and past experiences to a stranger who knows nothing about you. *Insert TikTok of preparing a PowerPoint of all your past traumas for your new therapist to see*
But the way I see it, with any other difficult long-standing journey, the time will pass anyway. In a year from now, I could either be working on myself with a therapist/counselor, or wishing I had done it.
1. WTF do I need?
The question of the century, right? How do I even find out what I need? Do I need medication? Do I just need to talk to someone? But just like any other health concern, you’re not going to know exactly what you need. You don’t go to your primary care office when you’re sick asking for a CBC, thyroid panel, flu swab, albuterol 4-6 puffs PRN, and azithromycin x10d. You present your complaints and they examine you and decide on management together. In the same fashion, your needs depend on a professional’s assessment of you. By starting with talking to a professional, whether this be your primary care provider or a counselor in your area, you can discern what you need.
So the first step is to discern whether you need a counselor, psychologist or psychiatrist. I had no idea that there were so many key players among mental health professionals. Professional counselors (LPCs) and clinical social workers (LCSWs) provide talk therapy without prescribing medications such as anti-depressants or anxiolytics. Psychologists also provide talk therapy utilizing scientific methods such as cognitive behavioral therapy and interpersonal psychotherapy. Psychiatrists start and manage medication therapy as needed, and often provide talk therapy, as well.
Depending on your diagnosis or main symptoms, you will have different needs. The evidence shows that for those diagnosed with depression, the combination of psychotherapy (talk therapy) and medication therapy may be more effective than one alone. For anxiety, psychotherapy may be more helpful than medication management alone. This all being said, there is no one-size fits all and I think this is the most important reminder. You will have friends who only do talk therapy. You will have coworkers who are managed with medication alone. Everyone’s mental health journey is their own and there’s no point in comparing.
2. Where do I even start?
PsychologyToday is an amazing place to start. It’s basically a search engine for providers near you that allows you to filter by your insurance, your needs (ADHD, anger management, grief, PTSD, etc), sexuality, language, age, faith, ethnicity and types of therapy. You can find the providers’ credentials, photos, biographies, areas of expertise and this way you can kind of get a vibe of what they’re like. When I first started my process, COVID was rampant and it was important to me that my provider provided teletherapy. Honestly, it’s kind of like flipping through a dating app! And you’ll also hear that therapy is a lot like dating – daunting and nerve wracking at first, exciting, terrifying, but can turn out really well.
Once you find a provider you think you can connect with, you can see if they are accepting new clients, and how they are seeing clients (video/phone/in-person) and then call or email them to schedule a visit. Below is an example of what someone’s page looks like!
In the beginning of my journey, I started out with BetterHelp. I thought it would be a great way to have access to my counselor when I needed them, without the commitment of going into someone’s office and bearing my heart to a stranger. For some reason, the thought of sharing my emotions behind a screen felt… safe. The process of connecting you to a counselor can take anywhere from 24-48 hours, but in certain circumstances can take longer. It was very important to me to be connected to an Asian American female provider but there wasn’t one available to me, so I ended up matching with 2 providers who I eventually didn’t feel a connection with. If you value accessibility to your counselor and struggle with social anxiety, I think BetterHelp is a great option.
3. How do I afford it?
Psychology Today is very transparent in showing you each provider’s cost per session and payment options. In addition to this, your insurance can cover a lot of these costs (seen in the example above). A lot of providers also provide sliding scale options, meaning cost can be adjusted depending on your income.
If you have insurance:
If a provider you find is “out of network” and doesn’t accept insurance, it is ultimately up to you to decide if it’s worth paying out of pocket for your sessions, and often times providers will provide payment plans and packages depending on the frequency of your sessions.
In addition to this, if a provider you really want to work with is out of network, you can contact your insurance company to see if your provider can provide you with a monthly superbill to submit for reimbursement. Depending on your insurance, you can receive in-network benefits if a specific provider (in this case, your therapist/counselor/etc) provides specialized care that you can’t find within your network. For example, because my therapist specializes in Korean-American clients around identity development and cultural tensions, some of them have been able to get special permission for in-network reimbursement for sessions.
If you don’t have insurance:
BetterHelp cost me $65/week and a membership covers you for 4 weeks after you are matched with a counselor. I paid a total of $234/month after a 10% discount I found online. This was out of pocket, but I budgeted because this was a priority for me. However, I ended up cancelling my membership and was refunded.
Another amazing option if you’re a college student or college employee is to seek services at a university counseling center. For example, Georgia State, where I’m a current graduate student, provides free and sliding scale options for students seeking counseling. They have a Counseling Center that offers free short-term therapy for students, as well as a Psychology Clinic staffed by psychology graduate students.
Bliss is a free online psychotherapy treatment based on cognitive behavioral therapy, a form of treatment for depression. You can 8 free sessions and other resources to guide your journey.
Open Path Collective is similar to Psychology Today, but requires a one time lifetime membership of just $59 that connects you with low-cost therapists. Each session is around $30-$60.
Other amazing resources for finding the therapist for you, whether you have insurance or not are:
- APISAA Therapist Directory by the Asian Mental Health Collective
- Inclusive Therapists – connecting you to therapists who celebrate your cultural and sexual identity.
- Therapy for Latinx – connecting Latinx individuals to Latinx therapists
4. How long does it take?
The first 1-4 weeks are typically used for weekly sessions for both you and the provider to get to know each other. This includes questions your therapist has for all their clients, such as, “What do you hope to get out of this?” or “What are your greatest concerns?” Then the more you two get to know each other, you explore the various avenues of your identity, such as familial upbringing, gender identity, career, relationships, etc. I feel like the first couple of weeks are the hardest, kind of like starting a new job. It can feel robotic, make you feel nervous, and might question why you’re doing it. I think that’s normal.
My therapist tells me she has clients who “graduate” from therapy eventually, but it usually is a mutual decision that you and your therapist make when you both decide that you may not need as regular sessions. For example, I started with weekly sessions for 3 months, moved to bi-weekly, and now I’m at monthly sessions. However, I don’t think I’ll be “graduating” from therapy. I love meeting with her, even if some sessions are harder than others. I hope to go through life with her and her guidance as I experience new situations and relationships and continue to work on healing from past traumas.
So although I don’t have the perfect answer to this question that I often ask, too, I’ll just say that I don’t think it’s fair to put an end date to your mental health journey. After all, it’s a life-long journey, right?
5. What do I need to know before & during the process?
The first therapist you work with might not be your forever one. I don’t think forever therapists are even a thing. You change, things change, and that’s the one constant of life, right? So I’m telling you that it’s okay to break-up with your therapist. Or not continue a relationship after the consultation. You’re not held to one person. And a supportive therapist will understand that.
Communicate with your therapist clearly. I understand it can be scary to maybe hurt someone’s feelings or be too forward. However, this is your health we’re talking about. Be clear if you want homework between your sessions! Be clear if you hate homework between your sessions. Be clear in what was helpful for you. Be clear in what you are afraid of, what you want from the experience, or if you have no idea what to expect.
I hope you found this helpful. I am rooting for you. I am so proud of you for even reading this blog post and acknowledging that you can’t do it all alone. Keep going.
xo,
Clara
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