How to Choose a Psychotherapist in San Francisco

How do we choose a therapist in San Francisco? This is a question that many people ask me, and at Therapy Now SF, the way we go about it is I'm the first point of contact, and I assess what's going on symptom wise, what's bringing you into therapy right now, and then from there I think of our therapists and their personality styles, their different theories they use, and ways of being and engagement and everything, and then I sort of sorta match them.

Let's get into the details of when you are looking for a therapist and what that can look like.

First off, I would say, take your time. There's no rush. You can, most if not all, almost all, I would say therapists offer a free, like a 15 minute sort of phone consultation or video consultation so you can get a feel of somebody of who they are and their personality and see if you click.

In San Francisco specifically, there's such a variety of people, of cultures, of therapeutic approaches, of just the different schools they've been to. There's such a plethora, which is wonderful, but it can also be a little bit overwhelming.

Assess Your Needs

 So start with assessing what your needs are.

So what do you want to achieve with therapy? You can think about what your symptoms are like maybe you're struggling with some anxiety. You feel nervous. Often you worry a lot. You're in your head. You are ruminating about different things. That can translate into the everyday mundane.

It can also translate into work and your relationships. So if that's something you're going through, think of, what you're wanting to work on around that anxiety. Then if you want, you can, you don't have to do this, but you can also look into different therapy types. So you could do this by, just simply Googling, what's effective for managing anxiety.

You can look at what's evidence based, or you can look at what people have found helpful in the past such as, cognitive behavioral therapy is really popular for managing anxiety, but it's also not the only way to go. There's ways that somatic interventions are really helpful for anxiety or narrative therapy is really helpful.

And what the research actually shows, the literature shows, is that what's most important is not necessarily the theories a therapist uses, it is the relationship you build with the therapist. And so really keeping that in mind when you are talking to potential therapists.

Research Potential Therapists

 When you're looking into therapists, you can look into their qualifications and their credentials.

There's different types of licensures. There's LCSW, which stands for Licensed Clinical Social Worker, MFT or LMFT, which is Licensed Master's Family Therapist, a PhD or a PsyD, which is a doctoral in psychology. My personal sort of feelings around this degree can matter or cannot matter.

So much of it again is personality and compatibility and connection with your therapist and their experience with what you're wanting to work on. And how that experience aligns with your needs and sort of your values in life.

Consider Logistical Factors

 So then you want to consider some logistical factors.

Are you wanting telehealth? Are you wanting video sessions, phone sessions, or are you wanting in person? And then, even like deeper into the logistics, if you are wanting in person, make life a little bit easier for yourself. Maybe get somebody who works close to where you live or where you work.

You wanna decrease as many barriers as possible to get to therapy. But at the same time, if you find the right fit across town could be worth it.

And you're going to find out their availability. What is their scheduling look like? What times work for you?

You're going to look into your insurance and what the fees are. Some insurance companies will have a list of in network therapists. Others will be what's considered out of network, an out of network provider. And so they will be what we call private pay or self pay. The landscape has really changed in the past even five years where a lot of insurance companies are reimbursing for an out of network provider.

And that's huge. And that reimbursement rate can be anywhere from 50 to 80%. But the way to find that out is you have to directly call your insurance and find out what your plan does. Most therapists can't really tell you, what your Blue Shield Blue Cross specific plan will have.

In fact, they shouldn't tell you because every plan is different. So you need to find that out, do a little legwork for yourself.

 Check Reviews and Testimonials

 So then another piece is check their reviews and testimonials. The one challenge with getting reviews and testimonials, as a therapist, as I can tell you, is that one, ethically, legally, we actually can't ask our current or former clients for them.

So it has to be totally voluntary and therapy is private and confidential. So a lot of people don't want to be vulnerable and say they're going to therapy, there's still stigma, unfortunately around therapy. That can be helpful. Or if you have a friend who's been to a therapist, you can think of maybe seeing them.

That can be helpful unless you maybe want some space between your friend and your friend's therapist. And so maybe that therapist can recommend somebody for you.

Assess Your Comfort Level

 So then what I talked about earlier is you want to schedule that consultation. And take your time. Think of maybe some questions you want to ask. And think of the compatibility. Talking to them, do you feel safe with them? Do you feel like you can open up? Do you feel like you can be vulnerable? Do you feel like they're not going to judge you? Those like basic, basic ground level is extremely important because this is a person you're going to be talking to about possibly your deepest secrets, things that maybe you struggle to share with friends and family and you want to make sure this therapist can handle that and make you feel like you want to keep opening up.

I would say one of the last things is really trust your gut. Sometimes we can talk to somebody and we can't pinpoint why it just doesn't feel right.

And so you don't have to put words to that. You can just let yourself know something about that conversation didn't feel right to me. So I want to move on. Sometimes what I even encourage potential clients to do is if something does feel good over that consultation, schedule that first session.

You're never forced to continue for the rest of your life with that therapist. You can go, test it out for three sessions, I would say. And then if it's feeling great, continue. If it's feeling like something's off, or maybe you can pinpoint what's off, then move on, find another therapist.

In conclusion, take your time, trust your gut, have those conversations, talk to your friends or family about maybe how that conversation went. Again, do you feel safe? Can you be vulnerable? Can you open up? Can you build a relationship? Again, that relationship piece is huge. And that is the best predictor of feeling better, of achieving your goals, and of making the progress that you want to make.