Getting into therapy involves a handful of concrete steps: figuring out what kind of provider you need, finding one who fits your budget and schedule, and making the first appointment. The process can feel overwhelming when you’re already struggling, but most people can go from searching to sitting in a first session within one to two weeks. Here’s how to move through each step.
Decide What Kind of Provider You Need
The mental health field has several types of professionals, and they differ in meaningful ways. A therapist or counselor typically holds a master’s degree in counseling psychology, marriage and family therapy, or a related field. They’re trained to evaluate mental health and help you work through problems using talk-based techniques. A clinical social worker also holds a master’s degree and can provide therapy, with additional training in advocacy and connecting you to community resources.
A psychologist holds a doctoral degree (a Ph.D. or Psy.D.) and can conduct psychological testing and evaluations in addition to therapy. Some specialize in specific approaches like cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT). A psychiatrist is a medical doctor who can prescribe medication. If you think you might benefit from medication for depression, anxiety, or another condition, a psychiatrist or a combination of a therapist plus a prescriber is the route to consider.
For most people starting out, a licensed therapist or counselor is the right first step. If you need medication or more specialized evaluation, they can refer you.
Choose a Therapy Approach (or Don’t)
You don’t need to pick a therapy style before your first session. But knowing the basics can help you ask better questions when you’re shopping around.
CBT focuses on the connections between your thought patterns, behaviors, and symptoms. It’s widely used for depression, insomnia, and substance use issues, and it’s one of the most researched approaches in mental health. DBT teaches skills for managing impulsive or harmful behaviors and is commonly used for borderline personality disorder, PTSD, depression, and relationship challenges. EMDR pairs guided eye movements or other sensory cues (like tapping) with the processing of traumatic memories and is primarily used to reduce PTSD symptoms.
Many therapists blend techniques depending on what you’re dealing with. A good therapist will explain their approach in your first session and adjust it as you go.
Find Therapists to Contact
There are several practical ways to build a short list of therapists to reach out to.
- Your insurance company’s provider directory. If you have health insurance, start here. Log into your plan’s website or call the member services number on your card and ask for in-network mental health providers near you. This is the fastest way to find therapists your plan will cover.
- Online therapist directories. Sites like Psychology Today’s directory, the ADAA’s Find Your Therapist tool, and the Open Path Collective let you filter by location, specialty (anxiety, grief, ADHD, eating disorders, LGBTQ+ issues, and dozens more), insurance accepted, and session format.
- Your primary care doctor. A physician who knows your health history can make a targeted referral, especially if your mental health is tangled up with a medical condition or medication side effects.
- Your employer’s EAP. Many workplaces offer an Employee Assistance Program that provides a set number of free therapy sessions, usually three to six. Call the number on your benefits card or ask HR.
Aim to contact three to five therapists. Many won’t respond immediately, and some won’t have openings, so casting a slightly wider net saves time.
What the First Contact Looks Like
Most therapists offer a brief phone consultation, typically 10 to 15 minutes, at no charge. This isn’t a therapy session. It’s a chance for both of you to see if there’s a basic fit. Harvard Health Publishing recommends asking questions like:
- What certifications or degrees do you hold?
- How long have you worked in this field?
- What kind of treatment do you think might help with what I’m dealing with?
- How will we know if I’m making progress?
- How much will sessions cost, and do you take my insurance?
Pay attention to how you feel during this call. Do they seem to understand what you’re describing? Do they explain things clearly? Therapy depends on the relationship between you and your therapist, so a sense of ease matters more than credentials on paper. If the fit doesn’t feel right, move on to the next person on your list. This is normal and expected.
Understand the Costs
The average cost of a therapy session in the U.S. is roughly $139, based on 2024 billing data, though it varies widely by state, ranging from about $122 to $227 per session. That’s the blended average across both private pay and insurance-billed sessions.
If you have insurance, federal law is on your side. The Mental Health Parity and Addiction Equity Act requires most health plans to cover mental health benefits with copays, coinsurance, and visit limits that are no more restrictive than what they impose on medical or surgical care. In practical terms, this means your plan can’t charge you a higher copay for a therapy visit than it would for a comparable medical visit, and it can’t impose a cap on therapy sessions that doesn’t exist for other care. If your plan denies coverage or limits sessions in a way that seems unfair, you have grounds to appeal.
For in-network therapists, you’ll typically pay a copay of $20 to $50 per session. Out-of-network therapists cost more upfront, though some plans will reimburse a portion if you submit claims.
Options When Money Is Tight
Cost is one of the biggest barriers to starting therapy, but several options exist below full market rates.
University training clinics are one of the best-kept deals in mental health. Graduate programs in psychology, counseling, and social work run clinics where advanced students provide therapy under the close supervision of licensed faculty. Sessions often cost $15 to $50, with further reductions available based on income. The University of San Diego’s training clinic, for example, charges $30 per session after the first visit, with scholarships that can drop that to $15. Search “[your city] university counseling training clinic” to find one near you.
Community mental health centers offer therapy on a sliding-fee scale tied to your income. Open Path Collective is a nonprofit network of therapists who offer sessions between $30 and $80. And many therapists in private practice reserve a few sliding-scale spots on their caseload. It’s worth asking directly when you call.
Online therapy platforms are another option, though they’re not always cheaper. BetterHelp charges $70 to $100 per week (roughly $280 to $400 per month) for messaging access plus live sessions of 30 or 45 minutes. Talkspace runs about $396 per month for four video sessions and text-based therapy. Some of these platforms accept insurance, which can bring the cost down significantly. The tradeoff is convenience: you can schedule sessions from home and switch therapists easily if the first match doesn’t work.
What to Expect in Your First Session
The first full session, sometimes called an intake, usually lasts 45 to 60 minutes and feels more like an interview than deep emotional work. Your therapist will ask about what brought you in, your personal and family history, any medications you take, and what you’re hoping to get out of therapy. They’ll likely explain how they work, what approach they plan to use, and how often they recommend meeting.
It’s common to feel a mix of relief and discomfort. You don’t need to share everything in the first session, and a good therapist won’t push you to. Most people start with weekly sessions and adjust the frequency over time as they settle in.
If You Need Help Right Now
If you’re in crisis or having thoughts of suicide, the 988 Suicide and Crisis Lifeline is available 24 hours a day, 7 days a week. You can call or text 988 to connect with a trained crisis counselor. The Crisis Text Line is another option: text HOME to 741741. These services are free and confidential, and they can also help you find ongoing care once the immediate crisis passes.