Hi Quartz members,
Maybe it’s a realization you had after a particularly tough week, or month, or year. Maybe it was a gentle suggestion from a friend or loved one. Maybe you’ve decided it’s finally time. No matter how you got there, you’ve made the decision to explore therapy. Good for you—that’s an important step.
But finding a therapist who is right for you can often be a challenging and exhausting process. As my therapist once told me, it can often be like going on a first date—sometimes you have to kiss several frogs before you meet your match. That can cost time and money.
If you’re from a marginalized background, this can be an even harder task. For instance, after a year characterized by a pandemic that hit Black Americans particularly hard and national conversations around police violence, 15% of Black people living in the US reported feeling suicidal in June this year, compared to 8% of white respondents.
Even as the pandemic exacerbated mental health issues and normalized the idea of seeking therapy, there remains a vast shortage of mental health practitioners globally. The World Health Organization estimates that in 2020, there were only 13 mental health workers per 100,000 people in the world, up from nine per 100,000 in 2014. But what’s worse is that this ratio can wildly vary between low- and high-income countries—by as much as 40 times.
But things are changing, even if very slowly. Therapists are now far more visible on social media, collectively trying to erase the taboos around mental health and make therapy more accessible.
And unlike dating—or, in fact, much like it—if you apply the right filters, ask the right questions, and stay invested in the process, you could soon be reaping the rewards of peace and good mental health.
A step-by-step guide to getting started with therapy
Choosing a therapist
- Check databases. If you’re in the US, you can check the psychologist locator from the American Psychological Association or the National Register of Health Service Psychologists; both allow you to apply various filters including budget and insurance. In countries like India, where a comprehensive database does not exist, psychologist collectives are using social media to spread awareness. For instance, Therapize India and Inner Hour, among countless others, use social media to make therapists more easily accessible. But the process that is likely going to be most stress-free is to ask friends, neighbors, or even colleagues for references, if you are willing to share the fact that you want to be in therapy. I found my therapist through a crowdsourced list via Twitter, and it helped to know that others in my age group had recommended her.
- Ask the right questions. Is the therapist queer friendly? Are they trauma informed? Do they have experience in dealing with family and cultural situations similar to yours? Don’t be afraid to ask them the treatment approach they follow, and do a little research beforehand on the methodology that might work best for you.
Your first session
- Go in with an open mind. Your first session, in most cases, will be like a coffee date. You’re just there to chat, to establish context, to see how the other person reacts to your cues. Stay open and honest, and notice where you start to put your guard up.
- Watch out for red flags. From personal experience, I have gathered that if your therapist begins by offering neatly packaged advice before listening to your story, this is possibly a red flag. The purpose of therapy, a good therapist will tell you, is not to “fix” you, but to help you see your current problem for what it is. If a therapist makes moral judgments that instantly put you on guard, as Gurugram-based therapist Bhavya Kulshreshta shares on her Instagram page, you probably need to nip it in the bud. A therapist should give you all their attention, not be checking their phone in the middle of a session or cutting you short while you’re speaking. That said, they will be mindful of the clock and gently nudge you to close the conversation once the hour is up. A therapist will also never share deeply personal details about their own lives and keep a professional veneer up to avoid the all-too-common issues of projection.
Finding a therapist as a person of color
It can seem logical to try to find a therapist from your own cultural background. More and more Black people, for example, have contacted therapists within their own communities; white mental health practitioners, many feel, simply cannot understand the centuries-old trauma of racism that impacts their lives and families so deeply.
This can be true for south Asian people too, who often find themselves alienated in countries away from home, struggling similarly with racism. Uninformed therapists often fail understanding, understand the cultural context for behaviors, anxieties, and familial dynamics.
It isn’t necessary to find a therapist from one’s own community, even though it might ease the process. The right therapist, regardless of their racial background, could ask insightful questions to help their clients think critically. It will also likely be harder, given that 86% of the therapists in the US are white.
But don’t be afraid to ask questions about their awareness of and experience in working with diverse communities. Community-specific mental health initiatives like LatinxTherapy, InnoPsych, Black Men Heal, and Therapy for Black Girls can also often be good starting points.
Paying for therapy
With insurance: Finding the right therapist who also accepts your insurance can be quite tricky. If you’re searching via the databases, make sure to use the right filters.
Out of pocket: Navigating insurance is also a developed world problem, and several countries globally do not have comprehensive insurance plans for mental health. In low-income countries, 56% of the people pay mostly all their mental health bills out of pocket, according to the WHO’s Atlas 2020 report on mental health.
In India, for instance, serious mental illness that requires hospitalization may be covered by insurance—and with restrictions. But your therapist’s bill will likely need to be paid by you. In such cases, it’s always good to work out a payment plan with your therapist. Some even offer reduced rates for people from marginalized communities.
The limits of therapy
A therapist is qualified to help you with cognitive and emotional issues, but not when they manifest into severe physical symptoms. For starters, they are not qualified to prescribe medication. The main purpose of therapy is to help you adapt to changes and cope with past trauma. But it could mean different things for different people.
If your therapist feels that your mental condition is impacting your daily functions—sleep, eat, work, socializing—they may refer you to a psychiatrist. Psychiatrists generally focus on the biological aspect of mental health, though they don’t always exclude talk therapy from their treatment approach. Often, the psychiatrist and the therapist who referred them would work together for more well-rounded treatment.
- How to manage burnout (Quartz at Work)
- A mental health crisis brewing among South Asian immigrants in the West needs serious attention (Quartz)
- How to support employee mental health from every level of the firm (Quartz at Work)
- Therapists Are on TikTok. And How Does That Make You Feel? (New York Times)
- The mental health therapy-app fantasy (The Cut)
Have a mindful weekend,
—Manavi Kapur, Quartz India reporter (follows far too many self-help and therapy accounts on Instagram)
One 🤔 Thing
Got some unprocessed feelings from the pandemic? You’re far from alone. On a recent episode of the podcast On Being, host Krista Tippet spoke to author and therapist Pauline Boss about the idea of “ambiguous loss”: feeling grief without the expectation or possibility of true closure. In the case of the pandemic, when we mourn the loss of people and the lives we led, this episode was particularly poignant for talking about the unanswered questions and “losses minus facts.”