Why Can't I Find A Fucking Therapist?
And if I actually do, how do I make sure they're right for me?
I get emails on the regular from people asking if they can see me (maybe, if you’re in Texas…I opened my schedule back up again but it also filled back up again hella fast, my availability is pretty limited). Or do I know someone in the state they’re in? Or how should someone go about searching for a therapist?
Y’all, it sucks. I know. It already sucked and was shitty before Covid. Now it seems nearly fucking impossible. Because it is.
Therapists are also overfull and burned out and processing the same trauma at the same time. The good ones are aware of their limits and limiting their schedules and wait list and new client on boarding.
I generally start with recommending Psychology Today as a place to search for providers in your area not because this is a #sponcon post but if a therapist is advertising this is the site that is used the most (tho therapist.com is gunning for a takeover). And it lets you search by speciality, location, and the like. And let's exclude certain types of therapists as well.
But what if you STILL can’t find anyone? You can’t get any return calls for anybody? Then what?
When we’re in a scarcity based system, it really becomes about self-advocacy and personal connections. Yes, I understand that no healthcare should require this level of hustle. You don’t need to @ me, it’s already a hard agree. But it’s also reality.
***And this isn’t a plea for congress to write off student loan debt in exchange for providing services to underserved individuals, though THAT WOULD FIX A LOT OF THINGS FOR EVERYONE. (Also please don’t @ me about student loan repayment programs, telling me that they are available. Helping clinicians access student loan repayment was part of my job for several years and most repayment programs are not accessible to most non-prescribing clinicians and almost all applications that are deemed qualified are ultimately declined.)**
This is about how to advocate for your own treatment needs, and I can help you with that part.
Most clinicians do have a few available time periods even if their schedule is closed. We save them for client emergencies and the like. Ask your friends, family, and other treatment providers who they think is great and ask them to help you get an appt if they can (which is just “my friend soandso needs to see someone, can I have her email you?”). Then when you follow up drop the name of the person who referred you. “Hi Faith! My friend Nancy said you may be able to get me in if my schedule is flexible!” is plenty for me to remember the request. Even if the clinician in question is completely full, we may be able to give you a solid referral to someone we know and trust who is taking new clients. I give referrals locally to people I have trained and/or trust and will ask the clinician in question to please follow up with the individual I’m sending their way. It’s not a warm hand-off but is the closest thing to one. I just got a new prescriber referral through a friend who got it from a social media group. Sometimes we gotta dig for awhile. Sucks, but not getting care sucks more.
Check in with your local rape crisis center. If your trauma history involves sexual assault, they will likely have no-fee care available for you. But if they don’t or if your trauma work is not related to sexual abuse or assault, they will still quite likely have a list of trauma informed clinicians that they refer to. Then you can say you were referred by them, which can also help you get in the door.
Same goes with any LGBT pride centers in your area. Or more progressive orgs like Planned Parenthood. They will quite likely have lists of affirming providers. Awesome if you need a letter for gender confirmation treatment, but also awesome even if that’s not your issue, because knowing the provider is a trusted entity is still useful. And then you can say that’s the org that referred you. And if *are* needing affirming and competent care and the clinician in question is full, they’ll be able to point you in the right direction. I’ve had associates provide the needed assessment and I co-signed on their behalf (especially helpful if a doctoral level clinician was requested by the insurance company or surgeon’s office or whatever).
The online platforms? I mean 🤷🏽♀️. There are some great clinicians that use them because they make life so much easier for their practice management. You might find a good fit. And since it’s a subscription service, if you don’t like your therapist or any of the others that you try out after requesting a switch you can just cancel. My hesitation isn’t about the quality of the clinician but the apps themselves. Do look at their privacy policies and what data they share by doing an online search. Also check them for BBB complaints. Many have gotten popped for being shady in how they share data (these are tech companies after all) and your choice of platform may be determined on privacy policies.
Check with the local colleges that train clinicians. Schools that have master and doctoral clinical programs. This is also helpful if you’re broke AF and are looking for free or inexpensive-as-possible. Most schools have a clinic on site or have an MOU (memorandum of understanding) with clinics in the area where you can see a student counselor who is being highly supervised by a professor or other elder statesman of the field. Bonus? Sometimes specialty care may be available for free if a student is working on their thesis or dissertation or a professor is conducting some clinic research. I’ve helped people get free neurofeedback that way, as an example.
Ok, cool. Now how do you ascertain if they are a **good** clinician for your particular issue? It can be hard to suss out if it’s going to be a good personality match for you. Which is a nice way of saying, there are plenty of great clinicians that may not be great for you. There are always people who don’t like my style, my approach, or my tattoos. And that’s utterly fine. Seriously, the meta-analytic studies (see Bruce Wampold’s book “The Great Psychotherapy Debate” if you are intrigued) of different therapeutic techniques show that when it comes down to it, the common factors are the most important. Common factors is just an academic way of saying the relationship building and maintenance of therapy. Meaning y’all work well together and you trust your clinician and y’alls process. And that may not be something you can guess by reading their website.
That being said? It is utterly OK to ask them about their training and experience around certain topics. There are plenty of therapists out there that market themselves as affirming but say microaggressive bullshit on the regular. Or say they are trauma-informed but are really just trauma-aware. Please (no, seriously, PLEASE) ask that question if it’s important to you. If they are offended by the question this isn’t going to be a good experience for you, I promise. Ask “What is your experience and training around working with non-cis folx?” or “I am seeking an assessment and diagnosis (if appropriate) of autism….is that something you provide?” or “how do you approach trauma work?” or even just “do you work with couples? I’m seeking an appt for myself and my partner.” None of these questions require super long and intensive answers and they are entirely reasonable.
And if you’re a politician who wants to advocate for more student loan write-offs? Holler at your girl, I have ideas.
Faith