Finding a therapist who is a good fit for you in general can require effort. It can be even more difficult to find a Black therapist that meets your needs as there is a large disparity in the representation of Black providers in the mental health field. In 2019, the American Psychological Association reported that 3% of psychologists identified as Black.1 But finding a Black therapist who can establish trust and empathy while also maintaining a space that safe for you to process race-related issues like racial oppression, discrimination, and prejudice is worth with effort.
Why Finding the Right Therapist Is So Important
Seeking mental health services and support is a brave step and not one to be taken lightly. It is especially important to find a therapist that makes you feel comfortable and that you can build a strong therapeutic alliance with to help you achieve your goals. Within this therapeutic relationship, empathy and trust are essential. Establishing trust with your therapist is believed to be one of the most important factors contributing to the success of therapy.2
For Black clients particularly, the stigma of mental health treatment can be a huge barrier to cultivating trust. Research has shown that over 50% of African-Americans subscribed to negative beliefs about seeking treatment for mental illness despite the huge impact racism has on mental health.3 This is important to acknowledge, as you want your therapist to be understanding of the misconceptions and apprehensions that you may have and take a non-judgmental approach to help you feel at ease and safe.
Another preference for finding a Black therapist involves reducing provider bias and having a space to process race-related issues. In examining mental health disparities, the American Psychiatric Association reported that African-Americans are more likely to be misdiagnosed, receive less evidenced-based intervention and treatment services, and receive less frequent patient-centered communication compared to their White counterparts.4
Additionally, African-Americans have a long-standing history of trauma experiences due to racial oppression, discrimination, and prejudice. These circumstances are delicate, wherein they require sensitivity and culturally competent professionals to safely dissect. It is important to recognize that not every Black experience is the same, however there is a sense of universality experienced by Black clients receiving services from Black providers that comes from an understanding of their circumstances through lived experience versus explanation.5
Where to Find a List of Black Therapists
Once you have decided that you want to seek therapy services, you can begin your preliminary search. You can receive a referral for therapy through your primary care physician, insurance company, or friends and family. If those referrals do not pan out, you can also use databases that are curated to link you to therapy services. It may feel overwhelming to sift through profiles, but the good news is, there are comprehensive lists and directories available.
Many online directories exist which allow you to search for therapists in your area to meet your unique needs, and you can typically filter your ethnicity preferences.
Below are databases and websites specifically for locating Black therapists in your area:
- Therapy For Black Girls
- Therapy For Black Men
- Ebony’s Black Mental Health Resources
- Hurdle – accepting clients in Maryland, Virginia and Washington D.C.
- Melanin and Mental Health
- Health in Her Hue
Open Path Collective is one such database that allows you to search for therapists that provide affordable therapy at prices between $30-$60 per session. You can also filter your ethnicity preferences.
What to Do If You Can’t Find a Black Therapist
If you cannot find a Black therapist in your area, you may want to consider searching for telehealth providers. Some telehealth therapists are out-of state providers, meaning they can provide services in states that they do not reside in. You can check to see if any recommended therapists on the databases above are able to provide out-of-state services.
You may also consider working with a therapist that is not Black, but displays cultural competence and training in anti-racism work. You can evaluate if a non-Black therapist will be right for you by asking these additional questions:
- What work have you done to acknowledge your privilege?
- Are you a member of any anti-racist or culturally competent organizations?
- What cultural competence and anti-racism training have you received?
- How will you recognize if our differences become a barrier in providing me treatment?
Now that you have access to databases identifying the right therapist for you, what are the next steps?
Deciding What’s Important to You
Once you have a list of potential therapists, finding one that is compatible for you is most important. There are many professions that serve under the umbrella of mental health that vary in terms of education, specialty, and training. Additionally, identifying what you can afford, availability, and personality fit all factor into deciding if a therapist is right for you.
Licensing, Certifications, & Education
Mental health professionals that can provide therapy come from a variety of backgrounds including psychologists, counselors, therapists, licensed clinical social workers, and psychiatrists. There are some differences in the type of education, degree and training involved in these disciplines.
Psychologists have obtained a doctoral degree in clinical psychology, education, or counseling (Ph.D. and Psy.D.), and are licensed by their individual licensure board according to their respective state. Psychologists specialize in evaluating a client’s mental health using psychological testing and clinical interviews. Psychologists can provide individual and group therapy and make diagnoses. In addition to providing therapy, unlike allied professions, psychologists can perform evaluations and testing related to personality, intelligence, aptitude, neuropsychology and so on.
Licensed Clinical Social Worker (LCSW) or Licensed Independent Social Worker (LISW) are master’s-level clinicians (M.S.W.) that are also licensed individually according to their respective states. LCSWs or LISWs are trained and educated to evaluate a client’s mental health, facilitate assessments, diagnose and provide therapy, intervention services, case management, and advocacy services.
Counseling and therapy professionals include Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), or Licensed Clinical Alcohol and Drug Abuse Counselor (LCADAC). These professionals have obtained a master’s degree (M.A. or M.S.) in a mental health-related field, conduct assessments, make diagnoses and are trained to provide counseling and intervention services related to individuals, groups, and families. An LCADAC’s training involves working with, diagnosing, and treating individuals with substance and drug abuse challenges.
Psychiatrists are medical doctors (M.D.) and licensed physicians who have completed education and residency training in psychiatry. Psychiatrists conduct assessments, diagnose, prescribe medications, and provide therapy for mental health conditions. Typically, one would consider seeking a psychiatrist after an evaluation and referral from a mental health professional. Depending on the need and circumstances, psychiatrists and mental health professionals may work in collaboration to provide both medication management and therapy services.
Specialty
Depending on what is bringing you to therapy, you may want to identify if seeking a therapist with a specialty would be most beneficial for you. This can include locating a therapist with an area of emphasis in depression, anxiety, self-esteem, addiction, anger management, interpersonal challenges, family and relationship challenges, sexuality, etc. Some common treatment modalities that therapists can be trained/certified in can include: Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), and Family Therapy.
An Important Note About Trauma as a Specialty
Trauma is a subjective experience in which a person struggles with psychological and physiological distress after an incident. Experiencing a trauma can result in emotional reactions and disruptions in functioning which can cause significant impairment in a person’s life. Traumas can be experienced once or multiple times, and can have lingering effects long after the incident. Intergenerational trauma can also have significant and lasting affects.
Although you may not initially recognize that you are reacting to a trauma, with the assistance of a therapist, you will be able to process and develop coping skills.
Cost & Insurance Coverage
Unfortunately, the cost of therapy can be a barrier for some. Therapy session prices can range depending on a variety of factors. You can expect that an average therapy session costs anywhere from $75-$150, however some sessions may cost as much as $300.
Most insurances offer mental/behavioral health coverage in which a percentage of your therapy services will be covered by your insurance company. If you do have insurance, your first step will be to cross reference your preliminary list of potential therapists (ones that you have been referred to or that you have identified from one of the databases above) with those that take your insurance. This is considered an in-network provider, which means that your insurance will pay for your therapy sessions, and typically you will only be responsible for paying a copay.
Copays range widely based on the insurance company. They can be anywhere from $10 to $50 or more per session. It is best practice to call your insurance company and ask about your co-pay, deductibles, and additional clarifying concerns.
If you find a potential therapist you want to work with but they don’t accept your insurance, call your insurance company to see if you have any out-of-network reimbursement benefits. This means that although the therapist may not be in-network with your insurance, you still may be able to be reimbursed for a percentage of the cost you pay for therapy.
If you do not have insurance or cannot afford to pay the full session fee, there are other options to explore:
- Sliding Scale: Some therapists allow for session fees to be determined based on your income. Inquire with the therapist if this is something that they offer.
- Health Savings Account (HSA): A healthcare plan in which tax-free interest can be used to pay for medical services. Inquire with your employer to see if you qualify.
- Flexible Spending Account (FSA): An account you put money into which allows you to pay for certain out-of-network costs, copays, deductibles and other healthcare services. Inquire with your employer to see if you qualify.
- Employee Assistance Program (EAP): A work-based intervention program that provides wellness services to employees and their families at no cost. EAPs vary by the specifics of the plan, and may come with a limited number of sessions or treatment services. Inquire with your employer to see if you qualify.
- Open Path Psychotherapy Collective:This is a directory of clinicians who offer affordable in-office and online psychotherapy sessions, ranging from $30-$60.
- University Counseling Centers: Many educational institutions offer free counseling services. You may also want to look into schools with Master’s level programs in counseling and therapy as an option.
Scheduling
It is best to be flexible when scheduling your therapy sessions, especially your intake or first appointment with your therapist. Oftentimes, therapists might have immediate availability due to cancellations or rescheduling that may not be exactly what is most ideal for you. However, the goal is to get you in the door first and after that initial session you can collaborate and schedule according to what works best for both of you. It is important not to wait too long in terms of scheduling your first session.
When scheduling, always factor in commute time, traffic patterns, the time of day, and your availability to be uninterrupted—anything that may affect your ability to be on time and fully present for sessions. Some therapists charge late fees or no-show fees, which can be a full session fee, so always be sure to communicate if there will be any challenges preventing you from attending the session.
When considering scheduling additional sessions, be sure to assess whether the location and availability of the therapist will work for you on a consistent basis.
Personality Fit
Therapy is an investment, so it is critical that you feel comfortable, heard, and respected within the therapeutic relationship, otherwise it will not work. Personality can play a major role in the therapy process as everyone reacts and responds differently to certain personality types. It is important for you to self-reflect while looking for a therapist. Assess what factors are most important for you, what personality styles work for you, and what might get in your way.
Is having a therapist of the same gender and age important to you? Is it important that your therapist shares the same identities as you? Are you comfortable disclosing your feelings and experiences with a therapist that is of a different gender, age, or sexual orientation than you? These things can affect your ability to feel understood, therefore it is important to honestly reflect what matters to you.
Do you respond well to assertiveness and directness, or does that feel harsh and intimidating to you? It is also important to recognize if a therapist is calling your attention to a pattern that they notice, it is not to judge or blame you, but it is an opportunity to gain more insight and awareness. Will it be best to have a therapist that is more passive and allows you to direct the sessions? Understand that a therapist’s role is not static; in some sessions, they may be more direct and in other sessions they take a step back and allow you to vent your feelings freely without interruption.
How to Review a Therapist’s Profile or Website
There is no “one size fits all” approach to a therapist’s profile. Some therapist profiles offer a great deal of information and some do not. Most therapist profiles and websites at the minimum will include their licensing, specialties/populations served, insurances accepted or session rates, and contact information. More extensive profiles might include years in practice, training/certifications, skills and expertise, treatment modalities, and personal philosophy regarding their therapeutic approach.
By having a general idea of what you want to work on in therapy, you will be able to assess if the information on the therapist’s profile reflects your treatment needs. Specifically, you want to look at an area on their profile—either the bio, description, or areas of interest that states their focus.
Therapy is a team effort, so your therapist will help you develop specific goals and objectives, but it is important to know what areas in your life you are in need of support. This will direct treatment and allow your therapist to best assist you. For example, if you are struggling with mood challenges (feelings of sadness, irritability, frustration, etc.), as you are browsing a potential therapist’s profile you will want to see that they serve populations with mood disorders, depression, and so on.
A therapist’s profile will give a snap-shot of who they are and their areas of specialty. A profile will not be able to tell you whether or not you and the therapist are fully compatible—that is typically felt in the room and during sessions with the therapist. Even if the profile does not include extensive information, or you are unsure if they are “the one,” scheduling a phone consultation is a great way to find out more and assess whether this therapist is a good fit for you.
What Questions to Ask During a First Call
Most therapists offer free phone consultations which typically can last up to 15 minutes. The goals of the initial phone call serves both you as a potential client and the potential therapist to get to know more about each other. Do not be afraid to interview your therapist.
Some questions for you to find out more about the therapist include:
- Are you accepting new clients? Before you get started, you want to know if this therapist is accepting new clients and if there are any barriers to beginning treatment. If they are not accepting new clients, ask if they can provide you recommendations for colleagues.
- What is your cancellation policy? This is important to know, as cancellation policies vary between therapists. You will want to be aware of what the expectation will be should you schedule an initial session with them.
- Have you worked with someone like me before? You want to know if this therapist has experience treating clients like you to assess whether they will be most appropriate or if you should seek services from someone else.
- What do most of your client’s see you for? This is another way to gauge what their typical client demographics are and what their most common specialties are.
- What can I expect from working with you? This allows you to understand both the therapist’s role and your role within the therapeutic process.
- How often will we meet? This allows you to be aware of expectations and also determine if you and the therapist have compatible availability to meet for sessions.
- What does a typical session look like with you? You want to learn more about the structure of sessions. Some therapists give “homework” assignments to work on between sessions, while others don’t. This is helpful in understanding what to expect as you work with this therapist.
- How can I express if something is not working for me? It is especially important to establish feedback within the therapeutic relationship. Therapists work with you to address your treatment goals, so in order for therapy to be beneficial, you must be able to express if interventions, therapy styles, communication, or other factors are not working for you so that you can work together to find solutions.
- What more do you need to know about me to figure out if you are able to help me? This allows you to provide more information to the therapist and learn more about what to expect from the initial session.
What to Consider During Your First Appointment
The goals of the first session follow up from the consultation. The therapist will be focused on learning more about what brings you to therapy and understanding more about you and your experiences. During this session, expect that the therapist will conduct some form of an assessment consisting of questions exploring your current circumstances, medical conditions, past treatment history, family dynamics, intimate relationships, lived experiences and stress responses.
You should check-in with yourself during and after the initial session. Consider how you felt in the moment while you were sharing details of your life:
- Did you feel safe?
- Did you feel heard?
- Did you feel respected?
- Did you feel that the therapist showed empathy and understanding?
- Did you feel that the therapist’s verbal and non-verbal communication was comforting to you?
- Did you feel that the therapist allowed you enough time to share without feeling cut off or rushed?
Self-assessment will help you evaluate from the beginning if comfortability was established with the therapist. The first session alone may not be enough to determine if this therapist is a perfect fit, but you can recognize if initial factors such as empathy, trust, and safety are present.
What to Consider After 3-4 Sessions
A common misconception while seeking mental health treatment is that the therapist will “fix” you. Be careful of going into therapy with this expectation, as therapist’s jobs are not to solve all of your problems and they will not have all of the answers. In fact, you are the actual expert in your life. Your therapist will, however, work with you in collaboration to help you identify your treatment goals, develop strategies, and reach your desired outcomes.
In the beginning stages, your therapist will be focused on building rapport with you, continuing to learn more about the way that you function, and helping you identify areas to focus on. It is helpful to understand that progress is not immediate and it may take time for changes to occur.
If after 3-4 sessions, you notice that you do not feel comfortable with your therapist, you cannot connect with them, you do not understand their feedback or guidance, your goals are chosen for you without your input, your boundaries are not respected, or you are not allowed opportunities to ask questions or clarify information, then you will want to consider if this relationship is a good fit. If not, it is perfectly valid to terminate sessions with this therapist.
Finding a therapist is like dating; someone can look good on paper, but while you are on a date with them, you realize it just isn’t a good fit and you continue your search until you find the right one for you.
For Further Reading
For further information on mental health in Black communities and populations, the following resources may be helpful:
How to Find a Black Therapist Infographic
