COVID-19 meant mental health challenges in 2020. Here’s how to get help in 2021.

2020 was a difficult year for mental health. Feelings of anxiety, sadness, and loss were common for many. Lockdown measures led to job loss and social isolation. And of course the virus has led to tremendous suffering, death, and grieving. Mental health symptoms, such as depression and substance misuse, have spiked, according to data from the Centers for Disease Control and Prevention.

Therapy has long been recognized as a highly effective treatment for mental and behavioral health symptoms, and the pandemic has made it more accessible than ever as nearly all therapists have transitioned to teletherapy.

If you’re considering starting therapy this year, here’s what you need to know.

The relationship between client and therapist is the biggest predictor of a positive outcome in therapy, said Danielle Massi, owner of the Wellness Collective, a holistic therapy practice based in Center City. Whatever the qualities one seeks in a therapist, Massi said that when people find the right one for them, “speaking with [them] should feel like you’re speaking with a friend.”

“There should be chemistry,” she said. “It should feel easy. Energy is really important because you’re going to tell your whole life story to them. If you’re not comfortable and not sharing everything, then not everything in the room is going to be addressed. If you wouldn’t meet this person for a cup of coffee outside, it’s not going to work.”

To start, Massi recommended using a website like that of Psychology Today to identify therapists by specialties. Most therapists include a picture on their profile, as well as a brief biography, allowing people to get an initial sense of who they are and who they can help.

Searching for the right therapist can take some time. That’s why it’s important to be patient, said Chris Stoudt, a behavioral health specialist at NeuroFlow, a digital behavioral health company. He said that while some people may feel tempted to take the first available appointment they find, it’s a better idea to do research and make phone calls beforehand.

“Experience can vary greatly between providers,” Stoudt said.

When trying to identify a few providers that could be a good fit, Stoudt tries to dissuade people from looking solely at credentials. “It’s important to choose a therapist based on the person and their experience over a level of education and some specific pedigree,” he said.

Most therapists offer a 15- to 30-minute initial consultation over the phone to help prospective patients learn more about their practice and decide if they want to start formal sessions.

Massi recommended asking about the therapist’s training and specialties because most have “three things that they really put their energy into, like trauma or relationships.”

Julie Jacobson, a therapist with Emerge Wellness in Center City, said people should use that first conversation to get a better understanding of what it’s like to work with the therapist and whether they have experience working with clients who understand your background, even if they don’t share it.

“You want to find out whether the therapist is an advocate for people with your identity beyond taking a cultural competency class,” she said.

It might also be helpful to ask a therapist how they track the progress of their clients, Jacobson said. Goal-oriented therapy doesn’t have to look like a treatment plan, but most people seek therapy because they want to change, she said.

“You should be able to talk openly about what it feels like or looks like to not have the problem anymore,” Jacobson said. “What would it look like if things were better or different?”

During that conversation, it’s also important to find out what they charge, said Massi. Many practices are very specific about their payment options, such as whether they accept health savings accounts.

“Because it’s a pandemic, most therapists are really overworked and overloaded,” she said. “A lot of therapists don’t answer the phone when you cold call, so get yourself on their calendar if you can.”

Many therapists take health insurance, and some offer a sliding scale fee structure, which means that people with less income will pay less for sessions. Some therapists have also begun offering free or reduced fee sessions for people affected by the coronavirus pandemic, including health-care workers.

One good website to find affordable therapy sessions is Open Path Psychotherapy Collective, which sorts therapists who offer appointments between $30 and $60 by zip code.

If you find a therapist that seems like a good fit but their price is out of your range, contact the therapist and ask about off-peak pricing or other possible arrangements.

“Therapists may also offer appointments at rates lower than their standard fees during times that are less desirable for folks,” said Jacobson. “A lot of people want evening appointments, so some therapists may offer daytime appointments at lower rates.”

Therapy is different for everyone, Stoudt said. For some people, relief of symptoms may happen really quickly, he said. It might take longer for others.

Massi said it’s normal for clients to experience temporary lows before feeling like they’re making progress.

“As you go into deep emotions and bring stuff to the surface, it’s just going to feel a little icky for a short period of time,” Massi said. “And then you will feel infinitely better. We’re bringing this stuff up to process instead of shoving it under a rug. If you keep doing that, eventually the pile of stuff under the rug will get so big that you’re going to trip over it.”

Stoudt emphasized that communicating openly and honestly with your therapist is key.

“It’s important to continue doing gut checks throughout the process,” Stoudt said. “As you’re developing more trust with your provider, ask yourself whether you feel like things are moving forward. Is what you’re working on in treatment sessions having an impact on your day-to-day life when you’re not in session? And if you’re not making as much progress as you’d like, talk to your provider and be transparent about that. A good therapist will not feel criticized by that, and it will strengthen your relationship with them.”