Starting therapy comes down to a handful of concrete steps: figuring out what you can afford, finding a provider who fits your needs, and making that first call. The process feels overwhelming mostly because nobody walks you through it. Here’s what to do, in order.
Figure Out What You Can Pay
The national average for an individual therapy session in 2025 ranges from $100 to $250, depending on where you live, the type of therapy, and the provider’s credentials. Licensed professional counselors (LPCs) typically charge on the lower end, around $100 to $174 per session. Psychologists, who hold doctoral degrees, charge $175 to $250. Knowing this range helps you set realistic expectations before you start searching.
If you have insurance, call the number on the back of your card before you do anything else. Ask these specific questions:
- Is therapy covered for both in-person and online visits?
- Do I need a diagnosis to be covered?
- Is there a cap on the number of sessions per year?
- What is my copay for in-network versus out-of-network therapists?
- Do I have to meet a deductible first?
The difference between in-network and out-of-network can be substantial. An in-network copay might be $25 to $50, while out-of-network reimbursement could leave you covering most of the cost yourself. Getting these numbers upfront saves you from surprise bills later.
If you don’t have insurance or your coverage is thin, many therapists offer sliding scale fees. These are reduced rates based on your household income and number of dependents, often pegged to a percentage above your state’s poverty level. You’ll typically need to provide documentation like pay stubs or a tax return. Don’t be afraid to ask about this. Therapists build it into their practice expecting people to use it.
Understand the Different Provider Types
The alphabet soup of credentials can be confusing, but the distinctions are simpler than they look. Psychologists hold doctoral degrees and are trained in psychological testing, evaluation, and therapy. They can diagnose conditions and often specialize in specific approaches like cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT). They cannot prescribe medication in most states.
Licensed professional counselors (LPCs) and licensed marriage and family therapists (LMFTs) hold master’s degrees and complete thousands of hours of supervised clinical experience. LPCs work with a broad range of mental health concerns. LMFTs specialize in relationship and family dynamics, though many also see individuals. Clinical social workers (LCSWs) also hold master’s degrees and are trained in both therapy and case management, meaning they can help connect you with community resources beyond the therapy room.
For most people seeking talk therapy for anxiety, depression, relationship issues, or life transitions, any of these provider types can be a good fit. The specific person matters more than the credential category.
Choose a Therapy Approach (or Don’t)
You don’t need to pick a therapy style before your first session. Most therapists will recommend an approach based on what you’re dealing with. But having a basic understanding can help you ask better questions.
Cognitive behavioral therapy (CBT) is the most widely studied approach. It focuses on identifying thought patterns that drive your behavior, then actively challenging and changing those patterns. CBT tends to be structured, with homework between sessions, and it’s commonly used for depression and anxiety. Dialectical behavior therapy (DBT) adds mindfulness and emotional regulation skills, and it’s particularly effective for people who struggle with intense emotions or self-destructive patterns. Psychodynamic therapy is less structured, more open-ended, and explores how past experiences shape your current feelings and relationships.
If you’re not sure, that’s fine. A good therapist will tailor their approach to your situation during the first few sessions.
Search for a Therapist
Several online directories make it easy to browse therapists by location, insurance, specialty, and identity. Psychology Today’s directory is the most widely used and lets you filter by dozens of criteria. Headway’s directory is particularly useful if you want to find someone who accepts your insurance, with nearly 50,000 providers listed across all 50 states. TherapyDen allows you to search for therapists who align with your values and identity.
If finding a provider who shares your cultural background matters to you, specialized directories exist for that. Therapy for Black Girls, Therapy for Latinx, Asian Mental Health Collective, and Inclusive Therapists all focus on connecting clients with providers from specific communities.
When browsing profiles, pay attention to three things: what issues they list as specialties, what therapy approaches they use, and whether they mention your insurance or offer sliding scale. Most profiles include a short bio. Read it. You’re looking for someone whose tone and focus resonate with what you need.
Make a Short List and Schedule Consultations
Pick two to four therapists and reach out. Many offer free 15-minute phone consultations before you commit to a full session. This is your chance to get a feel for whether you’d be comfortable talking to this person. Harvard Health Publishing recommends asking questions like:
- What kinds of treatment do you think might help me?
- How does your approach work in practice?
- How will we track my progress?
- How long have you worked in this field?
- What will treatment cost, and do you offer a sliding scale?
Trust your gut during these conversations. You’re not looking for the most impressive resume. You’re looking for someone you could be honest with. The relationship between you and your therapist is the single most consistent predictor of good outcomes across all types of therapy.
Online Therapy Is Equally Effective
If commuting to an office feels like a barrier, or if your area has limited options, online therapy is a legitimate alternative. Research comparing telehealth to in-person therapy found no significant differences in depression symptom reduction or quality of life improvements between the two formats. This held true across different levels of care intensity.
Online sessions work well for most talk therapy. They’re less ideal if you need in-person assessments, or if your living situation doesn’t offer a private space to talk. Most therapists who offer telehealth use a secure video platform, and your insurance coverage typically applies the same way it would for an office visit.
What Happens at the First Session
Before your first appointment, you’ll fill out intake paperwork. This usually includes consent forms, privacy notices, emergency contacts, demographic information, a good faith estimate of fees, and a questionnaire about your mental health history. Some therapists also use brief standardized assessments to get a baseline on symptoms like depression or anxiety.
The session itself is mostly about the therapist getting to know you. They’ll ask about what brought you in, your current symptoms, your family background, any history of trauma, your medical history, substance use, relationships, work, housing, and general life circumstances. It can feel like a lot of personal questions in a short time. That’s normal. You don’t have to share everything at once, and a good therapist won’t pressure you to.
Toward the end, you’ll talk about goals. What do you want to be different? The more specific you can be, the better your therapist can build a plan. “I want to feel less anxious” is a starting point, but “I want to be able to speak up in meetings without my heart racing” gives your therapist something concrete to work toward. You’ll also get a preview of what the next session will look like and possibly some things to reflect on before then.
Give It a Few Sessions
The first session is not representative of what therapy feels like once you settle in. Intake is information-heavy and can feel clinical. The actual therapeutic work usually begins in sessions two through four, once your therapist has enough context to start guiding the conversation more purposefully.
If after three or four sessions something feels off, it’s completely reasonable to switch therapists. Not every match works, and finding the right fit sometimes takes more than one try. You can tell your current therapist directly, or you can simply schedule with someone new. You don’t owe anyone an explanation, though honest feedback can help both of you.
The hardest part of starting therapy is almost always the logistics: making the calls, checking insurance, filling out forms. Once you’re sitting in that first session, you’ve already done the heaviest lifting.