This checklist covers what to sort out before booking your first therapy session: credentials, insurance and costs, format options, and what to expect in that first appointment.

This article is general information about everyday health habits, not medical advice. If you have a health condition, are pregnant or take regular medication, talk to your doctor or another qualified health professional before making big changes to your diet, activity or sleep. Figures come from US public health sources such as the CDC, HHS and the Dietary Guidelines for Americans.

Finding a therapist for the first time can feel like a second job stacked on top of whatever prompted the search. The practical side is mostly checklists, though: what to figure out before searching, what to verify, what to ask, and what a first appointment normally involves. Work through the lists below and the first phone call gets a lot easier.

Know What You Want Help With

Before comparing providers, spend ten minutes writing down what is bothering you and what you would like to change. That short exercise makes the first call easier and turns a long directory into a short list.

• Describe the problem in plain sentences. Saying that Sundays have become something you dread and that worry keeps you awake at night gives an intake coordinator more to work with than a general request for therapy. If it is hard to tell whether what you feel is ordinary stress or something more persistent, Stress or Anxiety? How to Tell the Difference can help you put it into words.
• Decide what kind of professional you need. Some people mainly want someone to talk to, while others may need a specialist who can prescribe medication. Therapists and counselors have specialties too, so it helps to know whether the main concern is worry, grief, relationships or something else.
• See a health care provider first if you can. A primary care provider can do an initial mental health screening and refer you to a specialist, such as a psychologist, psychiatrist or clinical social worker. That visit also helps rule out physical causes, since some medical conditions produce symptoms that resemble mental health ones.
• Plan something for the waiting period. Free peer support groups exist in many areas, and the National Institute of Mental Health notes that self-care can support treatment and recovery. Healthy Ways to Handle Everyday Stress is a practical starting point.
• Set aside myths before you search. If ideas like “therapy is only for crises” are slowing you down, Self-Care Myths That Hold You Back looks at the beliefs that keep people from getting support.

Check Credentials and Licensure

A few early questions weed out providers who cannot answer the basics.

• Confirm the person is licensed. Common licensed roles include psychologist, psychiatrist, clinical social worker and licensed marriage and family therapist. Licensure rules vary by state, so check with your state agency if you want to verify a license.
• Ask about training and certification. A therapist should be able to describe their formal training and certification plainly, without hesitation or roundabout answers.
• Ask how they work. A good sign is someone who can lay out the strengths and limits of several treatment approaches, including ones they do not offer. Some approaches, such as cognitive behavioral therapy, have been studied in large groups of patients and shown to reduce symptoms of depression and anxiety.
• Ask about supervision if the therapist is in training. Therapists in training work under clinical supervision, which means a licensed professional oversees the care they provide. It is fair to ask who supervises them and how often.

Check Your Insurance and Total Costs

• Start with your insurance company. A representative can tell you which local providers are covered, and many insurers offer an app or online database of participating providers. Ask for several names rather than one referral.
• Ask the plan specific questions. Coverage differs from plan to plan, so ask what each session would cost out of pocket, whether approval is needed before starting, and whether there is a cap on covered sessions.
• If you do not have insurance, low-cost options exist. The Substance Abuse and Mental Health Services Administration runs an online treatment locator and a 24/7 referral line, 1.800.662.4357, that include facilities offering sliding scale fees and other special payment arrangements. Universities and teaching hospitals may also provide low-cost or free services, and a federal directory lists clinics that offer low or no-cost care.
• Ask providers directly about sliding scale fees. Some therapists adjust fees based on income, and some directories note whether a provider offers this arrangement.
• Check whether your employer has an Employee Assistance Program. An EAP is free and confidential, paid for by the employer, and can help with mental health concerns, grief, trauma, or drug and alcohol use.

Small step: If cost is the main thing holding you back, try the SAMHSA referral line or your employer’s EAP before deciding therapy is unaffordable. Both can point you toward low or no-cost options.

Decide Between In-Person, Telehealth and Other Formats

• Therapy can be virtual or in person. Both are standard options, so choose based on schedule, privacy at home and what feels comfortable.
• Telehealth widens the pool. Looking outside the immediate area helps when local waitlists are long or a particular specialty matters.
• Consider group formats. One-on-one sessions are the most common setup, but group therapy, where several patients meet with the therapist together, is also standard.
• Know a consultation from an intake. A consultation is a brief, informal conversation to see whether the two of you are a good match. The intake is the first full session, a detailed clinical assessment that sets up a diagnosis and a treatment plan. Asking for a consultation first is a reasonable request.

Questions to Ask on a First Call

Keep this list next to the phone, since one short call can answer most of these.

• What experience do you have with concerns like mine?
• Which types of therapy do you think could help in my situation?
• What sort of timeline do you expect for treatment?
• Are you licensed, and what are your credentials?
• What are your fees, and do you offer a sliding scale?
• How will we check in about whether treatment is working?

There are no trick questions here. If a therapist seems irritated by any of them, that is useful information too.

What the First Session Is Usually Like

• Expect an assessment, not instant results. The intake covers your history, your current situation and what you want to change, and it ends with a treatment plan built together.
• You are interviewing them too. Research on therapy outcomes points to the match between client and therapist as the strongest predictor of how well treatment goes. Notice how it feels to talk to this person, not just what they say.
• You do not need everything figured out. Arriving with a vague sense that something is wrong is normal, and saying so is a fine way to start.
• One session rarely changes much. The goal of the first appointment is a plan and a working relationship, not a breakthrough.

Red Flags, and Knowing It Is Okay to Try Someone Else

• Vagueness about credentials, licensing or fees. A qualified provider answers these questions plainly.
• Promotion of only one method. A therapist should be able to weigh other treatments, not just the one they happen to offer.
• No talk of progress. Ask your therapist to check in with you about progress now and then. If several months pass without noticeable improvement, a second opinion is a reasonable step.
• Any sense that concerns cannot be raised. Treatment tends to go better when you trust the person providing it, and that includes being able to say when something is not helping.
• Expecting the first person to be the only option. It can take time and persistence to find a good match, and trying more than one therapist is common, not a sign of failure.

Still wondering?