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Therapy Didn’t Work for me Before… Why Should I Try Again?

As a clinician, when I tell people I am a psychotherapist, I often hear a common refrain. Unfortunately, many individuals have had negative experiences with therapy, which discourages them from returning or trying the process again. Oftentimes, people bear their souls and share their stories only to feel they have not received proper support or understanding from the clinician. 

If you are open to considering the process again, I encourage you to give it a try and do your research. There are a great deal of skilled therapists available and it is highly likely you will find one that better fits your needs if you are willing to try again Remember, just like searching for a new car, you have to consider all of your needs and expectations in order to make a decision and find the one that best fits what you are looking for. 


Things to consider when searching for a new therapist: 


How to afford therapy: All insurance plans are now mandated to cover some part of mental health services. Start by researching your health insurance to understand your benefits, including if you need to see someone in-network or if you have “out of network” benefits. 

With in-network, the therapist (or their office administrator) will submit the claims for you. The clinician is contracted with your insurance company, meaning you are only responsible for your copay, deductible, or co-insurance. 


With out-of-network coverage, you have more options for choosing therapists, and the insurance company will have less access to your treatment details. Since out-of-network clinicians are not contracted with your insurance, they are not obligated to submit notes to insurance companies or report on progress.  Your insurance cannot audit out-of-network clinicians. This allows for more privacy for you. Typically, you will pay the therapist the full fee upfront and then submit a “Superbill” (which the clinician will provide) to your insurance company for reimbursement.


Do not submit to insurance: this assures the highest amount of privacy as insurance will not know that you are seeking therapy. Additionally, if you have a Health Savings Account (HSA) or Flexible Spending Account (FSA), you can often use these funds to pay for therapy. Be sure to check with your administrator to confirm that they do not require notes or receipts with a diagnosis.

ACT, CBT, DBT, and all the other acronyms: There are many evidence-based theories that therapists become trained in to treat clients. When researching options, you may want to search for what theory interests you the most. This can help you narrow down your search. 


Virtual or In-Person: This is something to consider based on your schedule, convenience, privacy, and personal preference. Research shows that virtual therapy can be just as effective as traditional in-person sessions. If you choose someone in your area (whether virtually or in-person), they likely know more resources in your area that you can access. Additionally, If you travel often and wish to seek therapy while traveling, you must find someone licensed in the state where you are visiting. 


Gender, religious affiliation, sexual orientation, and other factors: Take into consideration who you feel that you would be most comfortable talking to. Many therapists have websites and there are multiple directory sites where one can search for a therapist based on these specific criteria. Also, consider whether it is important to you that the therapist has extensive experience in their field.


PhD, Social Worker, Clinical Counselor, or Coach? To be a coach, there is no professional licensure or board ensuring that a coach has sufficient education or training. As a result, anyone can call themselves a “coach” even if they don’t have any background in the subject they are coaching. In contrast, PhD’s, Social Workers, Licensed Professional Marriage and Family Counselors (LCMFT), or Clinical Counselors must attend graduate school for at least 2 years, undergo supervised training,, and pass a licensing exam before they can practice independently. Most professional clinical licensing boards require continuing education every two years to renew their license. There is a great deal of work (and financial investment) that goes into being a fully licensed clinician. The difference between the licensures can vary, but all can take the same approved continuing education courses. 


What do you hope to achieve from therapy? Is there a specific goal you are working on? Do you want to develop skills, receive assignments, find strategies, or get feedback? Do you want an empathic ear and an outlet? Do you want to recover from a past trauma? Keep these questions in mind while searching for a therapist.


Ask family, friends, or medical professionals: See if someone has a recommendation that they have had a good experience with. Many medical professionals maintain lists of therapists to whom they refer to often. 


Complimentary Consultation: Many therapists offer complimentary 15-minute consultations where you can chat with them on the phone and express your concerns. Skilled therapists understand the importance of having a good fit and rapport with their clients. It’s a good idea to speak with a few therapists to determine who you feel you could “click with” before scheduling. 


Try at least two sessions: The first session with a therapist will often feel a bit uncomfortable or awkward. Especially if you had a bad experience before. If the therapist does something egregious or offensive, let them know you are not comfortable in the moment. If they are unable to take your feedback appropriately, then move on to someone else. Skilled therapists are trained to handle feedback and address concerns effectively.  If you are simply feeling “unsure” about the first session (which can be more of a “getting to know you” session), I encourage you to try one additional session to see how you truly feel about the clinician. 


Don’t give up: Try not to be defeated if you attempt meeting with another therapist and they are not a good fit. You might have to try 3-4 clinicians before you find one that meets your needs. (Hopefully, that won’t be the case!) 


Congratulate yourself! The process of finding a therapist that could be a good match can be challenging. Be proud of yourself for not giving up and continuing your therapy journey! 


“The trouble with most therapy is that it helps you feel better. But you don't get better. You have to back it up with action, action, action.” -  Albert Ellis

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