Guide: How To Find A Therapist

Mental Performance Consulting is not therapy. There are times when you and your Mental Performance Consultant (MPC) may discuss tougher or uncomfortable topics (i.e. team dynamics, burnout, performance anxiety and fear…etc.) but MPCs do not treat or diagnose mental health. The goal of consulting is to provide psychoeducation and mental skills training that improves your athletic performance so if you and your MPC come across a topic they feel could be better tackled by a licensed professional, they may refer you out. Typically this doesn’t mean you stop working with your MPC or have to leave your sport, but rather begin to form a team with other professionals better suited to support you. This is no different than how you have a head coach for your sport, and then strength and conditioning coach for your gains, an athletic trainer for injuries & rehab, a sport nutritionist...and so on. This guide was created to help address just how to find that person to add to your team.



10 Reasons to Try Therapy:

  1. A space to prioritize time where you can focus on you; be seen, heard, understood and not judged.

  2. Clarity in an area of your life; understand your behavior, past, or the core of your issues.

  3. Help working through complex emotions.

  4. To move forward from a traumatic experience or grief and loss.

  5. To learn new techniques to cope with difficult situations.

  6. Personal growth and constructing a future in alignment with your goals.

  7. Challenge negative patterns; learn healthy ways to regulate negative emotions and unlearn protective behaviors that no longer serve you.

  8. Help separating your struggle from your identity.

  9. Learn strategies to manage toxic people.

  10. Increase your belief systems, self-worth and self-esteem.

Outcomes:

According to The Hidden Opponent around 30% of student athletes and 35% of elite athletes report experiencing mental health conditions and only ~10% seek help (“Mental Health and Athletes”; Athletes for Hope, 2021). Athletes become accustomed to working under such stressful extremes of practice and competition and pushing themselves to their limits that sometimes it feels a part of sports culture to just accept what’s also going on mentally.


“It can be difficult to imagine that a person who can produce so much success on the athletic field would experience anything other than pleasure, pride, and an unending supply of self-confidence. But mental health issues don’t discriminate,” - Caroline Silby, Clinical Sports Psychologist and former member of the U.S. National Figure Skating Team.


The good news is that therapy is effective for most people and the majority of people who go to therapy (75-80%) share they’re better off for it. Naomi Osaka, Michael Phelps, Abby Wambach, and many other athletes have weighed in on what it was like to seek additional support:


“Not talking about our inner lives robs us of really getting to know ourselves and robs us of the chance to reach out to others in need. So if you’re reading this and you’re having a hard time, no matter how big or small it seems to you, I want to remind you that you’re not weird or different for sharing what you’re going through. Just the opposite. It could be the most important thing you do. It was for me.” - Kevin Love, Cleveland Cavaliers.

Read: AASP Statement on the Continuum of Mental Health & Relationship to Performance: A Response to the Conversation Supporting Naomi Osaka and Simone Biles


Read: AASP's 'How To Identify the Right Provider'


 

PART I:

How To Find A Therapist in Ontario, Canada: The Basics*


*All information was compiled using multiple resources provided by the Canadian Psychological Association and other professional advice associated with the organization. Guide is specific to Ontario, Canada only. Skip Ahead to Part II if based in the U.S.


Last updated Feb. 2022.


COST CONSIDERATIONS:

1. Consult Your Insurance Provider

If you plan to cover therapy through your insurance, your first step might be to look through your plan to find out what/who is covered. In general, OHIP will cover psychiatrists and other medical professionals (MD) but typically only partially cover (if they do cover at all) the cost of therapy from other non-medical providers (i.e. psychologist). However, most non-medical providers are typically covered by employer benefit plans. Therapists might advertise that they provide a ‘sliding scale’ which means they are willing to lower their cost per session to a specific number (for example; “Yes I have a sliding scale. If you need a re-priced session, I am willing to go as low as X…”) or they will work with your specific budget. Even if it’s not advertised, you can still ask and I encourage you do.

  • Call and ask directly “Will I need to pay you directly and then seek reimbursement from my insurance company or do you bill the insurance company?” if you believe you have found a therapist to double check.


2. Try Online

Due to the pandemic, most therapists have begun offering virtual sessions to work with Covid-19 restrictions and stay safe. However, there are also several apps like TalkSpace or BetterHelp that offer the tools to help you explore the kind of therapy you want. Don’t think you have to go the “traditional” route. Weekly sessions range from $35-$80 and will also be provided by licensed professionals (as discussed below).


For Ontario and Manitoba: https://myicbt.com/home

"[...] offering AbilitiCBT for free to all their residents age 16 or older for the anxiety, depression, and anxiety related to a pandemic programs."


3. Access Affordable Options

Look local to you for nonprofit organizations, university counseling centers (for students or the community), support groups, and options through employee assistance programs (EAP).


WHO AM I LOOKING FOR?:

1. Know Before You Go

Make sure you are working with a licensed professional who possesses some letters around their name. Terms to know:


Psychiatrist - MD (they will have Dr. before their name)

Regulated by Royal College of Physicians and Surgeons

Education Level: Medical School

Provide Diagnosis: Yes | Provide Medications: Yes

Price Range: OHIP Coverage, $100-$200

  • Overview: Specializes in the diagnosis and treatment of mental illness and focuses on complex mental health. In an outpatient setting psychiatrists typically manage medication and often work with another practitioner who handles the therapy if they do not integrate psychotherapy into their practice.

Psychologist: Ph.D, Psy.D, Ed.D, D.Psy. and use C.Psych (they will also have Dr. before their name)

Regulated by CPO

Education Level: Doctoral Level

Provide Diagnosis: Yes | Provide Medications: No

Price Range: $160-$250

  • Overview: Though PhDs are often doing research, some offer therapy and private practice. Many of these individuals will have a very specific area of interest or expertise, which can be great if their interest matches your needs. They cannot prescribe medications, but may work with a psychiatrist who does medication management.They are trained to assess and diagnose challenges in thinking, feeling, and behavior to help individuals overcome challenges.

Psychological Associate: M.A., M.Sc, M.P., M.Ed and use C.Psych.Assoc

Regulated by CPO

Education Level: Masters Level

Provide Diagnosis: Yes | Provide Medications: No

Price Range: $160-$250

  • Overview: The difference between a Psychologist and a Psychological Associate is how they are trained as they both provide the same service. Psychological Associates have completed a masters level degree in psychology which is then followed by four years of supervised experience working in the practice of psychology instead of pursuing a PhD.

Psychotherapist: M.Ed, M.A., M.Div, M.Sc, MPS and use RP or PA

Regulated by CRPO

Education Level: Masters Level or diploma in counseling and psychotherapy; can be Registered Nurses (RN) in a medical setting vs private practice.

Provide Diagnosis: No | Provide Medications: No

Price Range: $110-$180

  • Overview: They offer counseling and many practice a range of different therapeutic approaches. They may have additional certifications based on their specific area of interest or experience (even more letters after their name). These practitioners specialize in providing counseling on interpersonal, social, and psychological obstacles which have come as a result of mental health challenges.

Social Worker - MSW, RSW, RCSW

Regulated by OCSWSSW

Education Level: Masters

Provide Diagnosis: No | Provide Medications: No

Price Range: $120-$180

  • Overview: Trained to conduct assessments of an individual’s functioning and needs but do not diagnose. Their approach often takes into consideration the context of an individual’s system and typically earn additional certifications in evidence-based therapeutic treatments (even more letters after their name).

Counsellor - CCC

  • Overview: Psychotherapy and counselling are interrelated. Both involve conversations between client and provider aimed at helping the client achieve changes within themselves and in their lives. Psychotherapy is often treatment based in response to a diagnosable mental health issue such as depression, bi-polar disorder, attention deficit hyperactivity disorder, adjustment disorder, etc. It is often in-depth and used in conjunction with psychotropic medication, but not necessarily. Counselling tends to be wellness oriented, providing increased insight and learning how to effectively overcome problems and challenges. Unlike psychotherapy, however, counselling is not a protected title in Ontario. Counsellor is a broad term that can include some of the professionals listed above, including providers who are not licensed/regulated. Some counsellors may seek certification with the Canadian Counselling and Psychotherapy Association to obtain the credential of Canadian Certified Counsellor (CCC).

You can use these online resources to help you find the right person. Note that this list is not all inclusive and there may be more sites available to you to use than just these. The hope is that this list gives you a start.


General Search Links:

Inclusive Counseling:

Asian Canadians:

Punjabi, Hindi, Urdu and Malayalam-speaking:

Faith-based: Islamic

Black Canadians:

Indigenous:

LGBTQIA2S:

2. Think About Your Goals Ahead Of Time

You might already know what it is you’re seeking help for and this can help you narrow your field of scope when looking for a therapist. For example, you may want a therapist who is familiar with anxiety and low self-esteem. Maybe you’ve become concerned about disordered eating and want someone with lived experience too (meaning they’ve gone through what you’re experiencing). Don’t forget you can also further hone in on a therapist not only for what they have experience working with, but also how they work with or treat clients. This is often referred to their theoretical orientation or their approach and looks like the types of therapies they provide. Terms to know:


Psychodynamic

  • May be good for addressing depression, anxiety, eating disorders, somatic symptoms, substance use disorder

  • You will work to explore the connection between your unconscious mind and your actions by examining your emotions, relationships, and thought patterns. May be a longer-term approach to mental health treatment compared to other therapies as it explores past events.

Behavioral Therapy

  • May be good for addressing anxiety, phobias, ADHD, OCD, ODD, substance use disorder, behavioral issues that result form communication difficulties or emotional challenges

  • You will focus on the ways to change behavioral reactions and patterns that cause distress.

Cognitive Behavioral Therapy (CBT)

  • May be good for addressing mood disorders (i.e. depression, bipolar…), anxiety, eating disorders, substance use disorders, OCD, insomnia, some symptoms of schizophrenia

  • You will explore ways to replace negative thought patterns or behaviors with more helpful ones. Doesn’t spend a lot of time addressing past events but rather existing symptoms and making changes.

Acceptance and Commitment Therapy (ACT)

  • May be good for addressing mood disorders (i.e. depression, bipolar…), anxiety, substance use disorders, struggling with life transitions

  • At its core, ACT is a mindfulness-based therapy with the primary goal of increasing psychological flexibility by helping you build a life that fits in line with your values and to focus on the realities of your life.

Humanistic Therapies (Existential, Person-centered, Gestalt)

  • May be good for addressing self-esteem issues, difficult coping with chronic health concerns, effects of trauma (NOTE: if someone specializes in trauma, they should have additional trauma informed training in other techniques like somatic therapy, EMDR and more...), depression, relationship issues, feelings of worthlessness or being lost in life.

  • You will work towards the goal of living your most fulfilling life by exploring ways to grow and increase self-acceptance along with discussing the issues you are dealing with.


3. Ask Questions Before You Go

You don’t have to book the first therapist you find only to go to the first session and realize this isn’t it. Some therapists will provide a way for you to call or contact them and ask questions first, almost like a brief, 15-minute consultation to see if it would be a good match. This is the most important aspect of your therapy. Any trained professional can teach you the coping skills and work with you but it’s the relationship you develop with that person (How you two vibe, The trust, Do you really feel understood, seen, heard? Does the therapist brush off or invalidate your concerns? Do you feel respected as a whole person?) that helps the process along. If you are unable to do so before your first session, know that as a client you have the right to use the first session to get to know your therapist and ask all the questions before continuing forward. Possible questions to ask:

  • How many years have you been in practice?

  • What do you consider to be your specialty or area of expertise?

  • How much experience do you have working with people who are dealing with ____?

  • How do you work with someone/What do you do for someone dealing with ____?

  • If I need medication, can you prescribe it or do you refer out? What does that look like?

  • How soon can I expect to start feeling better/start seeing progress?

  • What do we do if our treatment plan isn’t working?

  • Questions pertaining to their values are fair game. This includes politics or what you need to know in order to feel safe and be authentically you in a therapeutic environment. This is your right.

If it doesn’t work out with a therapist, don’t get discouraged as it can happen and isn’t uncommon. I recognize giving this next bit of advice comes with an extreme amount of privilege because there is a real cost associated with trying multiple therapists before finding the right one. If you can though, treat the process like you’re tasting what ice cream to buy. It’s ok to try 2-3 “flavors” before being happy with what scoop you’re committing to. After all, you are paying for these services. Don’t settle for butter pecan ice cream when you want cookie dough. Therapists are also aware of this dynamic and are used to it. You are not hurting their feelings; in fact, they can help redirect you to someone who may be a better fit so be honest if it’s not working.


OTHER:

In the meantime, you can use short-term mental health resources to tide you over. If you’re in crisis, you can call Canada Suicide Prevention Service at 1.833.456.4566, or text 45645, between 4pm-12am to talk to a trained counselor from Crisis Text Line. Look through a list of DIY tools (https://cmha.ca/document-category/mental-health) for other resources you can use to stay mentally healthy while you wait.


See Further Reading

 

PART II:

How To Find A Therapist in the U.S.: The Basics*


*All information was compiled using multiple resources provided by the American Psychological Association and other professional advice associated with the organization.


Last updated Feb. 2022.


COST CONSIDERATIONS:

1. Consult Your Insurance Provider Directory

If you plan to pay for therapy through your insurance plan, your first step might be to look through your plan’s provider network. It’s also a good idea to find out whether your plan limits the number of sessions you can attend each year and whether using an out-of-network therapist will affect your out-of-pocket costs. In general, some plans will cover the partial cost of therapy. Therapists might advertise that they provide a ‘sliding scale’ which means they are willing to lower their cost per session to a specific number (for example; “Yes I have a sliding scale. If you need a re-priced session, I am willing to go as low as X…”) or they will work with your specific budget. Even if it’s not advertised, you can still ask and I encourage you do regardless of if you have insurance or not.

  • Expect therapy to cost anywhere from $60/1 hr. up to $120/1 hr. on average per session.

  • Call and ask directly, “What insurance do you accept?” and “Will I need to pay you directly and then seek reimbursement from my insurance company or do you bill the insurance company?” if you believe you have found a therapist to double check.

  • Ask your employer if you have access to an Employee Assistance Program (EAP), where you can get short-term counseling.

2. Try Online

Due to the pandemic, most therapists have begun offering virtual sessions to work with Covid-19 restrictions and stay safe. However, there are also several apps like TalkSpace or BetterHelp that offer the tools to help you explore the kind of therapy you want. Don’t think you have to go the “traditional” route. Weekly sessions range from $35-$80 and will also be provided by licensed professionals (as discussed below).


3. Access Affordable Options

Look local to you for nonprofit organizations, university counseling centers (for students or the community), support groups, and options through employee assistance programs (EAP).


WHO AM I LOOKING FOR?:

1. Know Before You Go

Make sure you are working with a licensed professional who possesses some letters around their name. Terms to know:


Psychiatrist - MD (they will have Dr. before their name)

  • Training: Medical School

  • Overview: In an outpatient setting psychiatrists typically focus on medication management and often work with another practitioner who handles the therapy.

Psychologist: Doctoral Level - PhD, PsyD, EdD (they will also have Dr. before their name)

  • Training: Completion of a PhD, PsyD, or EdD program in psychology. All degrees require clinical field experience and dissertations, though a PsyD or EdD is typically more clinically focused, while a PhD is more research focused.

  • Overview: Though PhDs are often doing research, some offer therapy and private practice. Many of these individuals will have a very specific area of interest or expertise, which can be great if their interest matches your needs. They cannot prescribe medications, but may work with a psychiatrist who does medication management.

Counselor/Therapist: Masters Level - MA, MS, LGPC, LCPC

  • Training: Completion of a masters program in psychology, counseling psychology, mental health counseling, or a closely related field. Those with an “L” have completed licensure requirements which may involve state board exams and supervision hours.

  • Overview: These practitioners can diagnose, offer counseling, and many practice a range of different therapeutic approaches. They may have additional certifications based on their specific area of interest or experience (even more letters after their name). They cannot prescribe medications, but may work with a psychiatrist who does medication management. Be aware, “therapist” is not a protected title in the U.S. and anyone can use it. If someone identifies as a therapist, they should have at least those letters after their name.

Social Worker - MSW, LGSW, LCSW, LMSW, LCSW-C, LISW, LSW (and probably more, as this varies depending on state license, but will always involve an “SW”)

  • Training: Completion of a masters program in clinical social work. Those with an “L” have completed licensure requirements which may involve state board exams and supervision hours.

  • Overview: These practitioners can diagnose, offer counseling, and many practice a range of different therapeutic approaches. They may have additional certifications based on their specific area of interest or experience (even more letters after their name). They cannot prescribe medications, but may work with a psychiatrist who does medication management.

Marriage and Family Therapist - MA, MFT, LMFT, LCMFT

  • Training: Completion of a masters program in Marriage and Family Therapy. Those with an “L” have completed licensure requirements which may involve state board exams and supervision hours.

  • Overview: These practitioners can diagnose, offer counseling, and many practice a range of different therapeutic approaches. They may have additional certifications based on their specific area of interest or experience (even more letters after their name). They cannot prescribe medications, but may work with a psychiatrist who does medication management.

Pastoral Counseling - MA, CCPT, CpastC, NCPC, NCCA

  • Training: completion of a masters program in Pastoral Counseling or Pastoral Therapy. These programs typically involve a combination of coursework in therapeutic approaches and clinical counseling skills in combination with theology, spiritual counseling, and pastoral care/chaplaincy.

  • Overview: This is a specific degree program that differentiates a pastoral counselor from a priest, pastor, or clergy person who may provide informal spiritual support. These practitioners can offer licensed counseling services, and many practice a range of different therapeutic approaches. Many pastoral counselors work in hospital or hospice chaplaincy, in ministry, institutions of higher education, or individual clinical practice.

You can use these online resources to help you find the right person. Note that this list is not all inclusive and there may be more sites available to you to use than just these. The hope is that this list gives you a start.


General Search Links:

Inclusive Counseling:

Asian Americans & Pacific Islanders:

Black & African Americans:

Indigenous: