TL;DR: Therapy can help if you feel overwhelmed or stuck, and want someone outside your social circle to talk to.

Everyone experiences hardships in life, so how do you know if you truly need counseling?

Sometimes things happen to us; other times, we experience problematic thoughts, behaviors, or emotions that seem difficult to navigate or manage on our own.

Regardless of what you are experiencing, it is important to consider how you make meaning or sense of your situation.

We can often rationalize that someone else may be having a “harder” situation than you and therefore shouldn’t be complaining.

However, if what you are experiencing feels overwhelming or concerning, regardless of how small it seems, what you’re feeling is valid! Your brain and your body are trying to communicate something to you. Listen! If it’s significant to you, then it is important enough to talk about.

Additionally, it can be helpful to talk to someone who is outside your current social network. Sometimes our biggest struggles pertain the ones we care the most about. You may be looking for someone uninvolved in your situation who can keep what you share confidential or give an unbiased reflection.

If any of these are true to your current experience, then counseling could be beneficial.

TL;DR: There are multiple factors to consider when choosing a counselor—including their education & specialties, background & values, price, and your compatibility with a therapist.

How do you find—let alone choose—the right counselor for your needs? There can be seemingly endless results on Google searches or Psychology Today. Here are a couple things to look for from a prospective therapist:

Education

All licensed or pre-licensed therapists have at least a Master’s degree in a counseling-related field (e.g., Clinical Counseling, Marriage & Family Therapy, Social Work) from a program-accredited university.

Pre-licensed therapists are recent graduates who are acquiring additional clinical experience to gain full licensure. In Colorado, these titles include Licensed Professional Counselor Candidate (LPCC), Marriage & Family Therapist Candidate (MFTC), and Licensed Social Worker (LSW). These therapists are trained in various modalities can often provide reduced rate sessions.

Licensed therapists have met all state requirements regarding training and clinical experience to maintain a counseling license. In Colorado, these titles include Licensed Professional Counselor (LPC), Licensed Marriage & Family Therapist (LMFT), and Licensed Clinical Social Worker (LCSW). Licensed therapists can specialize a particular issue, counseling modality, or population.

Clinical Psychologists (PhD or PsyD) have undergone extensive training and research. These therapists are highly specialized in a particular presenting issue, modality, or population.

Specialization

You want to find someone who “gets” you and has the expertise to help you successfully move through whatever you are facing. Look to see what populations or presenting issues a therapist specializes in and if those specialties fit your description.

Whether you identify as LGBTQ+ or neurodivergent or you struggle with anxiety, faith deconstruction, relationship issues, or anything else, therapists each have a passion to work with specific intersectionalities and have devoted training and clinical experience to work with them.

As you’re searching for a therapist, you can type in multiple descriptive factors that describe your experience and what you’re looking for, such as “Asian young adult male struggling with burnout.” The more specific, the more helpful it could be to find a counselor who can understand and help you through your unique experience.

Theoretical Orientation

Each counselor uses a particular lens to understand and approach treating your concerns. There are many empirically-backed approaches as well as some newer modalities which are showing promise.

Theoretical approaches can focus on thoughts, behaviors, emotions, somatic feelings, or simply resolving the problem. Some therapists may have you re-enact a situation in-session. Others may assign homework. There are also specific approaches, like EMDR for trauma, which has its own protocol for treatment.

Think about what you may need and what angle resonates well with you. If you’re unsure, you can reach out to a therapist and ask them to explain their approach to counseling and their philosophy of change.

Background & Values

You may also want someone who has firsthand knowledge of what you’re facing. Therapists are human, too, and have their own life experience and wisdom that can be utilized for therapy. Whether it be a particular life stage, ethnic/racial background, gender or sexual identity, faith, career change, or relationship hurdle, you can connect with a therapist who knows what it’s like to be in your shoes.

Price

Money can sometimes be the biggest hurdle to receiving the therapy you need. There are a handful of varying pricing structures.

Many therapists and clinics accept insurance. Be sure to clarify with your provider what services can be reimbursed and for how much.

There are therapists who accept only private pay, however, they can provide a superbill which can be submitted for possible reimbursement from your insurance provider. Again, be sure to clarify with your provider what services your policy can cover.

According to the No Surprises Act, you can ask a prospective therapist to provide you a Good Faith Estimate to give you a quote of how much sessions would cost across the course of therapy.

If you are interested in working with a private pay therapist but cannot afford the full price of therapy, ask if they offer sliding scale options. Many therapists provide a handful of reduced-fee sessions to increase accessibility to those where finances are a major hurdle to therapy.

If a therapist does not have availability or is unable to provide a sliding scale rate, ask if they have any referrals to connect you to another therapist who can meet your therapy and financial needs.

Fit

Ultimately, you want to connect with someone with whom you feel safe and seen. You’re going to be entering into a vulnerable space. Just because a therapist has all the expertise and knowledge does not mean that they are a good “fit” for you.

Many therapists offer a free phone consultation. Chat with them and see if your personalities could work well together. Sometimes you won’t know how good a fit is until you start working together. You can use the initial few sessions to see if there is a good connection with a therapist.

There are no hard feelings if you decide to turn down a therapist. Each therapist wants you to have the best possible fit as you journey through counseling, and at the end of the day, so do you—so make a choice that’s honoring and serving to your needs!

TL;DR: It’s a matter of personal preference.

Both in-person and telehealth therapy aim to provide the same level of care. However, here are a few pros and cons of each to consider:

Pros of In-Person Therapy

1. Presence. In-person therapy is a devoted time for you to be present. You enter into a physical space where you can set aside daily rhythms or responsibilities to focus in on your personal needs/growth.

2. Connection. Humans are inherently relational beings. In-person therapy gives you space have human-to-human connection.

3. Seen. In-person therapy gives you the space to share what is important to you and allows you to be seen as you are, without the need to be “put together.”

4. Confidential. Whatever is shared in therapy is kept confidential between yourself and your therapist.

Pros of Online Therapy

1. Convenience. Online therapy can be a convenient option for those with full schedules or are unable to commute to an office.

2. Accessible. Online therapy can be accessible from anywhere in your state with Internet or cellular connection.

3. Health. Telehealth therapy can be a suitable option for those with health risks or concerns.

4. Secure. Telehealth platforms are HIPAA-compliant.

Cons of In-Person Therapy

1. Time. The time and distance to travel to an office can be a stressful addition for those with an already full schedule.

2. Health risks. While offices are kept as clean as possible, there is no 100% guarantee that germs can be prevented and that illnesses can be avoided.

3. Discomfort. Entering into a human-to-human interaction can be a vulnerable space. Discomfort can arise when meeting in-person.

Cons of Online Therapy

1. Tech issues. While technology is constantly improving, there is still no guarantee that tech issues like unstable Internet connections or audio quality can be avoided.

2. Safety. While telehealth platforms maintain HIPAA-compliance, a therapist cannot guarantee the safety or privacy of the space you sign into your session. If you sign into session at home or at work, be sure to find a quiet space where others cannot hear you.

3. Lack of connection. While video sessions can be a convenient way to meet with a therapist, you may not feel as seen or connected as if you were meeting in-person. Cameras can’t show your full body language, and sometimes video lag can make conversations feel a little awkward.

4. More screen time. In a society that feels inundated with screens, having another appointment online can feel straining.

TL;DR: You and a counselor establish goals for therapy, and then each session is aimed towards pursuing those goals.

Common counseling formats include 50, 75, or 90 minute-sessions. These times are based on a “therapeutic hour,” in which you meet with a therapist for the allotted time, and the remaining time in the hour (e.g., 10 minutes following a 50-min session) is devoted for completing clinical notes.

Either prior to the first session or during the first session, you will complete an intake questionnaire (written/typed or verbal). The goal of this is to understand your presenting problem and other current factors.

This holistic view helps show if there are other noteworthy things to consider, such as medical concerns, that may be impacting your struggle. It can also help highlight underlying strengths which can aid the therapeutic process.

In the initial sessions, you will collaborate with your therapist to identify specific goals for therapy. This helps provide structure and direction for subsequent sessions. From these goals, your therapist will create, follow, and monitor a treatment plan to ensure these goals are pursued.

From here, therapy ensues. Your therapist will guide each session based on his/her/their counseling modality. Goals can be reviewed and revised throughout the therapy process.

A therapist can wear many hats, including a consultant, coach, or even cheerleader. However, it is important to note that a therapist is not an advice-giver or problem-solver. Rather, it is ultimately you who does the work in sessions and outside in your personal life. This locus of control is aimed to equip and empower you to navigate the obstacles you’re facing.

This expectation of engagement is still coupled with grace. Therapy is hard work. It takes a lot of energy to engage in heavy emotions or to practice new skills like positive self-talk and communication patterns. It is normal to feel exhausted or emotionally heavy following a session. All you can do is your reasonable best, and a good therapist is willing to walk with you at whatever pace you need.

TL;DR: It depends!

This answer is dependent on multiple factors—the therapist’s counseling modality, client goals, how intense/chronic a client’s symptoms are, one’s personal capacity (financial, emotional, time) to engage in therapy, etc.

Some therapies, like solution-focused brief therapy, can be as short as 6-8 sessions, whereas other work, like trauma-focused, can take place over the course of years.

Your therapist will advise how frequently to schedule appointments. Following a routine, such as attending one session every 1-2 weeks, can help build consistency and momentum towards pursuing your therapy goals. However, discuss with your therapist what frequency works best with the type of treatment, your level of distress, and your current needs & resources.

When is therapy finished? Consider what markers or changes you’d like to see achieved, objective or subjective.

Maybe you are satisfied with the improvements you’re looking for and are ready to try out life without counseling. Maybe you’ve reached end of a season of life, like graduation or moving. Or maybe you haven’t seen the progress you’ve wanted and want to try something else with another therapist.

As with life, there is often not a predictable end. However, keep in mind a few notable metrics (e.g., SMART goals, self-report) to track your therapy progress and if/when you’re ready to conclude.

You can openly discuss with your therapist when to end therapy, how to transition well, and brainstorm what factors to consider for if/when you may want therapy help in the future.

• What is your education and training? What populations or treatments do you specialize in?

• How do you go about conducting sessions? What kind of exercises, practices, or homework do you utilize?

• Can you describe your theoretical orientation? How do you see change occurring?

• What are some of your values?

• Do you accept insurance? Private pay? Do you offer sliding scale or other financial accommodations for counseling?

• What is your availability? Do you offer evenings? Weekends? Telehealth?

• What values matter most to you when selecting a therapist (e.g., faith, multicultural background, LGBTQ+ identity or alliance)?

• What do you hope to achieve in therapy? What kind of support do you want/need from a therapist? When are you available for sessions?

• What can I afford?

• What can I commit to (financially, emotionally)?

• How will I know that I am done with therapy/have met all my goals?