How to Find a Therapist, Especially if You’re Queer or BIPOC

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Episode artwork for Enthusiastic Encouragement and Dubious Advice Podcast for the Episode titled "How to Find a Therapist, Especially if You're Queer or BIPOC”

Show Notes

Patricia and Nicole share advice on how to find a therapist that is right for you regardless of your identity with added advice for folks who are queer and/or BIPOC (Black, Indigenous, People of Color). Finding a therapist can be inaccessible, difficult, and overwhelming, and in this episode we try to demystify and simplify the process. We offer not only advice on how to find a therapist that meets your needs and finding therapists for a diverse range of identities, but we also talk about why a person might want to go to therapy at all.

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Sound editing by Jen Zink

Transcript

Music: [Intro Music] 

Patricia: Hello, my fellow Deviants! Welcome to Enthusiastic Encouragement and Dubious Advice, the podcast for folks who would rather curl into the fetal position than lean in. I’m your host, Patricia Elzie-Tuttle. 

Nicole: And I am not bound by cohost listener confidentiality, Nicole Elzie-Tuttle. We’re recording the show on May 7th, 2024.

Patricia: Before we really get into this show, I want to acknowledge that things are really hard right now for everyone. You know, I was in a work meeting the other day and people have personal things going on and everyone seems really busy at work right now. And there are global things going on that just make it really hard to exist and be present right now.

And sometimes it feels silly that we’re all still having to like, go to our day jobs, make content, make art. And I just wanted to call it out. I didn’t just want to, you know, bulldoze through into our show today without acknowledging, like, stuff is really weird and hard right now. 

Nicole: Yeah. Thank you for acknowledging that.

And I hope our listeners who, who are finding it really hard, just take a moment to breathe and kind of just take a moment. 

A reminder for our listeners that we do have a Patreon community, and you can gain access to that by subscribing on Patreon. And if you do that, we still have a survey up, you can fill it out. And, uh, we will send you a rainbow prism sticker with our podcast logo on it. 

Patricia: Yeah. Only if you want a sticker. Like, still fill out the survey if you are a paying member. We only have one level. It is three dollars. It is the Helpful Helper level. 

Nicole: Helpful Helpers! 

Patricia: And we are actually going to start our first paid feature.

I want to try something that I do with my mentees, I do it with my therapist, I do it with my friends. Which is being accountability buddies, or accountabilibuddies. 

Nicole: Whoa. 

Patricia: Whoa. 

I’m going to make a weekly post, and just kind of check in, like, this is the one thing I would like to get done by the end of the week.

And sometimes I do this with friends, like, oh, I have a phone call I don’t want to make, and I’m like, I also have a phone call I don’t want to make, let’s check in on Friday and see if we made the phone calls, or… These are things, like I said, I do with my mentees, I do with my therapist, and I would like to get a thread going, and I’m not only going to be there to check back in in a week to see if we all did the things, but I’m also expecting some reciprocity, and I’m going to share, like, here’s the one, the one hard thing or the one thing I’ve been putting off that I’m going to do this week.

So, if you are a helpful helper, you also get to be an accountabilibuddy if you want. 

Nicole: I may drop in and out on that one. 

Patricia: [Laughing] 

Nicole: Maybe it’ll be helpful to have someone outside of our house helping with accountability for some things. 

Patricia: I mean, we’re not that great with accountability for each other. Like, we run a really loose ship here.

Nicole: [Laughing] Yeah. As tight as we keep everything else in our lives together. 

Patricia: Yeah. 

I’m like, well, I’m not going to force you to do this thing if you really don’t want to do it. 

Nicole: I’m just like, I am so tired.

Patricia: [Laughing] 

Music: [Music] 

Patricia: I did mention this is something that my therapist helps me with. And today we’re actually going to talk about therapy and specifically about finding a therapist from our perspective, both as a queer person of color and another queer person. And it is something that there’s a lot of content out there on how to find a therapist.

And it’s actually often written by people who are therapists. So there are, you know, certain biases from, from their side. And we want to share about finding therapists as patients. 

Nicole: Yeah, so you need to first go to a place with a lot of people, like a theme park or a tourist destination and it might take you a little while, but you want to look for the person with a red and white striped shirt and big glasses.

Patricia: That, uh, is your therapist Waldo? 

Nicole: Oh, therapist, I’m thinking of Waldo. Yeah, okay. Sorry, everyone.

Patricia: [Laughing] You just completely derailed me. Um, no, I think, you know, we often see memes and so much content about, like, go to therapy and people telling people, like, you need to talk to a therapist. You need to see a therapist. And it’s a very popular thing to say. And I think it’s said so much, but without actually offering any support because finding a therapist isn’t necessarily easy. It’s not necessarily accessible to most people. So just telling someone to go see a therapist is not actually helpful. We will go over what therapy is, why might a person want to see a therapist, and how does a person go about doing that.

I want to note, we’re talking about psychotherapy, not other therapies like physical therapy or immunotherapy. The National Institute of Mental Health, NIMH, defines psychotherapy, also called talk therapy, as a variety of treatments that aim to help a person identify and change troubling emotions, thoughts, and behaviors.

Most psychotherapy takes place one on one with a licensed mental health professional or with other patients in a group setting. 

Nicole: Now it’s important to understand that psychotherapy is kind of an umbrella term and there are a lot of different modalities. Like, therapeutic modalities that happen under this umbrella, and different therapists may specialize in different types of therapies.

And these can be things like cognitive behavioral therapy, which in the mental health world you may often see abbreviated as CBT, but there’s other things that are like other art therapy, attachment based therapy, music therapy, there’s things like dialectical behavioral therapy, there’s a whole wide range of different types of therapies.

So as you go through this, and may or may not be experienced with any number of these things, know that, like, most therapies are not one size fits all. Like, they don’t work for everyone. That being said, I do remember when I was in psychology class, and specifically one on clinical therapy, the instructor basically said, like, most therapies work for most people most of the time.

And so it kind of just depends on what you’re working with, and, and what you find yourself comfortable working within, and what framework your therapist likes to work under. 

Patricia: Right, and a therapist may specialize in only one of these or multiple of these different things. So you may find a therapist who primarily does cognitive behavioral therapy, but they may also do music therapy and bibliotherapy or something like that as well.

Aside from cost, which we will talk about in a bit. We want to acknowledge up front that therapy isn’t for everyone. Again, returning to people just saying like, go see a therapist. Like, clearly, if a person doesn’t have buy in and actually want to do the work, then therapy is going to be a waste of time and resources.

But also, historically, there was a lot of racism, sexism, ableism, homophobia, transphobia in both psychological research, as well as psychiatric research. And some of those biases have carried over to today. That being said, a lot of mental health professionals, a lot but not all, recognize this, and they are trying to do things to combat the historical effects of all of these kinds of biases.

Nicole: So you just mentioned both psychology and psychiatry. It’s important to know that these are actually two very different things. When most people think of psychology, that’s often a lot of what people think of when they think of therapy. Psychology is actually a scientific methodology or field for studying human behavior and cognition.

And there are some psychologists who are clinical psychologists, who may practice therapy. A psychiatrist is someone specifically with a medical degree who has specialized in treating mental and psychiatric, the medical field will say disorders, but you know, um… 

Patricia: issues. 

Nicole: Issues. And so they’re the ones primarily who would be able to provide prescription medications if that is something that would benefit you.

A psychologist cannot prescribe medication, and that’s like the big difference. 

Patricia: There are some psychiatrists who also do talk therapy. 

Nicole: This is correct. 

Yes. 

Patricia: Yes. But there are many people who have thought that they, they want help and they go to a psychiatrist and they’re surprised they get prescribed medication because they don’t know the difference between psychiatry and a therapist who does psychology, or like we were talking about earlier, actually, there are different kinds of people who do therapy. 

Nicole: Yeah. So depending on what state you live in, there are different professional degrees that can be licensed to conduct psychotherapy and see patients and do talk therapy.

Here in California, those are typically marriage and family therapists or social workers. In other states that you live in that there may be just licensed clinical therapists and there is… 

Patricia: Or licensed family therapists. I’ve seen LFT. 

Nicole: Yeah. 

Patricia: There are often a lot of letters after people’s names. So, LCSW, licensed clinical social worker, MFT, marriage and family therapist.

Nicole: The thing to remember is that most people who are providing talk therapy or psychotherapy in a professional setting in just about every state need to be licensed to do so. 

Patricia: And a license is something you can actually do a web search for. You can google the database to find someone’s license. So as you’re looking for a therapist, you can also look up their licensure.

Nicole: And you can also, often also see if there have been any complaints filed against them with the licensing board and things like that. We are not going to be talking about today other people in other professions who may provide things that resemble therapy, people like priests or preachers. 

Patricia: Life coaches.

Nicole: Life coaches, bartenders, beauticians. 

Patricia: Although I do remember seeing an article a while ago, there was a hair salon somewhere where the stylist also went and got their MFTs, which is very interesting. 

Nicole: Yeah, I like that. That’s not to say people in those professions can’t become licensed mental health practitioners.

Patricia: But they usually aren’t. 

Nicole: They usually aren’t and therefore have not received that level of professional training to do this. 

Patricia: We also want to note another reason why people may not be getting therapy is therapy is a privilege. It takes so many resources and even thinking about things like you need to have time to talk to a therapist, even if it’s over the phone or over zoom.

Like you need to have a schedule that allows you to talk to a therapist. You need to have privacy. This may mean also having childcare. This may mean having a home where there’s more than one room. And there’s so much privilege behind being able to see a therapist. 

Nicole: Thank you for mentioning that. 

Patricia: Yeah.

Again, it’s something that pops up when people are like, go see a therapist. And it’s just like, it’s not that easy. And, and there are also social taboos or communities or cultures that have a lot of judgment around psychotherapy. It is something I encountered in my own life with some specifically evangelical folks in my family that were don’t think that therapy is the way to get the kind of help someone thinks they need.

I’ve also had some other people of color in my family thinking like, oh, so and so doesn’t need therapy. They just need to, I don’t know, toughen up or be strong or suck it up or whatever. 

Nicole: Some folks may also have like an internalized shame about needing therapy. Thinking that it means that they have some sort of weakness, or there’s something to be ashamed of, with regards to taking care of their mental health.

And the way we like to think of this is like, you would see a dentist for your teeth, an optometrist for your eyeballs, you would see a cardiologist for your heart. Why is it not okay to see a mental health practitioner for your mental health? 

Patricia: Thank you for saying that because I also think about people prioritizing these other things.

They will totally, make time to go see someone if they had a sprained wrist, or a, or they hurt their knee, or they’re, they were having some weird heart palpitations, like, you would make time, even your regular checkups, there are so many people who would make time for those things, and they don’t necessarily make time for, they say, oh, they don’t have time to see a therapist, and I think it’s also a matter of if they have access prioritizing mental health as just important as these other things.

Nicole: And I do want to note here that not prioritizing your mental health can lead you to need to prioritize other aspects of your physical health down the line. 

Patricia: Ding, ding, ding. 

Nicole: Other thing I do want to mention and fill in here is mental health practitioners cannot fix things that come from a societal systemic cause.

Patricia: Absolutely. It’s something that we’ve mentioned in a past episode. You know, we’re not going to therapy our way out of capitalism. 

Nicole: Yeah. If, if the source of all of your mental health struggles is because you’re working 80 hours a week, barely being able to afford rent and child care, and still not being able to get adequate nutrition for yourself, let alone your children, and you’re not getting enough sleep.

Like, that’s, therapy can’t fix all of that for you. They may be able to help provide some supportive structures for you to work within, but it’s not gonna fix that. That, that’s got a whole other level of things that need fixing. 

Patricia: Exactly. But what therapy does is help us manage our feelings around these things, right?

And help us, you know, often after I talk to my therapist it kind of gives me a couple extra spell slots. 

Nicole: Yeah. 

Patricia: In order to face these things 

Nicole: That’s a good way to think about it. Yeah, it helps you understand your feelings around these things and may, may help you find ways for coping within the structure you’re in. 

Patricia: Yeah. 

I also want to call out that I’ve noticed some people are even ashamed to say this, so I’m just going to say it out loud.

Finding a therapist can be intimidating and scary, especially if you have never been to therapy before. It is unfair that it’s so hard, especially considering the mental state that we’re in when we decided it’s time to talk to a therapist. 

Nicole: Oh my gosh, yes. The time when you need a therapist the most, and it’s, it’s so incredibly hard to find someone, especially in a short amount of time.

Patricia: Right? 

And of course, if you need someone immediately, there are many crisis lines. And I’m going to link to some in a newsletter issue that I’m going to link in the show notes. But even so, being able to find someone who you could talk to within the next couple of months, even. 

Nicole: That can be really hard, depending on where you are in the services available to you. 

Patricia: Right?

Nicole: Yeah. And unfortunately, it’s also expensive. It can be very expensive. Many practitioners have hourly rates upwards and beyond a hundred dollars, two hundred dollars. Even with insurance, you can still have a significant co-pay for these things. And so, again, going back to it being a privilege, you have to have a certain level of financial stability to be able to go to regular therapy.

Patricia: So, why would someone even see a therapist? Like, why should you see a therapist? Well, there are so many reasons. One of them could be managing a specific thing, like anxiety, or depression, or grief. 

Nicole: You can go for identity things. This can be gender identity, sexual identity, but also issues related to racial identity. 

Patricia: Religious identity.

Nicole: Religious identity, depending on where you are in your life and in the society you live in.

Patricia: You could talk to a therapist and they could help you work through a specific issue, like perhaps a relationship issue and not only a romantic relationship, but maybe some other kind of familial relationship or something like that. 

Nicole: They can also help you unpack and heal past traumas or generational traumas.

Patricia: They can also support navigating disability, illness, recent diagnoses, et cetera, including things like if you recently got an ADHD diagnosis and what this looks like and maybe, oh, it’s related to maybe there’s some things I want to unpack about this because I got this diagnosis late in life or things like maybe you are a person that got long COVID and suddenly you cannot do all the things that you could have done just a couple of years ago, and so having someone to talk to about that could be really important for some people. 

Nicole: Therapists can also help you with things like skill building, and this can be things like communication skills, where maybe you don’t do well talking in certain circumstances. I’ve seen therapists even help with like how to talk to people you maybe want to date and you’re not comfortable with that. They can help you with that. 

They can also help you with skills like setting boundaries, especially amongst people you are close with. Um, this may be parents, aunts, uncles, cousins, sisters, brothers, people who you are not good at maintaining boundaries with for whatever reason. This can also be friends, people who you’ve gotten in difficult relationships with.

They can help you with skills in kind of navigating that stuff. 

Patricia: Yeah, and not only help you with skills, like in a kind of teacher student kind of way, but typically the therapy session or this therapeutic relationship is a safe place to practice. These skills as well to practice these communication skills practice these drawing boundaries and things like that 

Nicole: That is such an important thing to note.

Yeah, they’re sometimes these therapeutic sessions look a lot like practicing and rehearsing, and getting comfortable saying certain words and phrases. 

Patricia: Yeah. 

I mean, sometimes you don’t know what you need, but you see a therapist because sometimes it’s just a vague of, I feel bad and I don’t want to feel this way anymore.

Or it may be some kind of sense of feeling stuck. Maybe you have, your identity is really tied to your career, but you don’t want to do your job anymore. Maybe you are of a certain age and you quote unquote thought you’d be further in life or something like that. There’s a lot of that. There’s It’s a sense of just stuckness, feeling bad.

And these are things that a therapist can help untangle. 

Nicole: Yeah, you don’t have to walk in with a very specific pinpointed, as they will say, complaint, um, because not everybody is in touch with their inner world and how that may manifest as even physical sensations and symptoms. So it’s perfectly okay to walk in and say, I just feel bad.

Therapists also can help you out navigating substance use or other behaviors that you would just rather not be doing. 

Patricia: Yeah, absolutely. 

And one that you and I talk about a lot in our own relationship is, you know, part of seeing a therapist can be because I want to relieve my loved ones of that emotional labor.

Your loved ones are not your therapist. That doesn’t mean that they aren’t open to listening and to you venting. You know, I, as the only child, oldest daughter, et cetera, of my mother, finally, at one point I had to ask her to find a therapist and talk to a therapist because I couldn’t hold all that space for her and what she wanted to talk about.

I’m not a mental health professional, and even if your loved ones are therapists, they’re not your therapist, right? Like, if your friend is a therapist, they’re not your therapist, and this is something you can totally, like, therapists are professionals. You can outsource these things like one does, maybe their dry cleaning, right?

There are professionals who do this and who have the tools. I don’t have, as much as I am willing to give you, Nicole, emotional support. I simply am not as well equipped as a professional. 

Nicole: And I wouldn’t want to unload all of that on you, nor is it realistic for me to expect you to help me navigate some of my, like, past traumas and issues from before we even met.

Patricia: For free in this economy? 

Nicole: I just think about the strain that would put on our relationship. 

Patricia: It could change relationships when, when there’s all of this emotional labor expected of another person. Yeah. 

So we talked about a lot of umbrella reasons, but I want to, I want to bring it back to the personal, you know, I first started seeing a therapist when I was in my early twenties and I was diagnosed with major depression.

And so I saw a therapist and we talked about some things. It was my first foray into therapy and It was fine, I guess. Many years later, when Nicole and I were together, and she decided she wanted to transition, I started talking to a therapist because I wanted to be my best self for, for you, and I didn’t want, you know, any anxieties that I have around this, it wouldn’t be fair for me to put them on you. So I was like, I’m gonna outsource this to a professional. 

And my current therapist, I, I think I found her in 2021. So it was less pandemic related and more the onslaught of imagery of Black people getting murdered by police. And I was like, wow, I need to find specifically another Black queer person to talk to about this, uh, in a professional setting.

So, yeah. 

Nicole: I really appreciate the awareness you had around all of that. 

Patricia: Yeah, I think, I think a lot about just all of the emotional labor that I’ve done for other people sometimes, and I wouldn’t wish that on you and I know how it can change relationships. So… 

Nicole: Yeah. 

Patricia: But yeah, it does it does take awareness to recognize that you might want to talk to a therapist. 

Nicole: Definitely.

I’m not really gonna get into all of it but I will say that I have been in and out of therapy as well since my late teens. I will say, as it comes down to it, one other thing we didn’t fully mention is that as you get into therapy, it’s really important to be able to find someone that you can be completely open and honest about.

Or honest with, because if you keep things from them, your therapeutic endeavors may not be as successful. 

Patricia: Yeah, the success depends heavily on the patient doing the work and being open and being honest. 

Nicole: Yeah. 

Okay, so then how do we find a therapist that we can be completely open and honest with. 

Patricia: Well, like we were just talking about, we want to have a basic idea of our whys, and as you mentioned, it doesn’t need to be a laundry list of complaints. Just go in with one or two things, and I promise other things will bubble up over time. 

Before we get any further, I want to talk about cost. Many people assume they can’t afford therapy without actually looking into it. If you don’t have insurance, some providers have low cost or sliding scale services.

Nicole: And if you are like completely unsure, one other thing is a lot of large organizations that employ people often have something called an employee assistance program or a staff assistance program or something like that. And they often offer, you know, three to six therapy sessions free. They get you hooked up with someone and you can try out a couple sessions of therapy.

And this is really good, especially if you have a very like specific issue you would like to talk about and work through. It does not have to be work related. Just know that this therapist will be likely working on a limited time. So they’re going to try to be rather intensive about helping you with what you’re asking for help with.

Additionally, sometimes if you have a local school or university with a professional program that graduates out mental health practitioners, they often have a program where people who are not students can come and receive Therapeutic services for low or no cost, or a sliding scale, just know that the people you’ll be talking to will likely be students who will be going back and talking to their faculty advisors or preceptors or whoever to help make sure that they are navigating their therapeutic relationship with you professionally and in a healthy manner. 

Another alternative is a lot of these places also offer group therapy sessions, which some people find incredibly helpful. And these can also often be less expensive as well. 

Patricia: Yeah, I’ve had some fascinating experiences in group therapy and one thing I will say positively about it is, it’s so helpful to know you’re not alone with whatever you’re dealing with. 

Nicole: Yeah. 

Patricia: Like, it’s so, it’s so incredibly helpful to even, you know, some might refer to themselves as a community, but just being there and being able to be like, yeah, I feel like garbage, and I feel like garbage too, and talk about these things, can be wildly helpful. Of course, I recognize that it sounds like an absolute nightmare to some people, so your mileage may vary.

Another possible low cost option is private practices may have interns who are interning there and they may offer some therapy at a discounted cost. 

The name of the game is asking, in all of these things, asking and not immediately self rejecting without asking if there is a lower cost option. 

Do you have a sliding scale? Will it cost less if I pay for more sessions up front? Do you have a payment plan or something like that? And I need to make this clear. Do not depend on the information you find on their website. Ask, ask, ask, you know, and they may say no. They may say it is what it is on my website or there may be some other options.

Nicole: Now, if you do have insurance with mental health coverage, there are often portals through your insurance provider to help you navigate finding a therapist. And sometimes there’s even people who work with your insurance company that will help you find someone that suits your needs and takes your insurance. Some employers even have internal people through their HR department that will help you navigate this process as well. 

Patricia: So I think what we really want you to know is there is more help out there than you think there is. 

Nicole: Mm hmm. 

Patricia: But it’s definitely one of those things you have to ask, which again, it’s hard. I think we had a whole episode on asking for help, but, and we’ll also get more into the insurance portal specifically in a bit.

Nicole: But a big question that a lot of people end up asking is the, the who, who is this person who is supposed to help me? And this is something you need to take some time to think about. Are you looking for someone who’s going to be really solution oriented and set a time limit or number of sessions on how long you have to work with them and how intensely they’re going to try to resolve your issues?

Or are you looking for someone who’s more open to just building a long lasting relationship and helping you go with the flow over time. And maybe some sessions are less intense and some are much more intense, and you just kind of work it out with them over a much longer period of time. 

Another thing to Keep in mind is, do they need to share some of your demographics with you?

Do they need to have similar intersections that you do, uh, with regards to identity? 

Patricia: I highly recommend it. If you are in any kind of historically excluded group, uh, a member of the global majority, um, at the same time. And, you know, I definitely, my, my first therapist was a cisgender white man. And… 

Nicole: Oh, same.

Patricia: And, when I would have complaints about male family members over time, he started defending them and I was like, you know what? This isn’t, this isn’t, uh, for me. This isn’t for me. I need someone who shares at least some of my identities and, and thinking about the therapist I wanted to talk to about queer and trans stuff, she was a cisgender Black woman, and I ended up having to teach her about a lot of queer and trans things, and if you are constantly teaching your therapist about your own identities and the identities of your loved ones, then that might not be the therapist for you.

Nicole: Also consider that you’re giving, you’re paying them to train them at that point. 

Patricia: Right. Right. I think, you know, Shani Tran, who is a therapist, who is online and also wrote a book I’m going to mention in a minute, talks about cultural competency versus cultural humility. With the idea of, like, are you looking for someone who is culturally competent versus someone who has cultural humility?

So cultural competence happens kind of, oh, well, I, I took a class in therapist school on Black people or on queer people or whatever. And that is just kind of knowing how to work with community members in theory. Versus a cultural humility, which is not only recognizing these things, but how do these things affect people’s experience of therapy, and how can we lean into them, how can we work with them, and kind of, she talks a lot about the differences in her book, Dope Therapy, A Radical Guide to Owning Your Therapy Journey, again by Shani Tran.

I wish I had this book before I ever went to therapy, but even as a person who has had a number of therapists, this book was still incredibly helpful. It was a phenomenal book. She goes over so many things, like all of the possible letters after people’s names, like we were mentioning, MFT and LCSW and LFT and LPCC. How to also end a relationship with a therapist. What to expect at your first session, and so much more.

And she… It’s a whole book, so she also goes more into depth in a lot of the things that we’re talking about today, but she is also doing it from the perspective of a therapist and a person of color, a Black person. 

Nicole: Yeah, I read that book, I think, within the last year, and it was, as someone who’s, I have no idea how many hours of therapy I’ve been to at this point, I still found it really insightful and agree, like, would have been really helpful a long time ago.

With regards to the cultural competency versus cultural humility, that is something you are allowed to straight up ask a therapist. 

Patricia: Absolutely. 

Nicole: Do you have experience working with whatever thing you want to ask about? 

Patricia: I actually don’t like to ask, do you have experience with, because they could just say yes, and leave it at that.

I like to ask, what is your experience working with people with, in my case, OCD? What is your experience working with people who, in my experience, are, uh, multiracial Black. What is, like, because just saying, like, do you have experience? That’s a yes or no question. 

Nicole: Yeah. Leaving, going with open ended questions leaves a lot more space for them to really shine or really tell on themselves.

Patricia: Absolutely. And we’ll get more into questions to ask your therapist in a bit. 

Nicole: So, spoiler alert here. The longer your list of specific requirements for what you would like to see in your therapist is going to make it harder and harder to find someone that checks all of those boxes. So in this case, it may be beneficial to have, like, two parallel lists of must-haves and nice-to-haves.

Like, what are the bare minimum requirements you want to see in someone? That, or, that someone has who you want to see, I guess? Versus things that would be really nice to see in a therapist. 

Patricia: Yeah, in, again, in my own experience, it may have been impossible for me to find someone if I insisted they were queer and Black and Filipino and Femmes in a queer trans relationship with another femme, in an interracial marriage where one person is white, is in California because usually if a therapist needs to be in your state and licensed in your state in order to treat you. Also, someone who takes my specific insurance, someone who has expertise in working with patients with obsessive compulsive disorder, a person who is anti-capitalist, is not religious, is taking new patients, will do virtual sessions, and also, we vibe.

Back when I was giving talks on dating, this is something a lot of people would do when they were looking for partners. Is, you know, the person I’m looking for dating, they have this huge list of things, and sure, they might look good on paper, but are they cool? Do you vibe together? And that is also something that is important with a therapist, because they may check all of these boxes, and then you talk to them, and it just, it just doesn’t feel right.

Nicole: Yeah. 

Again, so this is where you would want to build a base list of like what, what is the bare minimum and what are the nice to have things. I know for you with your most recent therapist, a must have was that they were a black person and specifically a black woman, if I remember right. 

Patricia: Well, specifically a Black queer person.

Nicole: Right. Okay. 

Patricia: Like, yeah. 

Nicole: Yeah. Versus having personal experience in a queer, trans, interracial marriage where someone is white. That’s gonna be a lot harder to narrow down. 

Patricia: And that’s also something that most therapists aren’t gonna put on their website. So, you can’t you can’t know that. 

Nicole: Yeah, you really can’t. That, there’s, there’s not a box for that on psychology today.

Patricia: But speaking of psychology today, I want to talk about portals and directories. So we mentioned sometimes your insurance, if you have insurance that has mental health coverage, they have portals where you can find therapists in, that are within network. That means in network means they take your insurance.

There are also external directories like Psychology Today, like Therapy Den. Where therapists put up their information and you can often search these directories in multiple different ways. My huge, my, my one tip out of everything is look in multiple places and cross-reference. Don’t just look in one place and pick out a person.

Cross-reference with directories and your insurance, if it has a portal, and also, you know, if they have a website. My experience is often insurance portals are clunkier than some, like, online directories, and there are specific directories for many communities, like Therapy for Black Girls, or the Asian Mental Health Project, or Glimmer, and Gaylesta, which has LGBTQIA plus therapists.

I have a roundup of a number of such specific directories in one of the newsletter issues I’m going to link in the show notes. 

Nicole: Something else to consider just trying to look up on a therapist is if they have an active social media presence. Because this will one, get you some information about them, but also if they have millions of TikTok followers, it may be really hard to get in and see them.

Patricia: Or you may not want to have someone who has a huge online presence. 

Nicole: Right. Yeah. Especially if you see them talking about patients, like they’re never going to name their patients. If they do, then someone should report them to their board. 

Patricia: Absolutely. Yeah. 

Nicole: But, are they still referencing things that come up in therapy? Are you comfortable with being talked about anonymously on Instagram? Like, something to consider. 

That being said, not all therapists are tech savvy or perpetually online, and that’s really okay. What that does mean is that often their website or their presence in all of these directories may not be up to date, especially when it comes to what insurance they’ve listed that they’re taking.

A lot of times they have set these up over a year ago and they may have forgotten to go back and update the particular database you’re looking in. And this is why it’s important to not self reject when you see that they don’t list your particular insurance. 

This is where you can still reach out to them. And we’ll talk about this in a couple minutes with your, your introductory email or phone call. Ask, “I have this insurance, do you take it?” 

Patricia: So, I do have a warning that is specific to psychology today, which is when a mental health professional fills it out, there are all kinds of boxes where they can check things they specialize in.

There are no checks and balances here, and there are more than a few that go through and check all the boxes. I actually learned from a friend who was in a marriage and family therapist program that people in their program were actually encouraged to check all the boxes. Just to get people in the door, and aside from like all of these ethical problems that are making my eye twitch, if one program is doing it, then I wouldn’t be surprised if multiple programs were recommending this.

But just because they have a box checked on psychology today, does not mean they are necessarily proficient in talking to someone about such an issue. I am actually a bit, like, weary of the ones that have, like, so many boxes checked. I’m like, really? Really? You know all of these things? So, that is something, again, cross reference with other directories and things like that.

Nicole: I feel like also some people are tempted to check extra boxes when they had like, you know, a week where they spent on a particular chapter in one class on like LGBT stuff or something like that, and so they’re like, I did some coursework on that, I’m comfortable seeing LGBT patients. And… 

Patricia: But are LGBT patients comfortable seeing you? Like… 

Nicole: And the answer to that is sometimes no. And I know this from personal experience. In one of my searches for finding a therapist, I remember I specifically had like two or three sessions with one person. She said she was good at working with LGBT people on her website, on her database profiles, or whatever, I did a bunch of cross referencing.

I sat down with her, and when I started talking about, like, what it’s like to be a queer person in America in the late 2010s, And all of the political implications for that, especially coming out of the end of the Donald Trump administration, she looked kind of bewildered and was just like, I don’t really follow politics.

And I knew like in, in that time, like one, I like was trying to explain all this to her and she was just like, I swear she had this look on her face like I am someone with paranoid delusions and I could just see it. And I knew like, this wasn’t going to work out. I just spent 45 minutes telling this woman all of this stuff and how, like, all of these states are passing laws to make it illegal for me to even use a bathroom and stuff like that.

And she just was like, if you’re not following all of this, yeah, you can sound, and we don’t use this word lightly, you can sound crazy if that person doesn’t know about it. So like after my, I think it was my second or third session, I was just like, I’m not good seeing this person anymore. 

Patricia: Yeah. 

Nicole: And I just didn’t make a follow up appointment and moved on to another person on my list.

And this is an important point here, as you’re going through and looking up people on these various platforms and databases and whatever, make a list of several people you’re comfortable with. Not all of them are going to work out, and also not all of them are going to take your insurance. Not all of them are even going to respond to your emails or your phone calls about reaching out, because maybe they are just too full up with patients and they’ve got a huge waiting list.

So, make a list, and start just reaching out to a couple people at a time, and see if anyone will give you a little bit of time to try to work together and see if you’re a good fit. 

Patricia: I think another thing that I forgot to mention that I want to mention now is therapists often have colleagues and communities of practice.

And if you have a friend who has, or even a partner or something who has a therapist they love, maybe they’re open to making recommendations. 

Nicole: Oh, yeah. We’ve done this. 

Patricia: Or making referrals. And we’ve, we’ve done this. We’re like, hey, do you know anyone who works with people who are interested in working with this or that?

And they reach out to their group and they’re like, yeah, here are some people. 

Nicole: Yeah. 

Yeah. That’s, that’s really helpful. 

Patricia: So, before you reach out, also have, if you have insurance that covers mental health, make sure you have not only your ID number, but sometimes there’s a group number and sometimes that group number isn’t on your insurance card or whatever, so make sure you have all the information that you need to have.

Nicole: Sometimes now these people aren’t, or these, these insurances aren’t even sending you a card anymore. It’s buried somewhere in your HR paperwork. 

Patricia: Fair. 

Nicole: From your employer. So you may need to reach out to your human resources department at your work if they’re the ones providing you this insurance and ask them for this information.

Patricia: So I want to talk a bit about Kaiser Permanente and I recognize that Kaiser Permanente is in areas on the West Coast. It’s an HMO, which means It has its own doctors, and its own hospitals, and its own everything. And also, there may be a lot of listeners who have Kaiser. Kaiser is notorious for having terrible mental health services.

I was with Kaiser for a long time. What I have encountered is they don’t have enough staff for the sheer amount of people who need help. And so, even if you can get in with someone, you may see them only once a month. You know, before I found my current therapist, I thought I would go through Kaiser first and try that, and it took forever just to get to talk to an intake person, and then they were like, oh, well, you can see a therapist in about seven months from now, we can make your first appointment and in the meantime, attend this online group.

And so I just straight up asked for an outside referral, which they will do, and asking for a referral so that there is someone within like the external network that Kaiser will still pay for. But Kaiser kind of doesn’t necessarily apply, if you’re going through Kaiser, apply to everything we’re sharing today, and I wanted to call that out.

So, now that you have your list of people, you have, if you’re like us, you have your spreadsheet. With your matrix, and your rubric, and your tiered choices, you are going to call or email, and I don’t know who I’m kidding, you’re all probably going to email, I definitely emailed, and this first email you need to keep it short.

I actually have this template in one of my newsletter issues that I’m going to link in the show notes. I’m going to read it out here, but you can actually just copy and paste what I’ve put. 

It’s hi, my name is so and so and I’m looking for a therapist to help me with blank. And this is where you put your brief why that you talked, that we talked about earlier.

Are you currently accepting new patients and do you accept, name of your insurance if you have it. If so, I would like to talk further to see if we’re a good match. 

This is also maybe where you ask if they offer virtual sessions versus in person sessions. I also want to put it out there that therapists are often better talking than over email, so don’t necessarily judge people by their emails.

They do talk therapy. They’re, they, they can really shine in sessions in ways that they might not over email. 

Nicole: Yeah. I think I’ve gotten an email back that was like, yes, how about this day and time on the phone? There was no like, hi, thanks for reaching out. It was just like a, how about Thursday at five o’clock?

Patricia: Yep. 

Nicole: It can also be really tempting to write a longer email, but really the goal here is not to, like, lay everything out on the table for them. That’s what a little bit of that first phone call is about, and the first session or two. That’s where you really lay it all out. Here, all you’re doing is seeing if they are available, and if you can talk to them for a little bit of time to get a feel for whether or not they may be a good fit.

The thing is that you are hopefully going to be entering in some kind of a therapeutic relationship. With this person and yes, it is considered a relationship you are paying for them. They are professional and they are there to help you so they should suit your needs. And you should be comfortable in that relationship.

Patricia: Yeah, I think you mentioned consultation call or zoom, and I want to let people know that is the goal of your initial call or email is to secure this consultation. Most therapists will offer 15 to 30 minutes on the phone or zoom or, or whatever they use. And this is where you get to ask you more specific questions.

You typically don’t pay for this consultation. It’s where you are kind of feeling each other out and seeing if you’re a good fit. So as Nicole mentioned, you are paying a professional to help you and they should suit your needs. This means it’s also your responsibility. If your therapist is doing something that isn’t working for you, or going down a line of conversation that you’re not interested in during that session, you need, you need to tell them, and you can even end your relationship with them if your needs aren’t getting met.

You do not owe them loyalty if it’s not working out. And also, many good therapists would help give you some referrals to someone else that may be more suited to you. 

Nicole: Yeah, don’t be afraid to just ask, and tell them, like, I don’t think this is gonna work for me. Do you have someone that you think this would be better for. A good therapist will recognize that.

Patricia: Absolutely. 

Nicole: Now, up front, you don’t have to figure out if this is a person that you’re going to talk to for the next 10 years of your life in that first, like, 15 to 30 minute consultation. All you’re trying to figure out, like I said, is whether or not you’re comfortable or possibly even excited to talk to them further.

As Patricia mentioned way earlier, do you vibe? Do you feel like this person is someone who can help you out with the thing you’re asking for help with. 

Patricia: Yeah, so during that consultation, that’s your time to ask some more in depth questions. And so we’re going to talk about a few questions that are important to me or our circles of community. But again, I’m hooking you all up with some further resources in the show notes with more ideas about questions. 

Nicole: Okay, so let’s start with some practical questions. These could be things like, what does a typical session with you look like? Or, how often do you tend to see your clients? 

What are the days you work?

What days and times do you have open? 

Will you be accessible by phone, text, or email outside of sessions? 

Is there a session limit? 

Do I need to get a referral? 

Patricia: Yeah, those are all great questions you don’t want to be surprised by, like, down the line. And I think about the, the other questions that are also important.

As we mentioned earlier, what is your experience when it comes to working with a specific racial or ethnic background, LGBTQ+ folks, ADHD, substance use, or whatever, asking about their experience and trying to understand if they are actually experienced working with folks who fall under these umbrellas, and they didn’t just take a class on it.

No experience, however, isn’t necessarily a red flag for everyone, and it’s up to you to decide what you need. 

Another question, how does your racial or ethnic and cultural background impact your work as a therapist? 

What is your comfort level when it comes to talking about topics such as white supremacy, privilege, racism, homophobia, or systemic oppression?

Does your practice tend to be more short term or long term? 

Is your praxis goal oriented and problem focused, or is it more organic? Some folks prefer one over the other. There’s no necessarily, like, hierarchy. It’s just, it depends on what works for you. 

Nicole: Now, like I mentioned earlier, you may have to talk to a few different people and you may even have one or two sessions with some of these people before you figure out whether or not they would be a really good fit for you.

And that’s okay. And that’s why we recommend having an ongoing list. I think at one point I went through like eight or 10 different people in a list and still didn’t find someone that worked out for me in the end. Until I tried looking in a whole new database or something. Like, I switched where I was looking, and that’s something you can do as well, is if you’re not finding a good fit in one of these portals, jump over to another one as your primary search and manipulate some of your search criteria.

Patricia: During this consultation, they will also be asking you some questions, again, to see if you are a person they think they can help right that they think they actually have something to offer to and I had read in a resource from the National Alliance on Mental Illness that their questions may make you uncomfortable, but the person should not.

And it’s important to kind of recognize like, uh, am I feeling put off by the person or the questions they’re asking? 

Nicole: I really like that. 

Something else to note in some of these sessions or even like this consultation call, the therapist is likely to open up with some kind of preamble that states right out like, if you are a danger to yourself or others, I will not be able to maintain confidentiality. I am required by law to report that to whatever authorities they’re responsible to, for reporting to. There are certain things that they want to tell you upfront, because most therapists do have some, some level of things that if you tell them, they are required to break confidentiality and report that to a greater mental health agency, or sometimes it’s law enforcement or something else.

So be aware that they are going to probably tell you something like that up-front up-front.

Music: [Music] 

Nicole: Okay, so we gave you a lot of information today. And if you were able to write all this down, I think we’re both going to be really surprised about that. But we, we’re not expecting that. We’re going to link to the corresponding issues of the Enthusiastic Encouragement and Dubious Advice newsletter that has a lot of this information.

Those links will be in the show notes. And are available wherever you’re getting this podcast. And they’ll also be on our website page for this episode at eedapod.com. In there we’re also definitely going to link to the book, Dope Therapy, that we mentioned earlier. 

Patricia: And also these newsletter issues have so many resources that we didn’t even mention today, and including specific directories for certain backgrounds.

And a reminder, it is all free 99. It’s all free. The resources issues of the Enthusiastic Encouragement and Dubious Advice newsletter aren’t behind a paywall. And like I said, these issues actually have more resources than we even mentioned today. I am incredibly dedicated to connecting all of you with this information and hoping that you and your communities can benefit from it.

Also, for paid Patreon subscribers, we are going to start accountability threads. Like I mentioned, it’s something I do with my own therapist, so I’m hoping it can be a form of community care for all of us. 

I mean, so many takeaways today, but I think one of my main ones is that therapy isn’t one size fits all, and while it’s not for some people, I think most people could get something out of therapy if they find a good match. 

Nicole: Finding a therapist can be an overwhelming and anxiety inducing experience, and honestly, that’s not fair. But, if you can find a way to work through that, finding a therapist can be incredibly helpful and helping you work through that is part of what we’re trying to do with this episode. Giving you some resources for how to navigate this process and hopefully demystify it a little bit.

Patricia: Yeah. 

I want to call out, especially, you know, this is even a call out of myself and Nicole. This is one of those situations where you can spend a lot of time hoarding information without actually reaching out to someone. You can spend forever trying to make this perfect rubric to triangulate the exact perfect therapist and just recognize when you are doing that thing where you’re hoarding information and start reaching out to people.

Remember, it can be scary, so just do it scared. 

Nicole: Just do it scared. 

Patricia: Do it scared.

Nicole: Hey Patricia. 

Patricia: Hey Nicole. 

Nicole: What’s filling your cup. 

Patricia: So, we just had our wedding anniversary. 

Nicole: Yeah. 

Patricia: And we went out to a nice linner, lunch-dinner. And then after that, we went to a new to us library and got library cards for a whole other library system, which I thought it was just the card for, it was for Redwood City.

I thought it was just for Redwood City. Apparently this card could be used for the whole Peninsula library system. So it’s a pretty freaking rad library card to have. 

Nicole: Yeah, that was very exciting. Also, we were totally those people that were dressed up in some of our nicer outfits, walking through and giving ourselves a little tour of a library.

Patricia: They had a makerspace, they had 3D printing machines, they had an embroidery machine, like, it was a good library. 

Nicole: It was a really good library. 

Patricia: Hey, Nicole, what’s filling your cup? 

Nicole: So the thing that’s keeping me kind of excited right now is all these things we are doing that, in particular, have us getting dressed up and, like, really, like, looking our best.

We are still very, very COVID safe, which means we spend a lot of time at home still. So going out and doing things, especially doing things that we are getting dressed up for, has just been really refreshing and honestly fun. I’ve really enjoyed kind of getting fancy for you. 

Patricia: Yeah, I love it. And yeah, we spend a lot of time at home.

And if we are out and indoors, we’re wearing masks. We still wear masks everywhere. So… 

Nicole: And various levels of masks. We have different masks for 

Patricia: Different situations. 

Nicole: Different situations that depending on the amount of people and the concentration of people. 

Patricia: Yeah, but you know, we’re going to get our nail’s done soon, and go to a friend’s wedding.

Nicole: I’m so excited for that. Also just to see our friends… 

Patricia: Also to see our friends. 

Nicole: All dressed up and everything. 

Patricia: Yeah, 

I’m excited about our outfits, so. 

Nicole: I’m excited about our outfits, I’m excited to see friends all dressed up, I’m excited to see our friends get married. Um, yeah. This is the kind of stuff that I’m just like, really excited about lately.

Patricia: Well, that’s our show for today. We’d like to thank our awesome audio editor, Jen Zink. You can find her at loopdilou.com, and we’ll leave a link to that in our show notes. 

Nicole: You can find the full show notes and transcript at eedapod.com. That’s E E D A P O D dot com. There you can also find a link to our Patreon, our Bookshop link, and a link to the ongoing Enthusiastic Encouragement and Dubious Advice newsletter.

You can also find us on Instagram and BlueSky at eedapod, and email us at eedapod@gmail.com. 

Patricia: We are nothing if not consistent. 

Nicole: We would also appreciate it so much if you would subscribe and rate us on Apple Podcasts, Spotify, or wherever you get your podcasts that allow ratings. It goes really far in helping other people find us.

We haven’t seen a new review in over a month now. 

Patricia: Le sad. 

Nicole: We would love it if someone out there could give us a new review. We love hearing from you all. 

Patricia: We would also appreciate anyone who can subscribe to us on Patreon. Support is going to help us keep this show going, especially without ads. You can find us at patreon.com/eedapod. 

In the meantime, we hope you find ways to be kind to yourself. Drink some water and read a book. We’ll be talking to you soon.

Nicole: I’m so ready for bed.