Steps to Take When Seeking Psychotherapy

Before your first appointment with a psychotherapist, there are some things you should know and some things you should do. These will increase the chances that the person you end up seeing is the right person for you, and that there will not be any unforeseen problems in dealing with your insurance company.

Understand your Insurance Coverage
The limits and allowances for mental health coverage are often different than those for physical health coverage. To get the most current information about your policy, it is advisable to contact the insurance company. There is usually a toll free phone number on the back of your insurance card.

Ask your insurance company:

  • Do I have out-patient mental health coverage?
  • Does my policy have a deductible (a dollar amount you must spend before your policy begins paying for services)? If it does, have I met any or all of my deductible for the current year?
  • Does my policy have a co-payment (an amount you will have to pay per therapy session)?
  • Are there a maximum allowable number of sessions (or dollar amount) per year?
  • Are there a maximum per lifetime?
  • Can I see any therapist, or do I have to see someone on the insurance company’s panel (a pre-approved list)?
  • If there is a panel, am I allowed to go to someone who is not listed? If so, how much more will my out of pocket expenses be (deductible and co-payments)?
Choosing a Therapist

There are many important considerations to weigh when choosing a therapist.  There are two very useful pamphlets published by the American Psychological Association.  They are: A Mental Health Patient’s Bill of Rights, and, Change Your Mind About Mental Health.

One obvious consideration when choosing a therapist is gender: do you have a preference for a male or a female therapist?  For many people, the gender of the therapist is of little concern.  For others, this is a very important consideration. While many women assume they will feel more comfortable talking to another woman, it is important to consider the benefit of developing a healthy therapeutic relationship with a supportive, accepting, nurturing male. Experiencing the safety of such a relationship, in which appropriate boundaries are clearly defined and respected, can help a woman redefine and establish more healthy relationships with men in other areas of their lives.

For heterosexual couples choosing a marriage counselor, one fact to consider is that there will be either two women and one man, or two men and one woman in the therapists’ office during counseling.  This should not make a difference to the progress of the marriage counseling, but may affect the perception of counseling during the first few sessions.  Especially if one of the partners in the couple does not really want to go to marriage counseling, that person’s perception might be that they are being “ganged up on.”  This “two against one” perception can be overcome if the therapist is the same gender as that person.

This is not usually a problem, and when it is, it is commonly experienced during the first few sessions only, until trust can be established, and a familiarity with the process, and with the therapist, can be gained.

Further Considerations
  • If you elect to utilize insurance benefits to pay for therapy, you should know that some otherwise confidential information will need to be released to the insurance company. This may include, but will not necessarily be limited to, a diagnosis (i.e. depression, anxiety, etc.), and, especially in the case of managed care, can include an initial summary of presenting problems and treatment plan, and subsequent updates on progress being made. If this is a concern for you, you should discuss it with your therapist during your first session.
  • If you can not afford the out of pocket cost of therapy, discuss this with your therapist, either during your first session, or immediately as your circumstances change (loss of job, loss of insurance, divorce, etc). Many therapists see some clients on a sliding fee scale.
  • If, at any time during therapy, you have questions about your therapy or the therapeutic process, do not hesitate to ask your therapist. He or she should be happy to answer your questions.
Resources for Getting Started
An excellent book describing the therapeutic process and what to expect is Deborah Lott’s In Session: The Bond Between Women And Their Therapists.

The internet makes a vast amount of information available to you. Unfortunately, it can be confusing to sift through it all and find reliable sources. The following links are considered to be reliable and offer useful information to help you as you begin therapy: