Mental Wealth Glow Up

Therapy 101 & Navigating Therapeutic Fit for (LGBTQIA+) BIPOC

If you came here for a provider directory, scroooolllllll down.

*Before I start I need to clarify that I am not a therapist, licensed professional, or giving you advice on what to do or what not to do.*

From 2016–2019 I sent an email version of this article to over a hundred BIPOC folks who were looking to develop a new therapist relationship or treatment plan. This offering reflects my personal experiences and privileges navigating the medical-industrial complex as an able-bodied first-gen queer cis woman of color surviving an immigrant family. This is written from a chronic perspective (aka my mental health has been affected for longer than 12 months). I developed an anxiety disorder and/or chronic depression really young, and in my mid-twenties I was finally diagnosed with Complex-PTSD. With that, everything below could also work for acute, short term (think sudden life change or limited time period issues, etc.) as well.

So, yes this article is loonggg. But that’s ok, this process of finding a therapist can take a long time. So go get some water and a snack and settle in, or bookmark this for later when you have the time to dive in.

If this is an emergency, stop reading this and get immediate support (Trans Lifeline / Lifeline Crisis Chat / Strong Hearts Native Help Line / Deaf Emergency Services / Police Alternative Emergency Services).

Table Of Contents

+ My Resource List
+ Insurance
+ Therapeutic Fit
+ How to Get Started
+ Community
+ Medication + Tools

My Resource List

This has always been a living document, so if you have resources or suggestions please send them my way!

Therapist Directories
+ Abolition Centered Care Provider Database — collective resource of abolition-centered, non-carceral care providers (therapists, social workers, peer supporters, healers) that are dedicated to provding care outside of oppressive systems (i.e. law enforcement, forced hospitalization, the psychiatric industrial complex).
+Melanin and Mental Health
+Brown Girl Therapy
+ Therapy For QPOC
+National Queer + Trans Therapists of Color Network
+Neither / Both (Mixed Race Identities)
+Therapy For Black Girls
+Therapy For Black Men
+ Depressed While Black
+Therapy For Latinx
+ Asian, Pacific Islander, and South Asian American (APISAA) Therapist Directory
+ Strong Hearts Native Helpline Database
+Therapy For Muslims
+ Inclusive Therapists
+ INNO Psych Therapists of Color
+ Soulace APP
+ A Therapist Like Me Directory
+ Healing In Colour
+ Clinicians Of Color
+ South Asian Therapists
+ Therapy That Liberates
+ The Boris Lawrence Henson Foundation
+Healing for SWANA Women: daloo3aseries
+ The Muslim Alliance for Sexual & Gender Diversity
+ Muslim Counsellor and Psychotherapist Network (MCAPN)
+ MuslimYouth Helpline (MYH)
+ Ayana Therapy
+ Alma
+General Psychology Today Directory

No Insurance Required / Nonprofit
+ Open Path
+ The Relational Center
+ Grow Ur Potential
+ Open Counseling
+ Nokdu Therapy (* not nonprofit but has dedicated sliding scale spots)
+ ZEPP Wellness Center (focused on the needs of Black folks, queer people, and sex workers)
+ APAIT (APAIT historically reaches out to the diverse multi-ethnic communities of LA and Orange counties who identify as LGBTQIA-2S, immigrants and refugees, at-risk for HIV/STIs, housing insecure, and with behavioral health lived experience.)
+ Check Your Local LGBT Center (LA Offers limited free sessions)

Support Tools
+ Health and Medical Information Template
+ Surviving the Apocalypse Together
+ Mental Health Crisis Management Resources
+ Fireweed Crisis Toolkit
+ BEAM (Black Emotional And Mental Health)
+ Project LETS
+ Pod Mapping
+Heart To Grow
+ Inspirted Minds
+ Muslim Women’s Network (MWN)
+ Emergency Services (Police Alternatives)

Books/Readings
+ Abolition and Disability Justice
+ Care Work
+ Trauma and Recovery
+ My Grandmother’s Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies
+ All About Love
+ Cripping Emotional Labor: A Field Guide

Let’s Talk Insurance.

Step #1: Figure out what your insurance situation is and what your budget is per month ($5? $50? Be real about what that number is, you’ll need it for step #3.)

Ok with insurance, the first question is — do you have it? Is it an HMO or PPO? With an HMO’s you’ll need your primary care doctor to refer you to a therapist in your HMO plan’s provider network. With PPO plans you are able to choose your own doctor without a referral, but they still need to accept your insurance or you are paying out of pocket. But, here’s the thing in-network provider lists are often very white, very cis, very heterosexual, etc., and seeing doctors who don’t really see you will cause more harm than good (I’ll get into finding the right therapist for you in the next section). In many ways exploring the option to go outside the insurance provider network (aka figuring out how to deal with paying higher copays) can be life-changing for QTBIPOC.

Don’t forget, even though the United States doesn’t seem to think so, universal health care is a human right. Lack of insurance or funds can be a barrier to starting therapy, but you deserve help and there are doctors who are willing to work with folks with limited financial resources. We can find you a provider for your budget. I’ll list some resources below that will include either free, community-based, or sliding scale payment options.

Trying to calculate coverage, asking for referrals, and advocating for yourself can be a rough process to navigate. If you’re feeling low spoons, you can always ask a friend to go with you to an appointment or make calls to your insurance. If you’re struggling to ask for help, send this article to a friend. If you’re that friend who is reading this right now, ask the person who sent you this if they need support.

Therapeutic Fit is really fucking important

Step #2: Figure out what kind of therapist you want and need. Write some questions down you might ask your new therapist.

Therapeutic fit is important. Like, critically fucking important. Therapeutic fit essentially means, figuring out what you are looking for in a therapist. You need to find a therapist that will understand the identities that are important to you (ex: your race, gender, sexuality, religion, etc).

A lot of people don’t realize that you should be interviewing your therapist. You have the right to ask your future therapist what their philosophies are, what types of training they received, their research emphasis, if they have received therapy themselves (all therapists are required to), and if they have any personal practices unique to their approach.

Therapy works best when you are able to develop a trusted relationship with your therapist.

Mismatches in therapeutic fit can prevent you from being as honest and vulnerable as you need to be for therapy to be effective. Especially for queer and/or non-white folks talking about things like sexual assault, disability, intergenerational and/or racialized trauma, you do not want (and let’s be real, can’t $afford$) to re-traumatize yourself by spending sessions attempting to legitimize your racial experience to a therapist.

You are paying for this space, and while no relationship is perfect, it’s important you feel comfortable, seen, and heard.

You should not be spending sessions over-explaining immigrant culture or teaching your therapist why respecting you or your partner’s pronouns is the bottom of the fucking barrel in LGBTQ informed care.

So, what can therapeutic fit actually look like?

For me, my current therapist is a queer, poly, Southeast Asian woman. Before we started I shared that alignment and understanding of my politics (abolition, community organizing, etc) is really important to me. Also, identity isn’t the only thing to consider. My therapist offers integrative therapy, that includes but is not limited to a family systems approach, CBT, Relational, etc . She also offers in office Ketamine / Psychedelic Assisted Therapy.

Don’t be afraid to talk to a few different therapists, or even leave your current therapist if you need to.

Your therapist should never make you feel ashamed, ogled at, or alienated. With the COVID teletherapy has become a standard offering for most therapists, so don’t be afraid to look for a therapist who is outside of your city.

Just do the thing, a starting checklist

Step #3: Now that you’ve got your info together here’s a list to help you get started.

1. Call your insurance provider and see what’s up. I got scammed out of $3k in the insurance run around. Ask the person on the phone to break down your mental health coverage costs for you. You can also ask for a list of local therapists that are covered. Remember you don’t have to stick to it if those doctors aren’t a good therapeutic fit.
2. Search for your own doctors and read up. Ok, so you got that insurance approved list, look them up! See if youre comfortable with their identities, approach, and training. For real, just start Googling / Yelping / etc. If you don’t vibe with anyone on that list, ask folks in your network you trust for recs — more people go to therapy than you think. Also you can always start with one of the therapist directories below.
3. No insurance? Ask doctors about sliding scale availability. A lot of doctors keep a few sliding scale client spots available. You have to be upfront and honest about what you can pay per session, $20? $70? When reaching out to therapists you can say something as simple as “Hi, Do you have sliding scale availability? I can pay a total of $XX per month and I am looking for 2–4 sessions a month.” You can also use things like Open Path to search for a doctor. Open Path offers in-office and online psychotherapy sessions between $30 and $60 out of pocket.
4. Start making calls. Go down your list and ask if they take your insurance? how does billing work?(do they handle claims or do they expect you to *do it? *don't do it, girl, again I got scammed by my insurance filing my own claims) are they taking new patients? can book an informational session? Before you book, ask if they charge for an informational interview or session. If you don’t have the spoons to make calls, you can ask a trusted friend to help you get started.

Community is also really fucking important

Step #4: Don’t do it all by yourself. Find someone you feel comfortable checking in with.

For many BIPOC, internalized shame stemming from community stigma has prevented us from pursuing mental health care. Some folks will have the support of their bio family when they start therapy and others won’t. Like therapeutic fit, figuring out your support system is also really fucking important. If you’re thinking about starting therapy find people you love and trust and start talking to them about it now.

You don’t need to overshare or trauma bond, but sometimes it’s nice to call a friend or family member and say “therapy was fucking exhausting today” or “I’m really excited about [insert emotional milestone you thought was previously impossible]!”

Also, remember that the adjustment period of starting a new medication can be painful. When I started my antidepressants the first two weeks I couldn’t sleep or eat much, and during the first six weeks, my depression worsened before it got better. I only made it through that adjustment period because my friends opted into bringing me food, checking in, and generally just supporting me (more about care planning in the support tool section — highly recommend Elliott Fukui’s).

Medication and Other Support

We know healing doesn’t just happen at your therapist’s office (or I guess now, in our zoom rooms?). Some people think therapy will be the thing that fixes an issue (anxiety, depression, etc). Hopefully, therapy gives you space to safely process feelings and learn new tools to use in the future. But, I think of therapy as just one tool in my toolbox.

However, something common across lots of BIPOC communities is medication shaming. Often in our communities, mental health issues aren’t treated like health issues but instead treated like there is a fundamental issue with you — or even worse your family.

Sometimes a person needs medication and sometimes they don’t. Only you can decide what is right for you. But whatever you decide, I encourage you to also look for additional avenues of support and healing outside of therapy.

Things* that have supported me outside of my doctor’s office: meditation, bodywork, community dance, mindful body movement (for me yes, it’s yoga), reading, psychadelics, reflection, journaling, and medication. *Pre-COVID times I had a list of free or low-cost community offerings in LA, but that was the before times and this is now ¯\_(ツ)_/¯.

—

Logistics (aka how does getting meds work?)

A former therapist recommended medication on four different occasions over 3 years before I finally started taking antidepressants. But I didn’t even consider taking them until I felt I was ready. I was on 300 mg of WellbutrinXL, a common antidepressant, for three years. And while medication didn’t fix everything, I can truthfully say that it helped me become the healthiest I’ve ever been. Most significantly my alexithymia dramatically decreased. For me, my time on medication helped me get me my quality of life back. And eventually, after lots of success with Ketamine Assisted Psychotherapy I decided to get off of the Wellbutrin.

If you dont have access to a psychiatrist you can as your PCP for a prescription. But do some of your own research. For example, I ultimately chose to try WellbutrinXL because doesn’t affect your sex drive, and let’s be honest I enjoy sex, so it was important for me to tell my doctors that when choosing a medication to try.

It is worth noting that the adjustment period was excruciating, but putting a care plan before I started them got me through it (again look to the resources above for care plans).

I know all of this is a lot, maybe way more than you were looking for. But, again, I’m just sharing the things I wish I had known when I started this process *10 years ago. I hope you are able to find something in this resource that resonates with you. I’m glad to hear you’re starting this process.

What works for me will not work for everyone. So, take what resonates with you and leave the rest. We know that imperialist white supremacist capitalist patriarchy has created systems that purposefully prevent people, especially QTBIPOC, from accessing care. We know that not all services/physicians offered are safe or helpful, and psychiatric care has ableist, sanist, and carceral histories. Not everyone has the same level of access, resources, time, energy, and/or support.

*This document, and some of my templates have taken years to put together. If you wanna say thanks — you can throw me some coin on venmo (@Bianca-NozakiNasser).