Monday, July 11, 2022

What do I do if I can't find a therapist?

Many folks are reaching out for support and treatment with therapists in these turbulent times. I receive at least 1 call (more like 3 or 4) per week from people looking for a therapist. Most want to use their insurance which is understandable. I use my health insurance for therapy too. Most of the therapists I know in my local area, especially those who are able to take insurance are full and cannot take new clients. Some have waiting lists, some are just having to turn people away. For me, I did not become a therapist to tell people I cannot help them. I think about those folks who are reaching out for support and not getting anywhere. I have tried to have a waiting list in the past but it has never worked out. 

Below are some suggestions for practical ways to get into therapy and also some suggestions/skills that you can start using today. I put the skills first and the financial stuff toward the end. You can scroll ahead of you to learn about Superbills and dealing with your insurance. 

While having a relationship with a therapist can be very valuable to help you sort out what is going on, these are some of the things I tend to recommend when we first meet. The relationship and talking things through is one part of healing. Most of the healing you do on your own, by conscious practice and working to create new habits. We meet for 1 hour a week and the rest of the time, the transformation happens within you. Every time you notice an unhelpful pattern and make a choice to do something different, you are healing yourself. Every time you acknowledge your feelings and needs, you are healing. I am going to skip some of the general things like ask your friends about their therapist, or try yoga, or the suicide/crisis hotline info. This is not meant to be a substitute for therapy but a starting point. 

These are in no particular order. 

1. Learn about how your brain and nervous system works. My approach starts with teaching people about how our bodies work. I utilize the Polyvagal theory to help people understand this idea. Polyvagal Theory is the idea that your nervous system has multiple states and by learning what those are, we can learn how to feel more calm and in control in the world. By understanding the pathway and function of the vagus nerve (which every single person has already), you can strengthen that existing pathway and feel better. The reason why things like yoga, breathing exercises, and meditation are recommended (and show benefits) are because they strengthen the vagus nerve and parasympathetic nervous system. Those mindfulness, meditation, and breathing exercises are the equivalent to the work out of the day at the cross fit gym, but its for your nervous system and thoughts. Whether you work with a therapist or not, it takes time and repetition to build up that muscle, much like training to run a 5K. Many of us spend a lot of time in an anxious/stress response, and learning to calm your body using your own pathways can be very valuable.  Here are some resources:






2. Start a therapy workbook. I believe there is something powerful about sharing our story and thoughts with another person, and sometimes we don't have someone in our life who can listen in the way we need them to. Friends and Family might jump to fixing or helping, or they may not know how to respond. They may even be the source of some of the issues. You may not feel ready to share those thoughts with the people closest to you. Whatever the situation is, working through some of the ways we think, the narrative we tell ourselves can help us understand why we feel the way we do. 

Here are some free workbooks on a variety of topics (Mood fluctuations, Assertiveness, Perfectionism,
Procrastination, Self-Compassion, Sleep, and so much more)They are evidence based and provided by a psychiatric service based in Australia.  https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself


The 12- Week DBT Workbook (Written by a local Athens GA therapist!) 



3. Learn about Radical Acceptance and Self Compassion. These practices and ways of being in the world help us become more loving to ourselves and others. Its hard enough out in the world, learning to be loving and kind in your thoughts towards yourself can be valuable tool for improving your life. 

Self Compassion Exercises with Dr. K. Neff




4. If you are not sleeping or sleeping too much, consider talking to a primary doctor about this issue specifically. They can talk to you about over the counter and prescription aids, as well as help you identify behavioral changes. There are several supplements and over the counter things you can take to assist with sleep but it is best to consult with a doctor before starting something you haven't tried before. Sleep is the cornerstone of health. Every thing is easier when you are sleeping regularly. I know its hard to make the changes needed but sometimes small things can add up to big gains. It might feel like everything is on fire right now. You still need rest. You still deserve rest. Here are some free resources for improving your sleep:




Here is some content about rest that changed the way I think about rest and recovery. 





5. Trust that you are an expert on yourself. You can do a lot of research and gain understanding without the help of a professional. Yes, we therapists have knowledge and perspective that can be valuable and needed. You also have the world of human knowledge available on this screen (for better or worse). Here are some self tests and assessments that might be helpful in gaining some insight into what's going on with you. Please note, you maybe found me because I am a specialist in trauma. Which means maybe you have had some trauma of your own. (I think most of us have had trauma and its the root of most mental health struggles). Take gentle care of yourself when reading content about trauma or taking any assessments. Just thinking in broad terms about the difficult things that happened can activate your memory of your own difficult experiences. Take a break as often as needed. Keep a journal nearby to write down any thoughts, memories, or sensations that arise when you are taking in content about healing or doing self assessments. Maybe invite your friends over and take a bunch of tests together. Also, please remember, you can have some traits or symptoms of a thing, and not have a full blown disorder. I only offer these tests because they can sometimes help us understand what areas you are struggling in and help you gain more insight into your own experience. 








6. If you have health insurance, call the behavioral health or provider finder number on the back of your card. They can sometimes do some of the leg work to find someone for you. Also, it lets them know the demand is there. When you contact your insurance, ask if you have "Out of Network Benefits." This means your insurance company may reimburse you if you work with someone who does not take insurance. This requires the therapist you chose to provide a "Super Bill" which includes a lot of numbers and codes. You pay the therapist up front and then they give you the super bill. You then submit that bill to your insurance yourself and then they send you some of what you paid back. It can reduce the cost enough to make it affordable, if you have the cash up front. 

7. Widen Your Search. Look on Therapy Den or Psychology Today for therapists outside of your local area who may provide telehealth services. I prefer in person visits, but meeting with someone online who is a good fit for your needs is better than not meeting with anyone at all. Consider if you can afford someone who doesn't take insurance. Most therapists charge between $75-250/session depending on their license, specialty, and location. Look to see if someone has a sliding fee scale. Maybe being able to see someone a few times at a self pay rate can be worked out for a short time to help you get an idea of what you need. 

8. Please do not give up. There are many wonderful therapists. There are some who you may not get along with because of personality, background, or approach. But that's ok. There is someone out there for you and you can find them. Learn to rest and not put so much pressure on yourself. Hopefully, sooner rather than later, you will find a therapist, a mentor, a teacher, who will help you on your path. Just keep going. Taking the next step, resting when you need to, stay hydrated, and remember a million tiny steps can get you pretty far. 

Thank you if you read this far. Be kind. 

With love, 
Valerie 


PS: if you made it this far, here is a picture of my cat Zelda as a bonus. She naps when she wants to, has a snack when she needs to, and doesn't take any nonsense from anyone. She has excellent boundaries. She had some trauma early in life that makes it hard to trust people and loud noises are very scary. But we've worked through that and she feels more secure in the world, I think. And we worked on it with mindfulness, kindness, love, and patience. You could give yourself that gift today.