Whether you’re considering therapy for the first time or moving on from another practitioner, choosing the right therapist for your specific needs is an important decision and crucial step in your mental health journey.
Knowing what to look for can feel overwhelming, so we’re sharing a few tips on knowing which therapist is right for you and some factors to consider before scheduling your first appointment.
Types of Mental Health Specialists
Before you start looking for a therapist, it’s helpful to understand the different types of mental health practitioners you may come across during your research.
Each specialist will be trained differently, informing their approach to mental health and the type of support they can offer you.
Therapists. Typically, therapists offer talking therapy and can assist in diagnosing various mental health conditions. Many therapists now hold doctorate degrees in specialized areas like family therapy or grief, so it’s always helpful to research individual therapists and their training before making an appointment.
Licensed professional counselors. Similar to therapists, licensed counselors usually require both a master’s degree and a license to practice in their state, along with 2-3 years of supervised experience. Counselors often use the word “therapist” interchangeably, so don’t let this phase you.
Psychologists. While psychologists can also perform talk-based therapy, they can also provide medical and diagnostic assessments using psychological evaluations. Their training is typically more extensive, requiring a doctorate degree, a full-time supervised internship during graduate school, a supervised post-doctoral fellowship, and passing national exams. Psychologists registered with the American Psychological Association should all fit this criteria.
Psychiatrists. These specialists are the most clinical mental health practitioners, focusing on biological factors like genetics and neurology. They can provide a diagnosis of mental health conditions but also prescribe medication directly and order medical testing (other practitioners usually refer you to a family doctor for medication). Their training requires either a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) qualification, a 4-year residency, and accreditation by the American Board of Psychiatry and Neurology.
In Washington, you can look for counselors and therapists with specific licensing to demonstrate the type and level of training they’ve received. This licensing means that these individuals have met the mandated requirements to be licensed in the State of Washington.
When you’re looking for a therapist, you’ll usually see letters after their name to show their qualifications. Here’s a quick explanation for what each of those licensing abbreviations means:
LMHC/A - Licensed Mental Health Counselor/Associate. These individuals must have a Master’s degree or higher, along with 2-3 users of post-graduate supervised clinical experience. Associates are usually those with their degree but still completing their clinical hours so are pre-licensure candidates.
LMFT/A - Licensed Marriage and Family Counselor/Associate. Like LMHCs, these therapists must have a Master’s degree or higher and 2-3 years of post-graduate supervised clinical experience. Associates are still in the pre-licensing stage, usually with a MA or MSC but still working on their clinical hours. These counselors typically specialize in marriage and family issues rather than broader mental health issues.
SUDP/T - Substance Use Disorder Professional/Trainee. These individuals specialize in working with patients who have a dependency on drugs or alcohol. Professionals must have at least an Associate’s degree in human services or a related field, with at least 30 credits in courses related to substance use disorders. 40 hours of continuing education every 2 years and at least 3 hours of suicide assessment, screening, and referral training is required every 6 years to maintain this certification in WA. Trainees may be currently enrolled in an SUDP program.
MSW - Master of Social Work. To be a licensed social worker in Washington State, individuals must have a Master’s degree or higher from an accredited institution approved by the Council of Social Work Education (CSWE). With 3,200 hours of supervised work experience after graduation, individuals can become a Licensed Advanced Social Worker (LASW).
Psychiatric ARNP - Psychiatric Advanced Registered Nurse Practitioner. Psych ARNPs in WA must have a current Registered Nurse (RN) license and at least 250 verified hours of advanced nursing practice. Many hold specialist certifications in psychiatric mental health to focus their attention on this field.
PA - Physician’s Assistant. Any WA PA must have graduated from an approved physician assistant program and successfully passed the National Commission on Certification of Physician Assistants (NCCPA) exam. As part of most PA programs, between 1,000 and 4,000 hours of direct patient care experience is required.
CPCs- Certified Peer Counselors. As a CPC, individuals must have successfully completed the Washington State Health Care Authority’s in-person training and pass the written and oral state exam.
What to Expect When Finding Your First Therapist
Deciding to start therapy for the first time is a courageous move and it’s completely normal to feel nervous about seeking professional support. Over 41 million adults in the US received counseling or treatment for their mental health in 2021, so you’re certainly not alone.
There’s no right or wrong time to look for a therapist and everyone’s situation will be different. You may have recently dealt with a difficult life situation and are looking for guidance on what to do next. Or you may be struggling with substance use and are now ready to make positive steps forward in becoming abstinent from drugs or alcohol.
Knowing exactly what you’re looking for help with is one of the most important factors when choosing a therapist. While other issues you’re facing may arise during your time in therapy, focusing on a clear goal will make it easier to find the right person to support you.
Specialists trained in the area you need help with are often a good place to start your research. Some of the common areas that therapists may have specialist knowledge or skills can include:
Eating disorders
Anxiety and depression
Grief and bereavement
Family and marriage
Substance use and addiction
Trauma
You can also find therapists who specialize in working with clients from particular cultural backgrounds or life stages, like adolescents and young adults, the LGBTQIA+ community, or BIPOC clients.
Beyond your goals for seeking therapy, you should also consider what type of therapy you might be interested in.
Some people prefer to work with a therapist who can provide guidance on identifying and changing patterns of behavior through techniques like cognitive behavioral therapy (CBT). Others may be more interested in exposure therapy, where anxiety and fears are addressed directly through situational support.
At ICS, we specialize in acceptance commitment therapy (ACT) and provide holistic support through mindfulness-based recovery skills and goal setting. Using a whole-health approach, we help our clients and patients to overcome their challenges using flexible and individualized techniques that equip you for lifelong recovery.
How to Switch Therapists
While many people choose to stay with their first therapist for several years, even decades, it’s also common to start thinking about if or when to change therapists at various points in your recovery journey.
There are plenty of reasons why changing to a new therapist might be the best decision for you, even if you’ve had an excellent experience with your current counselor. As you move through different phases of life, a new therapist may be better able to deal with your current situation and provide a fresh perspective for your continued growth.
Never be afraid to address your thoughts around changing therapists to your existing one—you won’t offend them, and they may even be able to give you recommendations for someone better suited to support you now.
They can also provide an objective viewpoint on whether switching therapists is the right decision. If you’re struggling to accept what they might be telling you in your sessions, this could mean you need additional work in that area rather than moving to someone new.
But it’s also important to remember that therapy is a collaborative process and your safety is important. Being uncomfortable at certain times is very possible and if you feel safe with your therapist, you’re more able to discuss and deal with any feelings of discomfort. At ICS, we can help you build skills to cope with discomfort as an alternative to avoiding, suppressing, or numbing your feelings. We offer Acceptance and Commitment Therapy (ACT) to help you accept thoughts and feelings, not struggle against them, as well as to access your values and take workable steps to build an individualized, durable recovery program.
Identify what you like about your current therapist and what you feel isn’t working for you anymore. You’ll also want to think about your goals and how those have changed from when you started going to therapy. Trust is a critical part of a successful therapy outcome, so if you can identify what is and isn’t working for you, you’ll have a better chance of building rapport with your current or any future counselors.
Important Details to Remember
Adding an ongoing health cost to your monthly budget can seem daunting, but it’s always best to check with your insurance provider before scheduling a session with a therapist. Many health insurance providers now include mental health coverage in their plans, making therapy a more cost-effective option.
You can even find therapists through your health insurance company, using their online databases to find local practitioners who accept that insurance.
Always check with your insurance provider how many sessions are included in your plan each year, if any types of counseling are not covered, and if you choose to use an out-of-network practitioner, what those costs might look like.
You can also look for a therapist that offers sliding-scale financing. This may be based on your income, current situation, or if you’re seeking therapy through another mental health program. Some offices may also offer low-cost options when working with interns or students in training from a local medical school. Although not qualified yet, these individuals are all supervised by licensed professionals, so they can be a great option for finding mental health support on a low budget.
If you’re thinking about starting therapy or looking to switch to a different practitioner, get in touch with our team at Integrative Counseling Services (ICS). We offer individual, group, and family counseling to individuals in the Seattle area, with compassionate and committed Washington State-licensed practitioners.