Let's face it: finding a therapist isn't always as straightforward as we hope. Navigating the options can feel simply overwhelming.

From struggling to find a therapist that specialises in your specific needs to determine if they accept your insurance, it's a wonder how anyone chooses one.

As a qualified mental health professional, I've worked with clients for over four years now, supporting people with a range of needs, from depression and anxiety to autism and ADHD.

Therefore, I've put together a step-by-step process on how to start therapy – how to set goals for treatment, financial aspects, the referrals and directories to use, and how to meet potential therapists.

Why start therapy? 

You know you need therapy. This is already a major step forward toward achieving better mental well-being and quality of life. But how do you start therapy? What is the process, how do you find the right therapist, and what do you talk about in therapy? 

Yes, it can all feel like a daunting process, but it is the first step in prioritising your mental health. Whether you're struggling with a specific issue or want to focus on your overall well-being, therapy can offer invaluable support and guidance. It is a place to work on understanding yourself and others, find new ways of communication, improve your relationships and overall well-being. 

By the end of this guide, you'll have the tools you need to start your therapeutic journey and help guide you toward achieving better mental well-being and quality of life.

You may have some goals for therapy in mind when starting therapy. These may be helpful when thinking about which approach to consider. Perhaps you've noticed:

• Higher anxiety levels or tension that is interfering with your daily life;

• difficulties in managing your emotions such as anger or sadness;

• frequent conflicts in relationships with friends, family, or co-workers;

• difficulties concentrating and decreased productivity;

• sleep problems, changes in eating habits, or other physical symptoms. 

These types of challenges can all be reasons to start therapy. You may be looking for support in navigating a specific situation, wanting to improve your overall well-being, or simply seeking tools and skills to get to know yourself better. Taking the time to clearly define your goals will make it easier to narrow down your search and find a therapist who can best address your unique needs.

If you are looking for short-term therapy to give you tools-based options, Cognitive Behavioural Therapy (CBT) might be a good option for you. If you're looking to understand your patterns and relationship dynamics, a more long-term therapy such as psychodynamic, psychoanalytic, and humanistic approaches may be more appropriate. To get an idea about your specific needs and preferences, take some time to dive deeper into each of these approaches. Moreover, many therapists offer an integrated approach to therapy, which might be the best option for clients. Check the therapist's approach and experience. You can always ask them for more information if anything is unclear. Find more information on different therapy approaches. 

When starting therapy, think about whether you could opt for insurance-based therapy or private pay. It is always worth researching whether your health insurance provider covers psychotherapy services. To know more, get in touch with your health insurance provider to ask more about what is covered by them (there's usually more information on your provider's website). They may have some English-speaking options. 

When opting for private pay, consider your realistic budget for therapy. How much can you afford to pay? Note that some therapists offer sliding scale fees (cheaper fees for lower-income clients), which you can find out more about by asking whether that's an option for them. Private pay may be a better option if you want to choose your own therapist with whom to work. It can also be a quicker option for care, and you can choose which approach resonates with you the most. 

Arula Counselling integrates creative, psychodynamic, mindfulness and ACT (Acceptance and Commitment Therapy) approaches with a focus on neurodiversity-affirming and trauma-informed care. 

You may also find it helpful to reach out to people you trust who have been through this process already. Perhaps they have gone through something similar and can recommend you to a specialist who was able to support them. It's useful to talk to your network; you never know the information they may have. However, be mindful that your needs may vary from the people around you, which means that the same therapist may not be suitable for everyone. Although, knowing about other people's processes can support you in your process of starting therapy. 

Diving into the world of online directories can be overwhelming when knowing how to start therapy. Depending on where you live, there are too many specialties, too many, or too few people to choose from. Since the beginning of my career, I have developed great respect towards It's Complicated therapy platform. Through their search filter, you can make choices depending on location, price, need for support, etc. Additionally, you can find recorded videos of therapists talking a bit more about themselves, which is a great way of getting a feel for the therapist. Choosing a couple of therapists from the list may help you to get closer to the one you'd like to work with. Give yourself time to make the best option for you. However, be mindful of some low-cost online counseling services that may not use professional therapists. Check whether the potential therapists are: 

Are they registered with a professional body?

Make sure any potential therapist is properly licensed and registered with appropriate professional bodies. This ensures they have the necessary training and qualifications.

What is their experience?

Look for therapists who have experience treating the specific issues you're seeking help with. Their bios should provide details on their background and areas of expertise.

Do they have the information you need on their website? 

Can you find the information you needs such as the cost of a session, format of sessions, location etc. If you’re struggling to find it, reach out to them for further details to help you feel at ease before booking the first session.

Take the time to review a few options from trusted online directories. This will help you get a feel for different therapists' styles and specialties so you can make the best choice for your unique needs and preferences.

It can be helpful to prepare some questions before starting therapy to determine whether a therapist is a right fit for you. Meeting a couple of therapists before starting therapy is a common way to go. Think of them as job interviews where you can decide who you want to work with. You could ask questions like:

How long have they been in the profession? 

Is it important for you to work with a professional who has been practising for a while, or would you be okay with a trainee therapist who usually offers a lower fee option?

Do they focus on your specific area of concern? 

You can scroll through the therapist's website or online directory profile to gather more information on the type of support that you need.

What qualities are you looking for in a therapist? 

What are the qualities that are important to you in a therapist such as their background, culture, language, age, gender. This will help you further down your search in finding a therapist who you could …

Timing of the session

Think about when would be the best time for therapy for you. Is it in the morning before starting your workday? Or before the weekend? It is important to allow yourself some time before and after the session to regulate your emotions and ground yourself before jumping into the next thing.

Therapy is a collaborative encounter, where the relationship between the client and the therapist is considered to be the most impactful part of a successful therapeutic experience. Therefore, take your time to make this important decision for yourself.

There is power in making the choice for yourself in how to start therapy and which therapist to see, depending on your unique needs and preferences. This is the first step towards healing. After reviewing your options, try to meet with a few therapists. This will hopefully make your decision a little bit easier. By meeting, you can get a better understanding of their personality, communication style, and their therapeutic approach. Pay attention to whether you feel comfortable opening up to them and if you think you could develop a strong, trusting relationship. 

It can also be helpful to discuss your thoughts and feelings with trusted friends or family members. However, getting an outside perspective from a trusted professional can provide clarity and reassurance. Trust your gut instinct - if something doesn't feel quite right, allow yourself time to keep searching. By taking an active role in your healing, it can have profound and lasting benefits on your mental and physical well-being. 

Building a good connection is an essential part of therapy. Research shows the importance of alliance, empathy and expectations for therapy being key parts to change. When starting out, I recommend my clients to start with 12 weeks of consistent therapy and then to do a check-in about what works and what doesn't work for you. If after a couple of sessions you feel like it's not working, talk to your therapist about it. They may be able to refer you to someone else or suggest treatment alternatives that work for your specific circumstances. I always encourage you to communicate your thoughts and feelings to your therapist, as it leads to deeper exploration. 

Conclusion

The process of starting therapy is not a straightforward one. It is about thinking about your goals for therapy, whether you're willing to put in the work and if you're able to feel supported by your therapist. 

Once you find a therapist that feels right for you, you can start working on creating trust. They will be there for you to hear you out, model healthy boundaries, build resilience, and encourage talking about topics that you haven't been able to talk about before. You can start getting to know yourself. The therapist will be the mirror and a reflection of yourself. 

However, the process will not be easy, and there may be times you don't want to go to therapy. You may feel like stopping altogether. The decision to start therapy may not come lightly, but it is a huge step toward recovery. Show yourself some kindness in getting this far. 

I offer online English and Estonian counselling in Berlin. If you have further questions or would like to go ahead and book a consultation session, I look forward to connecting with you here, or you can email me at arulacounselling@proton.me. 

Disclaimer: This content is for educational purposes only. If you are suffering from severe trauma, live in an abusive household or are in danger, call 112 or your country's crisis line, where professional mental health workers can offer you appropriate support. Here are some additional resources.

References 

British Association for Counselling and Psychotherapy. (n.d.). Home page. https://www.bacp.co.uk/

Crits-Christoph, P., Rieger, A., Gaines, A., & Gibbons, M. B. C. (2019). Trust and respect in the patient-clinician relationship: preliminary development of a new scale. BMC psychology, 7(1), 91. https://doi.org/10.1186/s40359-019-0347-3 

Finsrud, I., Nissen-Lie, H. A., Vrabel, K., Høstmælingen, A., Wampold, B. E., & Ulvenes, P. G. (2022). It's the therapist and the treatment: The structure of common therapeutic relationship factors. Psychotherapy Research, 32(2), 139–150. https://doi.org/10.1080/10503307.2021.1916640 

Kottler, J. A. (2017). On Being a Therapist. Oxford University Press. https://www.psychotherapy.org.uk/seeking-therapy/how-to-choose-a-psychotherapist/ 

Spalter, David (2014) How clients choose their psychotherapist: influences on selecting and staying with a therapist. Other thesis, Middlesex University / Metanoia Institute. https://mirep.metanoia.ac.uk/id/eprint/287/1/DSpalter_thesis.pdf 

Wikipedia contributors. (2021, July 1). Common factors theory. In Wikipedia. Retrieved May 13, 2024, from https://en.wikipedia.org/wiki/Common_factors_theory