As a therapist, I choose to take insurance. While the system is far from perfect, I made this decision because it is one way to address the inequity inherent in providing a service that is financially out of reach to a vast number of people that need it. When I say it is far from perfect, this is an understatement. Admittedly, I do so with a lot of mixed feelings about issues of privacy, oversight, and frustrating rates of reimbursement. I take insurance because I want to be able to see the school teachers, government employees, and regular folk with regular jobs. I love the diversity of my clients and I want to keep it that way.
Unfortunately, the other piece of taking insurance is that I get a LOT of inquiries because the amount of therapists who take insurance do not equal the amount of people who want to use insurance. And answering requests for therapy, as a sole practitioner, can end up being a lot of time-consuming unpaid labor. I figure most people don’t have any idea who they are emailing when they send a message. It is a daunting process to comb the internet looking for a therapist that fits your needs, takes your insurance, and has availability. Trying to get a reply from one shouldn’t be. When covid hit, the demand for counseling was overwhelming and I had to put a “not taking new clients” tag every place I was listed online or otherwise I would get dozens and dozens of emails and calls a week. Today, five years later, this is the first time that I have had enough availability to take down that tag and not surprisingly, I’ve seen a sudden uptick in requests.
I try my damnedest to reply in a timely manner but I know sometimes I fail. I’m usually juggling multiple replies and things can slip by. It made me wonder if there is any information I can offer potential clients to make this process work a little better. Here’s a few thoughts I’d like to share if you are seeking a therapist, particularly one that takes insurance:
The question “Do you have availability?” with no other information given, while understandable, is challenging to answer. It would be more helpful to ask, “Do you have availability for in-person appointments after work on a weekday?” or “Do you do telehealth on the weekends?” if that is what you are looking for. If you have a wide open schedule, say so!
The question “Do you take insurance?” with no other information given, while understandable, is challenging to answer. I do take insurance. Not all insurance. Not all plans. It’s clear many people have no idea what their benefits are and might not understand what their plan is. I don’t mind looking that stuff up but lead with “Do you take Cigna?” (No.) “Do you take Aetna PPO?” (Yes.) That save a lot of time and back/forth. Pull out your card and look. If you can check the mental health benefits beforehand, even better. If not, it is okay. Just have the accurate name/type handy and we can go from there.
Give just a little bit of information what you are looking for. It’s not necessary to unload your complicated childhood history in an inquiry message but if you are looking specifically for something i.e. couple’s counseling, EMDR, or addiction treatment, then by all means, mention it up front! I don’t expect that everyone will have read every detail of every Psychology Today profile but any pre-checking helps. Asking a therapist if they have competency with a particular population is not offensive. If a therapist is cagey or defensive answering a question about their understanding/training with a particular population, then it is a good thing you asked up front! You don’t want to spend the first 3 sessions trying to ascertain whether they are LGBTQ-friendly by their office decor. Just ask! If you don’t have any specialized needs that you know of, you can say that too. A simple “I’m just looking for individual counseling to work on anxiety or stress” is perfectly fine.
I know you probably sent the same message to 5 therapists when I first get your message. I expect that! If my reply doesn’t meet your criteria, then there’s no need to keep emailing but also know I am always happy to give referrals if I am able. It isn’t a burden for me to try and help you find what you are looking for. I actually enjoy helping people find a good fit. But if you DO want to move forward and schedule a consultation after you are pretty sure the schedule/insurance/type of therapy seems compatible, make that clear! If you come back 3 weeks later with a reply, that spot may be filled.
And if my website or Psychology Today profile (or any therapist that you want to work with, for that matter) says “FULL” or “Not taking new clients at this time”, it is still okay to email and ask about future availability or a wait list! That said, it is pretty helpful to send an actual message that says something like, “I see that your website says you are full. I am asking anyway because someone referred me/I saw you are trained in this thing I want to try/I’m struggling to find someone in your location who takes my insurance and I’ve checked that you do." It shows that it is a legitimate inquiry. When my website says “Not taking new clients at this time” and I get a message saying “Are you taking new clients?” with no other information, it feels like a facebook marketplace “Is it still available?” button pushed by a bot. Truly. Therapists, like everyone else, are inundated with the same scammy emails and junk requests on a daily basis. Sounding like an actual human being goes a long way.
If you have thoughts about how to improve this process from a client standpoint, I’d love to hear your feedback. I want to demystify anything that doesn’t make sense. Therapy should be accessible for everyone and I know that’s not reality. But if you are trying to find a therapist, please don’t give up. jilladams@jilladamscounseling.com