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getting through the door to therapy:

the nuts + bolts.

No one teaches a course on this. How do you go from abstractly toying with the idea of maybe possibly starting therapy to actually getting through the door for your very session first session? Deciphering deductibles, thinking through therapeutic orientations, and wading through waitlists can all feel overwhelming and complex. Whether it's your first or fiftieth time, this very brief guide seeks to demystify some of the steps it takes to start--and sustain--a positive therapeutic relationship.

Hotel Key


Before you hit the lot to buy a new car you probably have an idea of what you can afford, whether you'll pay in cash or take out an auto loan, and how this all will impact your monthly budget. Let's do the same for therapy!


People choose to pay themselves and not use insurance (self-pay) for many reasons. Maybe the amount your have to pay out of pocket before your insurance kicks in (your deductible) is really high. Maybe your plan doesn't cover the services you want or need Maybe you just prefer to not have insurance companies involved in your mental health care. Discuss this with potential therapists and ask about their rates, if they offer any sort of discounts or sliding-scale fees, and map out how much the therapy you want and need will cost you each month to make sure it fits your budget.


You may choose to use your insurance with a mental health professional who is in or out-of-network. Typically, if you've met your deductible, an in-network therapist will cost you less than self-pay (just the co-pay you have to make for office visits, typically about $25 or $30). If you decide you want to work with a provider who is out-of-network with your insurance, your therapist can provide receipts and other documentation for you to submit to your insurance company for reimbursement. Apps (e.g., GetBetter; Reimbursify) can make this easier.

Because each insurance plan is SO different, you can always call your insurance company to discuss your individual situation. Before doing so, make sure you know the basic terms related to insurance and look over your plan to see what's covered (see below). You can often find this information online and some companies have mobile apps as well.



So you've got a handle on your financial situation. Great! Now you'll move on to finding someone who's the right fit for you and the work that you want to do.

First of all - know that it's not only okay, but wise, to shop around a little for a therapist. You may start by searching online directories like Psychology Today or Therapy for Black Girls. You can look for someone in your area, sort by insurance coverage accepted, and add other features that may matter to you, for example: gender, approach to therapy, or their area of expertise, etc.. After you've read profiles, checked out websites, and developed a short list, you can start reaching out to potential therapists. Don't be discouraged if some folks don't pick up the phone immediately or if they aren't accepting new client at the time of your call. Keep searching and persisting. Your hard work will pay off. You can always ask a therapist who isn't accepting new clients, if they foresee openings in the near future or if they have recommendations for other therapists in the area.

Many therapists offer a free, initial consultation when you can ask questions and start to get to know a bit about them. So - what might you want to ask about during this call?

  • How frequently do you usually meet with clients?

  • What does therapy look like with you? What is your approach?

  • What are your areas of expertise? Where did you train?

  • Here's a brief description of what's going on with me. How might we work on this together?

  • What is your license/degree type - can you share what that means?

  • How would I get started if I want to schedule a first session with you?

Living Room

final decsions

After you've completed phone consultations, you may choose to meet with a therapist for an initial appointment. First appointments in therapy, sometimes known as an intake, are often really different than what a normal session looks like. They tend to be longer, you may need to complete paperwork, and your therapist will ask you *a lot* of questions. The session is a basically a speed introduction to all things you and the therapist is doing their due diligence to make sure they know as much relevant information as possible to best support you and help your pursue your therapeutic goals.

During this session, be sure to be your open, authentic self. You and your therapist are trying to get a feel for if you can work well together. Feel free to ask questions and explore what it may be like to work with this person on a regular basis. Try and attend to how you feel in the room with this potential therapist: even if you're a little nervous, does this seem like someone you can eventually trust and feel connected to?

Be sure to ask key questions that may impact the viability of an on-going therapeutic relationship. Know that you'll never be able to slip out of work in time to make a regular 3.00p appointment? Talk about that! Worry about being diagnoses and what that means? Ask about that! Want your therapist to coordinate care with your psychiatrist? Star that conversation! Your therapist should be happy to think through logistics, explore concerns you have, and respond in an honest, open, and caring way. It's kinda part of the job description. After this session, you will have a pretty good idea of if you would like to proceed with this therapist or continue searching. Either way - you're well on your way!

Still feeling stuck? Reach out to Dr. Peifer for a free consultation.

give me a call (678.561.4187) - shoot me an e-mail (

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