Navigating a Map of Choices

December 8, 2020 • 6 Min Read

Whether you are accessing mental health care for the first time or looking for a new therapist, finding a mental health provider can feel overwhelming. But you have the right to find someone who meets your needs. In the words of Zena Sharman, “When choosing a therapist, remember that you’re entering into an intimate relationship with another person and it needs to feel right for you.”

Our team has identified five key questions that you can ask yourself to help you during this process:

1. What are my expectations of therapy?

People access mental health care for many reasons: some are seeking support after a major life change whereas others are looking for strategies to help manage a diagnosis like depression. The answer to this question will inform all your subsequent choices.

Key Questions To Ask Yourself

• What would I like to change or not change in my life?
• What am I looking to gain from therapy?
• How long and how often would I like to work with a mental health provider?

Be prepared to share these thoughts when you start contacting providers.

2. What kind of service am I looking for?

Mental health providers use a variety of approaches when providing services, so think about which of these aligns with your needs and expectations. For example, cognitive behavioural therapy focuses on developing insight into how thoughts, feelings, and actions are connected, whereas mindfulness practices emphasize greater self-awareness through breathing and grounding techniques. Without going into details, ask the provider how they approach and deal with issues that are important to you.

Key Questions To Ask Yourself

• What approach will challenge me to change the most? Examples may include a discussion-based approach (counselling), or alternative arts-based approaches such as drama or music therapy.
• Would I like to participate in a facilitated group with others that have shared experiences, or have a one-on-one in-depth discussion? In MindMap, you can filter services by individual or group settings.
• Am I looking for a provider with expertise in a specific area? Mental health providers may have expertise in areas such as trauma, anti-oppression, grief and loss, and living with chronic pain, as a few examples.

While you may need to be flexible in finding a provider who matches your expectations, giving some thought to preferred approaches will help you narrow your search.

3. Would I like to work with a provider with shared lived experiences?

Working with a provider with shared lived experiences can be very important, especially for individuals who have experienced discrimination or other forms of oppression. In these cases, shared experiences can help to establish trust in the therapeutic relationship. For example, BIPOC individuals may feel most comfortable working with a BIPOC therapist and 2S/LGBTQ+ individuals may prefer to work with another individual who also identifies as 2S/LGBTQ+.

Use the 2S/LGBTQ+ filter on MindMap to find services that are explicitly 2S/LGBTQ+-affirming. For services not listed in MindMap, indications that a mental health provider may be 2S/LGBTQ+-affirming and/or a member of 2S/LGBTQ+ communities include:

• Listed experience and professional development working with 2S/LGBTQ+ communities
• Visual indicators of support (e.g. trans flag) displayed
• Identity self-disclosure (e.g. pronouns/sexuality)
• An explicit statement of support for LGBTQ2S+ communities

This is also a great opportunity to ask friends if they have any suggestions for providers and consult local 2S/LGBTQ+ agencies for a list of mental health providers experienced in working with 2S/LGBTQ+ communities. Other resources can help this process, such as https://www.healingincolour.com/directory, which lists Canada-wide BIPOC therapists who have agreed to an explicitly pro-queer value statement.

4. What are my cost, accessibility, and scheduling needs?

Therapy can be costly, especially for those without private insurance. Look into whether you have mental health coverage and which designations of providers are covered. Reflect on how much you can afford to pay out of pocket for mental health care. Many community organizations offer free, sliding scale, or low-cost services for a limited number of sessions, although waiting lists for these services can span months. Try exploring the sliding scale and free filters within MindMap.

If you’re seeking in-person care, consider the service location and accessibility features of the building. Many mental health care providers also offer remote services, allowing you to expand your search beyond local providers. When accessing remote care, it’s helpful to have a fast internet connection and a private space to take calls.

Key Questions To Ask Yourself

• How much can I afford to pay for mental health care?
• Would in-person or remote services work better for me?
• Do I have a private space and appropriate technology to access remote services?

5. How do the initial consultation and first few sessions feel to me?

You’ve gone through all the grunt work and found a provider that appears to meet your needs - great! Most providers offer a free initial consultation, which is an excellent opportunity for you to ask them questions. It can also be beneficial to consult with multiple providers to see if they feel like a good fit.

After the initial consult and first few sessions, check-in with yourself about how things went.

Key Questions To Ask Yourself

• Did I feel comfortable expressing my experiences and feelings?
• Did I feel respected?
• Did I feel better after the session?

If things don’t feel right, don’t be afraid to articulate your concerns, share feedback on your experience, or look for another therapist. If you don’t feel comfortable opening up to your therapist, you won’t get the most out of your time together. It’s okay to end the relationship and try looking elsewhere (this time perhaps with a clearer picture of what you’re looking for!). Your first obligation is finding the mental health care that works best for you.

We hope that these considerations provide clarity and guidance as you search for the mental health care that best suits your needs.

This piece was written by Natasha Vitkin, with input from SMHART, Eric Howey, and Meera Dhebar, and informed by research sponsored by the SFU Community-Engaged Research Initiative. We were inspired by Zena Sharman’s article “Five tips on finding an LGBTQ2-affirming therapist, according to LGBTQ2 providers” and content on GoodHead.ca.