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How to Choose a Therapist


As a therapist professionally, and a patron of the therapeutic arts personally, I understand that finding the right fit for your needs can feel daunting. While I wish I could welcome every aspiring gentle mother and her loved ones into my warm therapeutic embrace, the antiquated powers-that-be only allow me to serve as a therapist to folks in Washington state. If that’s you, come on in. If you don’t call this Pacific Northwest haven home, let’s explore how to find a therapist who would be a good fit for you.


Most therapists, particularly those who are very good, have a niche. They develop the intersection of their passion, their skill, and a community need into a specialization. They dive deep into formal training, personal exploration, and professional experience around helping a specific population with particular issues.

In my practice, I come alongside folks struggling with motherhood, parenting, relationships, anxiety, trauma, life transitions, grief, neurodiversity, gender diversity, or adolescence. I embrace these brave souls in a warm therapeutic space of becoming, tending the roots of suffering, planting for peace, freedom, connection, and joy, and growing into an embodiment of their values.

Someone struggling with anxiety would be a better fit for me than someone struggling with substance use disorder because anxiety is a specialty of mine—an issue I have spent years learning about and supporting clients through—while substance use disorder is not. I have a deep well of knowledge and experience in supporting mothers, parents, children, and teens but a shallow lake for geriatric care. If online therapy didn’t exist and I was the only therapist in your small town and you were a retired fellow, should you come and see me? Absolutely—my therapeutic skills would be helpful for you. But if there was a therapist down the street who specialized in working with seniors, I would refer you to him to get you the best available care.

Thankfully, we now live in a world with telehealth, so you are free to see any therapist in your state. Therapy directories like Psychology Today list each therapist’s specializations, so scan down to that section and check that your needs are present.


When I sought therapy in the wake of my mother’s death, I felt drawn to the support of a woman (even more specifically, a woman who was not younger than me). So in addition to seeking a therapist with Grief in their list of specializations, I sought a female therapist who seemed at least my age.

The therapeutic relationship is part of the mechanism of healing and growth in therapy, so the person of the therapist does get to matter to you. If you are an Asian woman struggling with a tiger mother, you may feel more seen and understood working with a therapist from within that experience, and that is okay. A great many unschoolers come to me for therapy because I understand that experience from the inside. There is a safety and a short hand that accelerates therapeutic progress. If I invite an unschooling teen into discomfort, they trust that it’s in service of their version of a meaningful life, not arbitrary school values.

It’s worth noting that sameness isn’t always what resonates. If you are needing to work through trauma related to narcissistic abuse from your mother, you might feel safer with a male or non-binary therapist–able to access more of the trauma in session. So it’s less about seeking someone who is the most like you and more about seeking the flavor of person you feel a hunger for, even if you can’t yet logically make sense of that hunger.

As a person who actively works to deconstruct racism, sexism, and ageism within myself, this permission felt important. Unconscious biases can definitely show up here (for example, we could be drawn to a white therapist because we hold unconscious bias around white equating to greater competence). We should hold a posture of open-minded curiosity around who we feel drawn to and why. And we can do that while honoring our present needs. A quality therapist can support this exploration.


In the field of therapy, we have various models that help us conceptualize the problems that people experience and provide tools and techniques for us to help clients through those problems and into wellness. We are educated on a multitude of theoretical orientations and we are invited to work through and draw from whatever model or models resonate with us. While Freud is unpacking my unconscious jealousy over not having a penis, Skinner is examining the rewards that are reinforcing my behavior. The experience of therapy can be vastly different depending on the therapeutic lens a therapist is holding.

While a thorough review of all the theories of therapy could be a jaunty tour for the psych nerds among us, I’ll embrace my inner minimalist and just share my favorites. These are the approaches that I bring to therapy and the ones I look for in a provider for myself or my loved ones.

Acceptance and Commitment Therapy (ACT): In ACT, which is my core approach, we mindfully make friends with our feelings while showing up in alignment with our values. Suffering is a result of our struggle with thoughts and feelings (everything we do to avoid them cuts us off from a fulfilling life), but we can make space for those thoughts and feelings while engaging in the actions that serve a meaningful life.

Internal Family Systems (IFS): In IFS, we connect with the parts of ourselves as an internal family of characters. While IFS has their own standard cast (exiles, firefighters, and managers), I bring your protector and your inner child to life in my therapeutic work (the thoughts and feelings you’ve been struggling with are often your protector trying to keep you safe and your inner child trying to get her needs met).

Narrative Therapy: In Narrative Therapy, we consciously author the stories that give our experiences and identity meaning. This approach harkened a new (postmodern) movement in therapy in which the client was viewed as the expert on themselves and their problems were externalized as being separate from who they are. I am forever grateful for this respectful paradigm shift that I fully embody in my work with clients.

Attachment Theory: In Attachment Theory, we center a secure connection with our people. This is essentially the theoretical foundation for attachment parenting, so if that resonates with you, this will too.

Feminist Therapy: In Feminist Therapy, we are acknowledging and shifting oppressive systemic expectations. As someone who primarily works with mothers, patriarchy is part of the conversation.

Positive Psychology: The field of psychology is generally focused on reducing suffering while Positive Psychology is focused on cultivating strengths and flourishing. Because thriving requires more than just an absence of negative, in Positive Psychology we are invited to build up the positive.

Solution-Focused Brief Therapy (SFBT): Solution-Focused Brief Therapy is a postmodern approach (viewing the client as the expert and problems as external, like in Narrative Therapy) that lives in the present and future as opposed to the past. In SFBT, we look at when the problem is not a problem, and do more of that, leaning into the strengths you already have within you. It’s positive like Positive Psychology and action oriented like ACT.

Polyvagal Theory: Polyvagal Theory helps us create a felt sense of safety within your nervous system. While it is not a psychotherapeutic modality per se, I do draw on it in my therapeutic work (as do other therapists).


While I aspire for both quality therapy to be accessible to everyone and quality therapists to be adequately compensated for their value, we are operating within a challenging system and money is one of the factors that will determine goodness of fit with a therapist.

Private Pay: I am a private pay therapist, meaning clients pay me directly for services. I can provide a superbill for clients to submit a claim for reimbursement from their insurance company as an out of network provider, but I do not bill insurance directly. Most of my colleagues are private pay with session rates between $150 and $250, which is the minimum we need to charge to cover our expenses and make a living wage. It can be a mindset shift to value mental health in the same we value other things like physical health, but it’s a mindset shift that’s worth making.

It’s also worth noting that therapy is a predominantly female profession with a high cost of eduction and training in which we engage in emotional labor, which needs to be made visible and valued to create a more equitable world for everyone.

Sliding Scale: Some therapists offer a sliding scale, where they are able to reduce their session rate for clients with a lower income. So if a therapist’s rate is beyond your reach, you can check for sliding scale availability in their fees section.

This can be a challenging model to sustain because therapists must increase their standard rate above market value for some to compensate for the reduced rate offered to others. In theory, “pay what you can” is a beautiful model. In practice, the therapist’s income sometimes subsidizes the gap. The ongoing financial negotiation can also introduce a potentially counter-productive dynamic within the therapeutic relationship.

Insurance: Some therapists accept insurance. If a therapist accepts your insurance, they bill your insurance directly and you pay only your co-pay for each session. When looking at therapists, check their fees section for the name of your insurance company.

The downside to the client to seeking therapy through insurance is that the insurance company gets a seat in the therapy room (metaphorically speaking). The therapist must diagnose a client from a limited set of medically-approved options and the insurance company gets access to a client’s records. For a therapist, the amount of time and work involved in insurance billing is substantial and reimbursements are low. What makes accepting insurance sustainable is quantity (group practices and therapists who with high client loads will more often accept insurance).


Do not underestimate the value of a vibe check. We can get Polyvagal and call it neuroception (your nervous system is registering cues of safety or unsafety) or we can call it intuition. Read their words, take in their branding, listen to their voice, and notice how you feel. In this season, what resonates with me is quiet warmth and rebellious wisdom (I seek to be influenced by that crone energy), but that’s me. What vibe resonates with you?

(Are we vibing right now? If we are (and you live in Washington state), you can explore therapy with me here.)

Now that you know what to look for, you can run a google search with a few key words (for example, Asian therapist Washington) or peruse a therapist directory like Psychology Today where you can select search criteria like approaches or insurances accepted.

Ultimately, it’s about finding the best available fit and taking the action step of booking a first session (which is often the hardest part). You might notice uncomfortable thoughts and feelings showing up as you take this brave step, and that’s okay. There is room for the fullness of exactly who you are today on this healing and growth journey.

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I work from an island in the Pacific Northwest, where I live wild and free in connection with my hilarious husband and three growing sailors in our fixer upper on the beach. I authentically live this healing work out loud raising my own neurodivergent family (inner child included) and draw on my decades of education and experience (I've done all the nerdy work so you don't have to) to guide a revolution of overwhelmed parents just like you to feeling at peace within yourself, consciously connected with your children, embraced by a supportive community, and enjoying a values-aligned life you love.

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I'm Rachel Rainbolt

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