Slander Confetti

Well, my established and excellent care team of professionals who are supporting me during this time are doing their best–and wow, are they amazing! However, I’m in the unexpected but understandable position of having to find an interim therapist, as my established doc (whom I had stopped seeing in December of 2024) has a full caseload and can’t meet as often as I need.

In listening to myself, and honoring what I need, here I go again finding a good fit shrink. Oy, loves. Not my fave. But I’m pretty dang good at it.

So, I thought I’d take a moment and offer my process for finding a therapist as a nudge to you (if you need one) to get your own healing team together. Over the pandemic, one of my methods of service was to help people locate shrinky types. By the middle of 2021 I had at least 5 people a month reaching out to me for help. So, let me check these URLS and offer a way forward for both of us. And. If direct help from me would be helpful, LMK.

1. If you’re insured: Do a search at TherapyDen and Psychology Today Therapist Finder. Filter for your location, modality (in person/virtual), insurance type, and other things important to you (identity factors of the therapist; specialties).
   
2. If you’re uninsured: One of the best starting places is Open Path Psychotherapy Collective. It is a site where therapists who offer lower-cost/sliding scale sessions gather. You can also reach out directly to therapists you locate on other sites mentioned above, and ask about their sliding scale availability. I have zero experience with Headway and other platforms and I don’t have enough clients/people in my life who have used them to offer anecdotal data.
   
3. If the therapist you want to work with doesn’t take your insurance: You can check with them regarding their ability/willingness to apply for a “Single Case Agreement” with your insurance panel.
   
   If you have minoritized identities (especially across race, LGBTQ+, disability) and the therapist you want to work with specializes with specific populations, a case can be made for “Culturally Specific/Culturally Responsive” care*. If you have a specific issue that isn’t a common specialty, the case agreement is more likely to be accepted.
   • You can also ask if the therapist offers “superbills,” to submit to your insurance company for at least *some* reimbursement. The reimbursement can be incredibly minimal, so check first with your insurance to see what the estimate would be for billing out of network using a superbills.
     
     **For QTBIPoC folx, this could be a helpful resource in screening out/in therapists who claim to “get it”: How to Find a Therapist Who Understands Oppression and Intersectionality My field continues to be white-AF; cis-woman AF, English speaking AF. Though, I gotta tell you, if attendance of graduate students at the Washington Psychological Association conference this month is any indication–this is CHANGING in a big way!!

A) Get a list of at least 5 practitioners that look like good possibilities–more if you are including providers who state they aren’t accepting new clients on their profile. In the case of the latter, you CAN ask if they are generating a waitlist.

B) Request a brief consultation to meet with each of the therapists via phone, Zoom, or in person to get a feel for them. Usually these are 15 minute virtual meetings that cost you nothing. Get a feel for their warmth, directness, and how they answer questions you have about their practice and how they tend to work. Ask about availability (do they have weekly or biweekly slots available and when could you start) and any other things you are curious about/need to know.

C) Employ the 4Cs: These are the 4 things I tell every new client of mine that are the bare minimum for decent therapy, as they decide if they want to work with me.

The first is a gimme: Confidentiality (legally mandated with very few limits related to immanent risk to self or others and descriptions of what meets the legal definition of abuse of a child or protected adult).

Competence: Does the therapist have the requisite knowledge, skills and abilities to help you with what YOU want help with? Part of competence is how well they can fit what they know about mental health to who you are as a person (especially your lived experience in a racialized, gendered, classed, disabled body in the US). You may decide that working with a Licensed Associate (they have an ‘A’ in their credential like LMHC-A) is or isn’t something you want to do. Personally, I have supervised some top-notch therapists who were doing amazing work with clients as graduate students or pre-licensed professionals. I’ve also had the opposite experience; they rarely do harm but the learning curve of a therapist is steeper and longer for some. Which is why I will never work with a therapist with less than 5 years of post-licensure experience.

Connection: This is different for everybody and can change across life-conditions or what you are bringing to the therapy space. But at the very, very minimum: Does my therapist care about me, understand me, and are they helping me with what I want help with? If the answer to these questions is ‘No’ for more than 2 sessions, I recommend telling them and/or scheduling with one of your back ups. It turns out that the therapeutic relationship between the client and therapist is THE biggest predictor of successful therapy outside of competent use of evidence-based approaches. I cannot emphasize enough how important a good connection (you get to define that) is. Personally, I need to trust my therapist enough so that they can jiu jitsu the hell out of my psychological self. I’ve learned what that feels like; I’ve also learned that if I stay with a therapist who doesn’t meet the connection rung, I’m wasting my time and money.

Choice: Often, we kind of land randomly with a therapist who is available and takes our insurance, has a time slot that works for our nutty schedules, seems good enough, etc. However, in many cases (not all) we are not stuck with the therapist unless we want to be. Sure, it IS work to get re-established. Find a groove and assess again. But I promise you: it is worth every moment of effort.

Someday, ya’ll, I’ll be as good at weeding out toxic dates as I am at picking a solid therapist. But until then, I’m headed into some free consults with providers this week. Wish me luck! And keep me posted if you need support in your journey with this.

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