How To Start Therapy: Life Kit If the mere thought of going to therapy seems overwhelming, you're not alone. Plenty of people put off seeking therapy because of the stigma, cost and inconvenience. We've got four tips to help you make your first appointment.
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How To Start Therapy

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How To Start Therapy

How To Start Therapy

How To Start Therapy

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Lindsey Balbierz for NPR
The prospect of starting therapy can feel overwhelming, but prioritizing your mental health is important to your overall health. Life Kit has tips on how to start going to therapy, with a focus on making the first appointment.
Lindsey Balbierz for NPR

Feeling anxious? Overwhelmed? Unhappy? Not sure what you're feeling at all? These might be signs that your "check engine" light is on and seeing a therapist could help.

If the mere thought of trying to find help seems overwhelming, you're not alone. Plenty of people put off seeking treatment or try to ignore symptoms because mental health is often easier to brush off as not urgent.

"We feel like there's a hierarchy of pain, and if our problem doesn't feel big enough, we wait until we're basically having the equivalent of an emotional heart attack before somebody will make that call," says Lori Gottlieb, a psychotherapist, advice columnist and author of the book Maybe You Should Talk to Someone.

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This story is adapted from an episode of Life Kit, NPR's podcast with tools to help you get it together. Listen to the podcast at the top of the page, or find it here.

On top of that, the process of researching and scheduling that first appointment can be an emotional burden on its own — but procrastinating often allows the problem to grow. If you wait until things get really bad, the harder it will be to address.

We've got four tips to help you make therapy work for you. Be sure to listen to the Life Kit episode "How To Start Therapy" for more advice from experts who know that this is more than just making a phone call. If it were that easy, you'd have done it already!

1. Acknowledge stigmas that might be holding you back from seeking help.

The fear of being stigmatized can keep us from seeking treatment. Our attitudes about mental health likely come from family, friends, society at large, the media — and even our own inner voices.

"I think that a lot of people feel like if they start therapy, that means something's wrong with them and other people might look at them differently," says Gottlieb.

The reality is that people close to us often notice when we're having a hard time. In fact, they're likely catching some negative side effects, since we tend to take things out on our loved ones. Remember, you're doing this for them too.

A good first step is to reframe therapy for yourself. "I think of seeing a therapist as just getting a second opinion about what you're doing," says Pahoua Yang, vice president of community mental health and wellness at the Amherst H. Wilder Foundation. "And then you can decide from there."

If you're concerned about privacy or disclosure, therapy is confidential. No one has to know! Licensed mental health professionals are bound by the law to protect your privacy. Unless someone is a threat to themselves or others, what goes on in therapy stays in therapy.

2. Find the right therapist — or type of therapy — for you.

Start by making a list of potential therapists. If you have medical coverage, your insurance company can help make that list for you. Ask the company for some nearby professionals who take your insurance.

Psychology Today also has a database, which you can use to search for providers in your area, along with specialties, reviews and experience.

Once you've identified a few potential therapists, reach out. Come up with some starter questions to ask when you interview them over the phone. What experience do they have working with your issue or community? How does a typical session with them work? Do their available hours match yours?

Asking questions before a visit can help you know what to expect. But Gottlieb says the visit itself is the most important piece. "The reality is, you're not gonna know if it's the right fit until you're sitting in a room with that person," says Gottlieb.

If transportation, access or motivation is a problem, online therapy like the app BetterHelp might be helpful. (BetterHelp is a sponsor of NPR.) You can also ask to do Skype sessions, but make sure the therapist is licensed in your state. Otherwise, the therapist can't legally treat you.

Not insured? Or on a tight budget? Look up a local clinic at a hospital or university where you can get low- to no-cost therapy with a therapist in training.

That's actually how Gottlieb got her start as a therapist. "I trained at a clinic where people came in for no fee or a very low fee," she says. "I was supervised by licensed clinicians. That's also a great way to get help."

Don't feel ashamed or shorted by the idea of low-cost therapy. Gottlieb says clinic sessions actually have an advantage over pricier options.

"In fact, you probably have more supervision than a private-practice clinician does, because when you're training, you have several sessions a week of supervision, so your case gets a lot of attention when you're in a clinic."

Group therapy can also be a great low-cost option. Group sessions tend to be relatively affordable compared with one-on-one sessions — sometimes even free.

Open Path Collective offers a network of therapists who charge $30 to $60 a session. And some professionals price their sessions on a sliding scale fee, meaning their rates vary based on a customer's ability to pay. If you can't afford your preferred professional's rates, it's worth asking if sliding scale payments are an option at the therapist's practice.

3. It's OK to move on to a different therapist, or kind of therapy, altogether.

If your current therapist doesn't feel like a good fit, it's fine to "break up" with the person.

"You want to make sure you find somebody who actually feels like they get you," says Joy Harden Bradford, Ph.D., host of the podcast Therapy for Black Girls. "It's OK to say, 'Hey, I think I may need something else' and to try to find another therapist who's going to be a better fit for you."

But after all that work of getting into therapy, it might feel daunting to dump someone and start over.

Harden Bradford understands. She says it's important to push through that uncomfortable conversation and find something that works for you. Plus, she says, the therapist likely isn't going to be mad at you.

"It is a part of our training, and we know that kind of thing happens," she says.

Mental health professionals want you to get better, even if it's not in their care. Your current therapist might even be able to help identify a colleague who would fit better.

4. If you're comfortable with it, talk about therapy with others.

If you're already in therapy, and you feel comfortable, be open about it.

John Kim, also known as The Angry Therapist, says he found an online following when he opened up about his divorce and his own mental health treatment.

"I would share ... all the revelations I'm having about myself," says Kim. "And how much that's helping my relationships at work, at home ... and all of that happened because of me starting therapy."

Kim says he wishes more people were open about going to therapy. He wants to see it normalized and encourages working it into conversation.

Just keep it subtle. No need to share details. Simply let others know that you're prioritizing your mental health.

But Kim says it's important to remember that if you're sharing because you think someone else needs mental health support, it's best to show, not tell.

"The best way to get someone in therapy is by example ... doing therapy and living a different way where they notice. To tell someone to go to therapy, that's not gonna land well."

Breaking down a stigma takes time. By talking openly about therapy and demonstrating its benefits, you just may inspire someone else to try it out.

Editor's note: In the original version of this story, we failed to mention that BetterHelp is an NPR sponsor. A full list of Life Kit sponsors is available here.


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The audio portion of this story was produced by Audrey Nguyen.