A cancer diagnosis, treatment, and survivorship can bring up many challenges to your mental health. You may feel stress, worry, sadness, a loss of control, and fear. You may also struggle with integrating your “pre-cancer” life---work, family, relationships, hobbies—into your life with cancer. This isn’t always an easy thing to do. Sometimes you need help from a professional who can help you work through your emotions. This person can also help you focus on coping strategies and mental well-being.

What is a therapist?

A therapist is a professional who provides you with space and encouragement to talk about things in your life and how they are impacting your well-being. Therapists want to help reduce symptoms you may be feeling as a result of the challenges in your life.

Therapists are typically licensed in the state(s) in which they practice. They may also have advanced training in special areas of therapy practice.

What are the different kinds of therapists?

Therapists may be counselors, social workers, psychologists, psychotherapists, or psychiatrists. You can tell more about the therapist and the types of training they have had based on their titles and credentials. For example, some therapists are:

Licensed Clinical Social Workers (LCSW).
Licensed Professional Counselors (LPC).
Licensed Marriage and Family Therapist (LMFT).
Licensed Mental Health Counselor (LMHC).
Psychologists (Psy.D. or Ph.D.).
Pastoral Counselors (MA or M.Div).
Psychiatrist (MD).

What should I look for?

Think about your goals for therapy. What do you want to get out of therapy? What are you willing to put in? Therapy is work.

Understanding your goals will help guide what kind of therapist may be most helpful. For example, are you looking for help in your marriage? You may want to consider a marriage and family therapist. Are you looking for medication in addition to talk therapy? You may want to see a psychiatrist. Are you looking to understand more about how your childhood experiences may be impacting your adult life? You may want to consider a social worker, counselor, or psychiatrist with training in relational or psychodynamic theories. Are you looking for ways to manage anxiety? A cognitive-behavioral therapist might be a great option.

You may also want to think about the gender and age of your therapist. Maybe you would feel more comfortable with someone closer to your age or who identifies as the same gender. There are also many therapists who identify as LGBTQIA+ friendly.

Where does therapy happen?

Some therapists work in a practice with other providers and offer therapy services in a private office space.
Tele-therapy services: Therapists are using a variety of online, privacy-protected platforms to deliver therapy services through telehealth. While this can make therapy services more accessible, it can be hard for individuals who don’t have private space at home to have therapy visits with their providers. Talk with your provider about strategies for managing privacy concerns and talking with your family.
Texting: Some platforms like Headspace and Better Help use “text therapy” methods. This can be very appealing for folks who prefer this method of communication. Remember, there are limits to your therapist’s availability via texting apps (they aren’t going to answer you 24/7). Your therapist will discuss these guidelines with you before starting text therapy.

What about paying for therapy? Is it covered by insurance?

Mental health and substance use treatment are considered essential health benefits under the Affordable Care Act (ACA). Most insurance plans are required to cover these services. One exception is “bare-bones” fixed indemnity plans that provide minimal coverage for all services.
A first step is to learn about your behavioral health coverage and the network of providers available with your insurance. Behavioral health may be managed by a different provider than your major medical coverage. There should be a number on your card to call your insurer about your behavioral health benefits.
If you have employer-affiliated health insurance, your employer may ask you to utilize their EAP (employee assistance program) first.
Not all therapists accept insurance. They will expect payment at the time of service. They should provide you with documentation to submit to your insurance company for out-of-network reimbursement. Be sure to discuss fees for service before your first appointment.
Many therapists offer sliding scale rates for those with lower incomes.
You may also be able to use money set aside in your health care spending account (HSA) for therapy co-pays/costs. Check your specific HSA guidelines for coverage information.

How do I find a therapist?

If using your insurance, start there to access their list of network providers. Not all providers listed as network providers will be accepting new patients. You may want to create a list of potential therapists and then contact each directly about their services. This can help you decide if they might be a good fit.
If you aren’t using your insurance, ask friends, family members, clergy, folks in your support groups, and your healthcare team for referrals.
You can also use the find a therapist tool (https://www.psychologytoday.com/us) on the Psychology Today website.