A lot of people feel bad. One in five American adults experienced symptoms of anxiety and depression in 2023, according to the Centers for Disease Control and Prevention (CDC). In the UK, 40.5% of people with anxiety experienced “medium” or “high” levels in 2022 and 16% of adults experienced moderate to severe depressive symptoms.

For many, psychotherapy is an effective way to address a range of concerns – from diagnosed mental illnesses to a general sense of dissatisfaction or inertia.

“People tend to look for therapy when they’re feeling stuck in some area of their life, and that is preventing them from living a life that feels full and meaningful,” says Dr Elisabeth Morray, VP of clinical operations at the membership-based mental health directory and insurance billing platform Alma.

But starting therapy can also feel daunting. How does one afford it? How do you find the right therapist? What can you expect from treatment? We asked the experts.

Think about what kind of therapist you’d like to work with

Starting therapy can feel difficult. “You are going into a situation in which you are sharing very vulnerable and intimate details about yourself with someone who, at least initially, is a total stranger,” says Morray.

Given that, consider what qualities you’d like your therapist to have that might make you feel more comfortable. Would you like them to be a certain gender or age, or to come from a similar cultural background as you? Is it important for you to see someone in person, or are you comfortable with telehealth? Do they have experience in the area you’re hoping to address, like relationships, sleep or body image? These questions can help narrow down your search.

Do some research

There are a number of ways to find therapists in your area.

“It’s okay to Google!” says Dr Marnie Shanbhag, senior director of the office of independent practice at the American Psychological Association. She suggests searching something like “psychotherapist near me” – psychotherapist is a more specific term than just “therapist”, which could encompass, say, physical therapists as well, she explains. Many therapists have websites or bios in which they outline their experience and approach to therapy. Check if any meet the identity and experience criteria you settled on earlier.

Experts also recommend searching on websites that have directories of providers, like Psychology Today.

If you don’t find many therapists in your immediate vicinity, look for therapists who are licensed in your state and offer telehealth services.

“For somebody in rural Tennessee, there might not be many therapists from their area, but they could find a therapist in Memphis or Knoxville,” says Matt Lundquist, the founder and clinical director of Tribeca Therapy in Manhattan.

If you’re comfortable letting people know you’re looking for a therapist, make use of your social network. Asking trusted friends if they know any good therapists is “an opportunity to get somebody who’s been vetted”, says Lundquist.

Even if you don’t want to see a friend’s therapist, Lundquist says, they might be able to recommend another practitioner “who works similarly to them or might be a good fit”.

Consider the cost

One of the biggest obstacles most people face when it comes to therapy is cost. In the US, most clinicians charge between $100 and $200 a session and sometimes significantly more in major cities.

In the UK, free talk therapy is available through the NHS, but wait times can be long, and some might choose to supplement their treatment with private therapy. The national average is estimated to be £50 to £80 a session.

Given that many therapists recommend clients come in weekly or every other week, the costs add up quickly.

Before you start looking for a provider, think about how you plan to pay for therapy, because that will determine which providers are available for you.

Paying with insurance – in the US:

“The first challenge for most people is finding a therapist who is in-network and takes their insurance,” says Morray.

This can be tricky, as navigating insurance can be a headache for both patients and providers.

“There are a lot of therapists, particularly in bigger cities, who simply don’t take insurance,” says Lundquist. Insurance coverage for mental healthcare can be complicated and prohibitive, he explains. Many companies “want to set limits on the number of sessions, and therapists end up chasing them for reimbursement”, he says.

One way to find in-network therapists is to ask your insurance company for a list of providers in your area.

If you want to see an out-of-network therapist, some insurance plans allow you to submit claims for reimbursement after you have already paid for a session. But confirm first with your insurance company that this is available with your plan.

Paying out of pocket – in the US:

Some may be able to pay for a therapist out of pocket, in which case they simply have to choose which provider seems like the best fit. For those without insurance, or who don’t want to use their insurance for privacy reasons and are unable to afford the regular fees of private therapists, there are options.

“One great place to look is local universities,” says Shanbhag.

Many universities that offer graduate programs in psychology offer sessions with doctoral students for a reduced fee. “They’re very senior in their training, and they’re being supervised every step of the way,” says Shanbhag. “It can be a great way to get affordable care.”

Experts also suggest reaching out to local hospital systems, community health clinics or mental health agencies that might offer low-cost or sliding-fee mental healthcare, or be able to direct you to providers who do.

And if you find a therapist you are very interested in working with, but you can’t afford their fee, Morray suggests emailing them. “Explain the constraints you have financially, and see if they’re willing to work out a sliding scale, or even pro bono services,” she says. “Most people wouldn’t think to ask.”

Set up a consultation

Once you have identified therapists who seem like they might be a good fit, ask if they are available for a consultation. Some therapists offer free, 15-minute phone consultations. Others offer full-session, paid consultations. If possible, experts recommend doing a full session so you can see how a person works.

During the consultation, pay attention to how you feel, says Shanbhag. She suggests asking yourself: “Do they seem to be paying attention to me? Do they seem interested in who I am as a person? Are they asking me relevant questions?”

It may take a couple of sessions to decide if a therapist is a good match. “Within two or three sessions, you can get a good feel for whether this is someone who makes you feel heard, makes you feel seen and offers you a sense of presence and attention.”

Find the right fit

When looking for a therapist, Lundquist says it’s important to “be picky”.

“This is a very important relationship,” he says. “It’s important to get it right.”

Don’t feel bad about telling a provider that they’re not a good match for you. “A lot of times clients are afraid they’ll hurt our feelings and they don’t bring it up,” says Shanbhag. If a therapist does take it personally, they’re probably not a good fit anyway.

If you try therapists who don’t seem right for you, don’t give up. “It might take a while to find the perfect fit, and that’s part of the process,” says Shanbhag. “That doesn’t mean you’re doing it wrong.”

Morray says she thinks of finding a therapist as a little like dating: “Finding the person you want to be by your side is important, and you’re probably not going to end up in a long-term relationship with the first person you date.”