The Abridged version:
- Experts suggest you can start your search for a therapist by contacting your primary care physician, exploring insurance and out-of-pocket options and reaching out to practitioners for consultations.
- If you’re deciding whether you should start therapy, analyze your sleep and eating habits, your relationships and routines.
- Sacramento County has several free and low-cost options for those seeking help.
Mental health has been on the decline in recent years across the United States, and seeking help can be difficult and daunting, even with clear instructions.
Mental illness is a common health condition in the region and affects all ages, according to Stop Stigma Sacramento, a mental health resource funded by the Sacramento County Division of Behavioral Health Services.
Still, people often don’t get help, said La Viola Ward, a behavioral health clinician with Dignity Health Medical Foundation Rancho Cordova. Stigma, and factors such as cost, fit and availability pose challenges.
In a survey about mental health in the U.S. conducted in April by The Harris Poll in partnership with the American Psychological Association, 41% of adults said they’re often uncomfortable asking for help. About one-third of adults said they’ve never reached out for professional mental health support and aren’t interested in doing so.
“We all deserve to have thriving lives in the context of whatever our normal is,” Ward said. “A therapist can be a wonderful tool to do that if you can find the right fit.”
Here are tips for finding a therapist, with considerations around fit, cost and access:
Should I start therapy?
Lynn Bufka, head of practice at the American Psychological Association, said mental health care is the key to overall well-being.
“I never want to discourage people from seeking care … recognizing that it could be very challenging to ultimately get that connection, I think is important to note,” she said.
The decision to start therapy is a personal one, and while there’s no wrong time to start, noticeable behavioral changes could indicate that it’s time to seek professional mental health support.
Here are a couple of questions to ask yourself to begin the process of self-introspection, said Bufka, a licensed clinical psychologist:
• Have my sleeping patterns changed?
• Have my eating habits changed significantly?
• Am I having difficulties in relationships?
• Am I struggling to do things that I used to do with relative ease?
Where do I start looking for a therapist?
Spokesperson Ben Avey with WellSpace Health, a nonprofit health system in the Sacramento region providing medical, dental and behavioral health services, said primary care physicians are often the first point of contact for people seeking mental health support.
“Behavioral health has to be part of health,” he said.
“We have to look at it as a comprehensive individual who needs different aspects of care at different parts of their life, and primary care plays into that.”
Bufka, with APA, said asking a person you trust to help you on your search for a mental health care professional is a “great way to lean on your support network.”
If you’re embarking on this journey alone, breaking down your search into actionable, concrete steps could make the search more manageable. That could look like finding three potential therapists one day and calling to check for their availability the next.
Another tip: Therapy consultations are an important step you shouldn’t skip.
Many therapists, Ward said, offer potential clients free consultations so both parties can decide if they’re a good fit. Time is limited, so head into the conversation with an idea of what you would like your therapeutic experience to look like.
And it’s perfectly OK if you meet with a therapist and decide you’’re not a good fit, Ward said.
“If we’re going on a job interview or a first date, we take those things very seriously because of the long-term impact that it could have to our life,” Ward said. “I think it’s important to consider a mental health professional to be just as important.
“A therapist … can quite literally save your life.”
Does fit matter?
The right therapist for your needs and preferences matters.
In fact, getting specific on fit could be a “game changer” in your therapeutic experience, said licensed marriage and family therapist Arielle Pinkston.
“One of the biggest predictors of success in therapy is the relationship between the client and the therapist,” said Pinkston, who serves clients in Elk Grove and across the state of California through her private practice, That’s So Well.
The “therapeutic alliance,” according to psychotherapy website Psychology Today, is a factor most likely linked to a positive therapeutic experience. A strong bond is formed when both the client and therapist agree on treatment goals and the steps to achieve them.
Get specific on what you’re looking for in a mental health professional and write a list of preferences and deal-breakers.
Ward, who’s been working directly with clients since 2017, said the list will shrink your pool of options, but it will also get you closer to your ideal match.
For some people, it’s important that their therapist belongs to a similar community as them or can speak to their lived experiences, Ward said. For others, sitting across from someone with a similar background is triggering.
A therapist may have a specific emphasis in areas depending on their credentials, which could further help narrow your search for your ideal match. Online directories, including Psychology Today, GoodTherapy and Inclusive Therapists, organize therapists with their credentials.
Can I afford therapy?
Health insurance networks make therapy more accessible, but there are disadvantages for both clients and practitioners. Research shows that using an out-of-network provider is more common in mental health care than in general health care among those using private insurance.
Clients using health insurance to access therapy may face long wait times, treatment and privacy limitations, and high service costs, Deanna deBara wrote in SimplePractice, a behavioral health project management site.
Therapists can receive “extremely low” reimbursement rates, deBara wrote. That means providers aren’t paid as much as they would per session if they were using other forms of payment for treatment.
Kathryn Brown, a licensed marriage and family therapist in Roseville, said many clients and therapists are also dropping insurance networks to have more freedom around treatment goals.
A formal mental health diagnosis, she said, is generally required for insurance to pay for therapy. But not everyone who seeks therapy meets a diagnostic criterion.
People without health insurance, as well as those using out-of-network providers and accessing specialized mental health care not covered by their health plan, will opt to make out-of-pocket payments to their therapist, according to mental health services site Grow Therapy.
Many mental health providers who don’t accept insurance offer other payment options to make therapy more affordable. That includes sliding scale pay plans and pay-what-you-can models.
Free and low-cost care
Sacramento area-based services and nonprofit organizations, such as WellSpace, provide resources to underserved communities across the region.
Avey, WellSpace’s spokesperson, said at least 92% of people served at the agency are low-income.
Jonathan Porteus, chief executive officer of WellSpace, said his team shares the belief that everyone not only has the right to access care but also in the proportion of how much they need it.
“Some people call that equity,” said Porteus, a licensed clinical psychologist.
Here’s a list of free and low-cost mental health services and resources in the Sacramento region:
• Stop Stigma Sacramento
• 211 Sacramento
• La Familia Counseling Center
• Hope Counseling
• Sacramento County Department of Health Services
• National Alliance of Mental Illness Sacramento
• Sacramento Mental Health Urgent Care Clinic
• Sacramento Native American Health Center
• One Community Health
If you’re experiencing a mental health crisis, you can dial 988 to reach the Suicide & Crisis Lifeline. It’s free and confidential. The Trevor Project, which supports LGBTQ youth, can be reached at 866-488-7386.
Brianna Taylor is a regular contributor, covering Health and Wellness for Abridged.
