What Should I Know Before I Look for a Therapist?
TL;DR
The basics of finding a therapist, like using directories and checking insurance, are covered well elsewhere and linked at the bottom. This post covers what most guides don’t: how to get specific before you start, what credentials tell you and what they don't, and why a therapist's framework matters more than their modality.
I've been doing this work long enough to see it from most angles. I've seen it as a clinician working across multiple settings, in executive leadership at a mental health agency, as someone who has needed my own therapy, and as someone who coaches other therapists through these same questions.
I've also come to understand that one of my strengths is thinking in side quests. This blog series started as a single post on how to help others find a therapist. But after considering the many angles and needs of complex human beings, it became a series. My side quest thinking brain likes to keep asking questions and understand how those questions shift at times.
So I’ve followed some of the side quests in this series, because this is an important topic, worthy of side quests.
So what’s in this series?
Last month's post covered why finding a therapist is harder than most people expect. This post is where the practical work begins. The basics of directories, insurance panels, and license verification are well covered in a few resources linked at the end. What follows is the part that tends to get left out because it's more nuanced, sometimes sticky, and won't drive clicks the way a general post will.
What follows is the part most guides leave out.
Most people open a therapist directory and start filtering. That's a reasonable first move, and often the only accessible one. But it skips a step that saves valuable time and energy later, like getting specific about what you're looking for before diving into a single profile.
For anyone whose brain resists open-ended tasks skipping this step does more than waste time.
It creates the kind of shapeless, hard-to-start project that turns into avoidance and paralysis. The more specific you can get before you open that first tab, the better.
What are the practical things I Should think through?
What's the reason for the search right now?
The answer is doesn’t have to be a specific diagnosis or a tidy problem that fits into check box. Are there specific symptoms or goals you have in mind? Are you dealing with something recent, something that's followed you around for years, or something you've never quite been able to understand? The answers here will shape the kind of support you're looking for.
What are your practical constraints?
Scheduling, format, budget, and location all impact the decision. These aren't things to figure out after you find someone, because that someone might not fit these constraints at all. These specifics help you narrow the field without compromising your needs or expecting a therapist to work outside their practice parameters. If you can only do evenings and your budget is firm, owning that upfront keeps you from investing time and emotion in a profile that simply won't work, and from talking yourself into thinking it will.
What has helped you before, if anything? What hasn't?
If you've been in therapy before, even briefly or badly, reflect on what worked or didn't. That's useful information in this search. If you've never been in therapy, think about how the people in your life have been helpful or unhelpful when you've needed support. That often tells you something about what you need.
Do you have specialty needs?
Identify these needs first, not last. If you need couples or family therapy, someone who works with substance use, or a therapist who can provide documentation for custody evaluations, forensic assessments, or work accommodations, that needs to be something you include in your search from the beginning. Therapists must ethically work within their scope and that may limit some of what they feel they can do for you. A therapist who does excellent individual work may not be the right person for any of those things. If a specific need isn't listed explicitly on their profile, ask them before investing time in a consultation.
These practical questions help narrow your search. The next ones explore the depth you are looking for.
Who do you need this person to be?
What about identity?
Most guidance doesn't spend enough time here. Think about the age, gender, and cultural background of the therapist you're looking for. Think about what affirming looks like for you specifically, because it means different things to different people. Some people need a therapist who is ND-affirming, not just aware of neurodivergence, but genuinely experienced working with it and with an appreciation for what it brings. Some need someone who is queer or LGBTQ+ affirming in a practiced way, not a performative one. Some need a therapist who is BIPOC or who has meaningful experience working with people of color. Others are looking for someone faith-based or faith-sensitive, disability-affirming, body-size affirming, kink-aware, or experienced with polyamorous or non-traditional relationship structures. Immigrant experience and first-generation identity matter here too. The list is long because identity and its intersections matter to people, and there are too many to name exhaustively. These aren't preferences to convince yourself you don't need. Depending on what's available given your resources, you may have less ability to select specific intersections, but it's worth exploring what's out there before deciding what to let go of.
What about language?
Don't give up on finding a therapist who speaks your language. Therapy requires a different kind of communication than everyday conversation, and that difference is amplified when you're working in a language that isn't your first. With insurance coverage especially, this is more possible than people assume. Community mental health centers are less likely to offer language options, but private and group practices often can. It's useful to search specifically for therapy in your language. You might be surprised what you find, especially if virtual is something you're open to.
You might be surprised what's out there.
What do therapist credentials tell you, and what don't they?
The letters after a therapist's name tell you two things. The first is what kind of license they hold. The second is what additional credentials they've pursued. Neither tells you whether this person is good at their job or a good fit for you.
The most common license types in the United States are LPC (licensed professional counselor), LCSW (licensed clinical social worker), LMFT (licensed marriage and family therapist), and psychologist (PhD or PsyD). All are licensed to provide therapy. The differences lie in their training path and, in some states, small variations in scope of practice. They are not a hierarchy of quality.
The license tells you someone is qualified. It doesn't tell you they're the right fit.
Additional credentials are post-licensure certifications a therapist has pursued in a specific area. Not all of them require the same rigor. Some require intensive training, ongoing supervision, and continuing education to maintain. Others require considerably less effort. Therapists are human, and some collect credentials because they genuinely value specialization while others collect them because more letters can mean more referrals. Meanwhile, some therapists have deep, real experience in an area without holding a formal certification, because pursuing credentials costs money and time that isn't always available.
If a credential matters to you, it's worth a few minutes to look up what it requires. What organization grants it? What training is involved? Is ongoing education or supervision required to maintain it? That tells you more than the letters alone.
One more thing about profiles. A specialty listed doesn't mean especially trained. Seeing "trauma" or "ADHD" or "grief" on a therapist's profile tells you they're willing to work in that area. It doesn't tell you the depth of their experience. It's a good starting point and worth asking about prior to or during a consultation.
Willing to work in an area and trained in it are not the same thing.
A reminder that therapist licenses are state-specific. A therapist licensed in only one state can't legally see you in another, even if your sessions are virtual.
If you're planning a move, splitting time between states, or have family members doing therapy across different states, look for someone with multiple state licenses or privileges to practice. If you've already found a therapist you connect with, it's also worth asking whether they have plans to expand into additional states. Sometimes they're just waiting for a reason to pursue one.
Why does a therapist's framework matter more than their modality?
A therapist's framework is different from their modality. Modalities are like a toolbox, and the specific techniques and approaches they use are the tools. A therapist can draw from many modalities. A framework is the worldview that determines how they see themselves, you, your situation, and what they believe is going on. That worldview shapes whether this person can see your situation clearly at all.
A few frameworks worth understanding, deciding what matters to you, and asking a therapist about directly, since they don't always fit neatly into profile filters
Trauma-informed means more than knowing trauma exists. It means their approach is shaped by an understanding of how trauma affects the nervous system, behavior, and relationships, and that they work in a way that accounts for this reality rather than one that can inadvertently retraumatize.
Strengths-based prioritize your existing resources, resilience, and capacity for change rather than focusing primarily on what's wrong. This framework doesn't minimize pain so much as contextualize it within a broader picture of what you're already capable of.
Attachment-oriented pay particular attention to how early relational experiences shape current patterns of connection, trust, and emotional regulation. This lens often shows up in work around relationships, identity, and long-standing emotional patterns.
Systems-aware see behavior in relational and social context, not just as an individual problem to be solved. What's happening in your family, your relationships, your community, and the broader structures you live within is part of the picture.
Intersectionality and oppression-aware understand how identity, power, and culture show up in the room, including in the therapeutic relationship itself. This isn't a political position. It's a clinical one.
Neurodivergent-affirming have real experience working with neurodivergent clients and approach it without pathologizing normal ND experiences. Ask how they demonstrate this in their actual work, not just whether they check the box.
Queer and LGBTQ+ affirming is common to see on profiles but covers a wide spectrum. Don't assume. Ask what it looks like for them specifically.
Culturally responsive means their practice reflects genuine awareness of and respect for cultural difference, shaping how they understand problems, how they communicate, and how they build the therapeutic relationship.
These frameworks cut across all modalities. A CBT therapist can be trauma-informed or not. A psychodynamic therapist can be ND-affirming or not. Using many modalities doesn't make someone automatically more aware of these perspectives. It's fine to ask directly.
On theoretical orientation, most therapists blend approaches. Knowing the broad buckets helps you read profiles and ask better questions.
Psychodynamic approaches look at patterns, history, and relational roots. The work tends to be exploratory and longer-term.
Cognitive-behavioral approaches (which include CBT, DBT, and ACT) focus on the relationship between thoughts, behaviors, and feelings. They tend to be more structured and skills-oriented.
Humanistic approaches are person-centered and growth-oriented. The therapist is less directive, the belief is that the client has the capacity to meet their own needs, and the relationship itself is considered part of what heals.
Somatic approaches work with the body as part of processing experience. These are particularly relevant for trauma and for people who want therapy that incorporates a whole-body understanding.
Solution-focused approaches are present-oriented and goal-driven. They work well for people looking for specific, practical support over a shorter time frame.
Most clinicians blend approaches in practice, drawing from multiple frameworks and modalities depending on the person in front of them. When a therapist describes themselves as integrative or eclectic, which is common and not a red flag, ask how they decide what approach to use with whom. That answer tells you more than the label does.
The research is consistent: the quality of the relationship between you and your therapist predicts outcomes more reliably than any specific modality. The specific approach a therapist uses matters, but fit matters more.
How therapists measure and document progress is also key to understand, because it varies by approach and by how therapy is funded. When billing insurance, therapists are required to demonstrate ongoing medical necessity, meaning they need to show that treatment is still warranted and that you're working toward measurable goals. That requirement can create real pressure on longer-term relational work that doesn't map neatly onto standardized symptom reduction. Self-pay removes that constraint and allows more flexibility in how progress is defined and paced. Even with self-pay, though, therapists should always be keeping good clinical records in case a need comes up down the road, whether that's a disability filing or a request for work accommodations. If you're planning longer-term work and using insurance to fund it, it's worth discussing this proactively.
What’s Next?
Part 2 of this post covers what you encounter once the search begins: how to evaluate the type of practice, how to think through telehealth versus in-person, and what to do when your options are limited.
About the Author:
Randi Williams, LPC, CPCS, ADHD-CCSP, is a licensed professional counselor, certified professional counselor supervisor, and ADHD-Certified Clinical Services Provider. She practices via telehealth in Georgia, Tennessee, South Carolina, and Florida, specializing in ADHD in adults, therapy for therapists, and clinical consultation.
With 20 years of experience in mental health, including serving as Vice President of Operations for a mid-size private agency overseeing 500 employees and contractors statewide, and doctoral candidacy at the University of Tennessee at Chattanooga, she brings clinical depth, leadership perspective, and a commitment to supporting both clients and clinicians doing meaningful work.
Your next steps
If you are in Georgia, Tennessee, South Carolina, or Florida and you are looking for support, particularly around ADHD or the specific challenges that come with being a therapist yourself, Kestrel Psychotherapy offers telehealth services and you are welcome to reach out.
If you are outside those states, the considerations above are a real place to start. The next post in this series goes deeper into how to evaluate fit, what questions to ask, and what red flags are worth paying attention to before you commit to working with someone.
Learn more from RESOURCES on THE BASICS
Healthline: How to Find a Therapist
True North Psychology: How to Find the Right Therapist
FOR A DEEPER LOOK AT FRAMEWORKS AND MODALITIES
Blue Note Psychotherapy has written a thorough five-part series on how therapeutic frameworks, modalities, and models differ and how to use that understanding when choosing a therapist. Part 1 covers frameworks. Part 5 brings it all together with practical guidance on finding a good fit.
Blue Note Psychotherapy Part 1
Blue Note Psychotherapy Part 5
Sources
Routledge. Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316-340.