A practical starting point
Looking for therapy can feel like a lot of work when you already feel stretched. This page walks through how to start, what the different titles mean, how online and in-person care compare, what to ask about cost and insurance, and questions that help you judge a good fit.
In the United States and its territories, call or text 988 to reach the Suicide & Crisis Lifeline, or chat at 988lifeline.org. If you or someone else is in immediate danger, call 911. More options are collected in Crisis resources.
You do not have to get every step perfect. The aim is to find a licensed clinician you can work with, then adjust if the fit is not right.
Write down the main issues you want to work on, how often you can meet, whether you prefer video, phone, or a room in person, languages you need, and any identities or life experiences you want your therapist to understand. A short list makes later conversations easier.
Start with your health plan’s directory if you will use insurance, or a professional directory that lists license type and state. Your primary care clinic, an employee assistance program, a university counseling center, or a local community mental health clinic can also refer you. Friends and family can suggest names, but you should still check the license yourself.
In the United States, therapists are licensed by the state (or states) where they practice. For telehealth, the clinician generally needs to be licensed in the state where you are located during the session. Look up the license on the state board’s website and check that it is active and free of restrictions you would want to know about.
Many clinicians offer a short consultation by phone or video. Use it to describe what you are looking for, ask how they work, and notice whether you feel heard. It is reasonable to contact more than one person and to say no if it does not feel like a fit.
A first session is often about history, goals, and logistics. After a few meetings, check in with yourself: do you understand the plan, do you feel respected, and is there room to talk about what is not working? Switching therapists is allowed. A good clinician will not punish you for looking for a better fit.
Ask about sliding-scale fees, training clinics at universities, community mental health centers, federally qualified health centers, and whether the clinician can provide a superbill for out-of-network reimbursement. If someone cannot take you, ask who else they would recommend.
Titles are not interchangeable. They tell you about training, what someone can legally do, and sometimes whether they can prescribe medication. Always read the actual license, not only a marketing title.
About unlicensed titles. Words such as “coach,” “mentor,” or “counselor” are not always protected. A coach may be helpful for goals or habits, but coaching is not therapy, is usually unlicensed, and is not a substitute for clinical care. If you want therapy, look for a state-issued license and ask what it allows the person to do.
Neither format is automatically better. The right choice depends on your location, privacy, schedule, and how you prefer to talk. In the U.S., the therapist generally must be licensed in the state where you are sitting during the appointment, including for video sessions.
Some people use a mix: in-person for some sessions and video for others, if the clinician offers that and licensing rules allow it. Message-based care can be convenient, but it is not the same as a scheduled session and may not be the right fit in a crisis.
Fees vary by clinician, region, license, and session length, so this page does not quote typical prices. Ask for the fee in writing before the first appointment, including what you will owe if you use insurance.
Call the number on your card and ask whether outpatient mental health therapy is covered, whether you need a referral or prior authorization, what your deductible and copay or coinsurance are, and how many sessions are allowed. Confirm that the specific clinician is in network on the date you will be seen. Get the representative’s name and a reference number.
In-network clinicians have a contract with your plan, so your share is usually clearer. Out-of-network clinicians may charge their full fee up front. Some will give you a superbill that you can submit for possible reimbursement. Reimbursement is not guaranteed; ask your plan what it pays and whether you must meet a separate deductible.
Eligibility and covered services differ by program and state. If you have Medicare, Medicaid, or a marketplace plan, use that program’s official directory or member services line, not a screenshot from a third-party site. An employee assistance program may offer a short series of sessions at no extra cost to you.
Ask about sliding-scale openings, cancelled-appointment slots, group therapy, or a training clinic supervised by a licensed clinician. Community mental health centers and some nonprofit clinics set fees by income. Paying out of pocket does not mean you should skip asking about licenses, records, or a written cancellation policy.
Ask what is included in the session fee, how missed appointments are billed, whether there are charges for letters or forms, and how insurance claims will be submitted. If a quote sounds unclear, pause and get it in writing.
You are allowed to interview a clinician the same way they are getting to know you. Bring a short list so you do not have to remember everything in the moment.
If you are thinking about suicide, are in emotional distress, or are worried about someone else, reach out now. You do not have to wait for a therapy appointment.
United States and territories
988
Call or text 988. You can also chat at 988lifeline.org. Veterans, service members, and their families can press 1 after dialing 988, text 838255, or visit veteranscrisisline.net.
If you or someone else is in immediate danger, call 911 or go to the nearest emergency department.
If you are with someone in crisis and it is safe to stay, stay with them until help arrives.