How To Find the Right Therapist for You: A Guide for Underserved Communities
How To Find the Right Therapist for You: A Guide for Underserved Communities
Millions of Americans who need mental health care struggle to find it—especially those in underserved communities. In 2019, an estimated 21.6 million adults reported moderate to severe symptoms of anxiety or depression, but 39% of them did not receive any treatment, primarily due to cost or lack of access. Among those with no insurance, nearly 92% with severe symptoms went untreated.
For people in BIPOC, LGBTQ+, low-income, rural, or disabled communities, these gaps are even wider. Many face additional hurdles like discrimination, stigma, language barriers, and a lack of culturally competent providers. Even when care is available, it isn’t always inclusive or affirming.
This guide is here to help you navigate those challenges, whether you’re searching for your first therapist or looking to switch to someone who truly understands your identity and needs. Inclusive, accessible mental health care is essential for everyone.
Why Inclusive Therapy Matters for Underserved Communities
Underserved communities encounter disproportionate barriers to mental health care. These groups are more likely to experience chronic stressors tied to discrimination, financial instability, and geographic isolation, yet they have fewer options for quality treatment. Common barriers include:
- Provider shortages in rural or low-income areas
- Lack of insurance or comprehensive coverage that limits access to care
- Language barriers and a lack of multilingual providers
- Cultural mistrust due to historical mistreatment by the healthcare system
- Few clinicians have the cultural competence to treat diverse populations effectively
These access issues aren’t hypothetical. According to the KFF Survey on Racism, Discrimination, and Health, 38% of Black adults and 36% of Hispanic adults said they had difficulty finding providers who respect their cultural background. These groups also report higher levels of unfair treatment and lower levels of trust in healthcare settings. Meanwhile, research from UC Davis shows that poverty-linked stress — from housing insecurity to adverse childhood experiences — leaves a lasting mental health burden that is often left untreated.
Inclusive therapy emphasizes a client’s lived experience and cultural identity. Culturally competent mental health care often includes:
- Using affirming, non-stigmatizing language
- Recognizing and validating systemic and intergenerational trauma
- Adapting therapy models to reflect the client’s cultural background
- Creating a safe space where clients don’t need to “explain” their identity
When therapy lacks inclusivity, clients may struggle to build trust or abandon treatment altogether. For underserved populations already navigating mental health inequities, a culturally unaware therapist can perpetuate the same harm within an incredibly vulnerable setting.
Common Barriers to Finding the Right Therapist
Finding a great therapist is easier said than done. Multiple factors can prevent someone from getting the help they need; here are the most common:
Financial Hurdles and Insurance Issues
For many people, the cost of therapy is the first and most persistent barrier. Mental health care remains out of reach for individuals without insurance or for those whose insurance doesn’t adequately cover therapy. Common financial obstacles include:
- Lack of insurance coverage for mental health or behavioral services, particularly among low-income or self-employed individuals
- High out-of-pocket costs, including steep co-pays, deductibles, or session caps that limit the number of visits per year
- A limited number of in-network therapists, which can mean long waitlists or settling for a provider who isn’t a good fit
Even when mental health services are technically covered, many insurance networks include only a small pool of providers, some of whom may not be accepting new patients. Navigating the insurance system itself — understanding benefits, verifying coverage, submitting claims — can also become a deterrent, particularly for those in crisis.
Cultural Disconnect and Stigma
When therapists and clients come from different backgrounds, it can lead to misunderstandings, distrust, or treatment that doesn’t fit the client’s experiences. For people from groups that have been unfairly treated or discriminated against, the shame associated with mental health issues is often made worse by bigger problems in society. The most common challenges include:
- Mistrust of mental health professionals, especially among BIPOC and immigrant communities with histories of institutional racism or cultural invalidation in clinical settings
- Language barriers that prevent full participation in therapy, particularly when bilingual or culturally fluent therapists are unavailable
- Cultural stigma that equates mental health issues with weakness, family dishonor, or spiritual failure
As the American Psychiatric Association notes, stigma not only reduces help-seeking behaviors but can also affect the quality of care a person receives. For many, fear of judgment, either from their community or from a provider who doesn’t understand their background, becomes a reason to avoid therapy altogether.
LGBTQ+ Discrimination or Erasure
The therapist-client relationship requires trust, and for queer, trans, and nonbinary individuals, providers may break this trust if they fail to affirm their client’s identity. Barriers specific to LGBTQ+ populations include:
- Limited access to LGBTQ+-affirming therapists, particularly in smaller cities, rural areas, or within specific healthcare networks
- Misgendering, deadnaming, or heteronormative assumptions that alienate or retraumatize the client
- A lack of training among providers in topics like gender identity, coming out, or navigating queer relationships and family structures
Inadequate or uninformed care can do more harm than good, particularly for individuals already facing depression, anxiety, or suicidal ideation linked to social exclusion.
Rural and Remote Area Challenges
Geography can be one of the most rigid barriers to therapy. In rural or remote communities, mental health care is often scarce, and logistical constraints make consistent care difficult. Common issues include:
- Severe shortages of licensed mental health professionals, especially those with expertise in trauma, substance use, or marginalized identities
- Long travel distances to the nearest available therapist, compounded by a lack of public transportation or inflexible work schedules
- Limited or unreliable broadband access, which restricts the use of telehealth and virtual therapy options
Even when someone in a rural area is highly motivated to seek care, the lack of available or accessible providers can mean months-long waits or complete abandonment of treatment efforts. This deepens existing disparities and contributes to the isolation and chronic stress already common in rural life.
Where to Start Your Search
Finding the right therapist starts with understanding what resources are already available to you. If you have health insurance, review your mental health benefits first. Many plans cover therapy services, but may have restrictions on which providers you can see or how many sessions are included. To better understand your options, it’s helpful to consult your insurance provider’s mental health coverage details and confirm what services are covered, whether telehealth is included, and which therapists are in-network.
For individuals with low income or no private insurance, Medicaid plays a vital role in expanding access. Medicaid is the largest payer of behavioral health services in the U.S., and many providers across the country accept it. This includes community health centers, private practices, and nonprofit organizations that are working to reach underserved populations with affordable mental health care.
Free and Low-Cost Therapy Options
Several resources connect you to affordable or no-cost care options:
- Federally Qualified Health Centers (FQHCs) offer mental health services on a sliding scale based on income
- Religious or spiritual support networks, with a focus on providers who offer affirming, culturally sensitive care
- Group therapy and peer-led support groups that address shared experiences like grief, addiction, or trauma
- School-based or workplace mental health programs, which may offer on-site counselors or virtual therapy
- Local nonprofits and advocacy organizations that provide direct services or financial assistance for therapy
- University counseling centers and training clinics, where graduate students provide supervised, low-cost care
- LGBTQ+ centers and BIPOC-specific therapy directories, which highlight culturally competent providers and affirming spaces
Starting with these resources can help ease the search process while ensuring your care is both accessible and affordable.
No matter your coverage or income, it’s essential to research potential therapists before scheduling your first session. A provider’s website or directory profile can reveal important details about their specialties, approach, and whether they prioritize inclusive, trauma-informed care. Visiting platforms like BasePoint’s provider network can help you evaluate whether a therapist is a good match for your cultural background, identity, or specific mental health needs.
How To Tell If a Therapist Is a Good Fit
Sometimes, you have to “shop” for the right therapist. But when therapy is new to you, finding the right kind of care can be a bit of a puzzle. Here’s how to put the pieces together:
Evaluating Cultural Competence and Inclusivity
A good therapeutic relationship is built on trust, safety, and mutual respect. For clients from underserved or marginalized communities, this includes assessing whether a therapist practices cultural humility — an ongoing commitment to learning about and honoring the lived experiences, values, and identities of others.
In practice, cultural humility looks like:
- Acknowledging power dynamics between therapist and client
- Asking thoughtful, open-ended questions without making assumptions
- Demonstrating a willingness to learn about your background and culture
- Reflecting on their own biases and actively working to challenge them
For LGBTQ+ clients, safety and affirmation are especially critical. Therapists who are affirming typically:
- Use your correct name and pronouns without hesitation
- Avoid heteronormative or cisnormative assumptions
- Understand the impact of minority stress and systemic discrimination
- Create a judgment-free space to explore identity, relationships, and trauma
- Are listed as an LGBTQ+-friendly provider or visibly state their commitment to inclusivity on their website or intake forms
If a provider seems dismissive, it may be a sign to continue your search.
First Consultation Questions
The first session or consultation is your opportunity to get a feel for a therapist’s style and values. Don’t hesitate to ask direct questions that help you determine if they’re the right fit for your needs. Consider asking:
- How do you approach topics like trauma, gender identity, race, or cultural background?
- What kind of therapeutic modalities or techniques do you typically use?
- Do you offer sliding scale rates or virtual sessions to make care more accessible?
- What experience do you have working with clients who share similar identities to mine?
A therapist who is a good fit will respond without defensiveness, welcome your questions, and view the conversation as part of establishing trust.
The Therapeutic Alliance
The therapeutic alliance refers to the collaborative, trusting relationship between you and your therapist — and research shows it’s one of the strongest predictors of positive outcomes in therapy. A strong alliance blends mutual respect, agreement on therapy goals, and a sense that you’re working together as a team. When the alliance is strong, clients are more likely to feel understood, stay engaged, and experience meaningful progress.
Signs of a healthy therapeutic alliance include:
- Feeling heard, validated, and respected
- Agreeing on goals and the steps needed to reach them
- Experiencing open, honest communication without judgment
- Sensing that your therapist is genuinely invested in your growth
If you consistently feel disconnected, misunderstood, or reluctant to share, it may be worth addressing the issue directly with your therapist — or considering whether a different provider might be a better fit.
How To Advocate for Your Mental Health During Counseling Sessions
Therapy should be a safe space where you feel respected, heard, and supported. If it’s not, you have every right to speak up or leave. You never have to stay with a therapist who isn’t a good fit. If you decide to move on, simply tell them you’re exploring other options or your needs have changed. You don’t need to explain further.
It’s just as important to speak up for yourself during sessions. If a therapist says something that feels wrong or invalidating, it’s okay to pause and say something. Saying, “That didn’t sit right with me,” or “Can we talk about what you meant by that?” can help clear up miscommunications, or it might confirm that you need to find someone else.
Clearly define expectations from the start by discussing feedback, boundaries, and therapy goals. Therapy is for you, and actively expressing your needs and values is vital to your healing journey.
Finding the right therapist isn’t always easy. But inclusive, affirming care is out there, and you deserve it. Whether you’re navigating systemic challenges or simply looking for someone who truly understands you, knowing how to ask the right questions and advocate for yourself leads to better, more effective care. Prioritizing your mental health means finding support that empowers you — that process starts with trusting yourself.
Counseling Resources for Underserved Communities
Access to quality mental health care can be especially limited for underserved populations. The following resources can meet the needs of historically marginalized communities.
Resources for BIPOC Communities
These resources increase access to therapists of color and promote culturally informed care:
- Therapy for Black Girls: A national directory that connects Black women and girls with culturally competent therapists.
- Clinicians of Color: A comprehensive directory of BIPOC therapists who are committed to providing trauma-informed, inclusive care.
- National Queer and Trans Therapists of Color Network (NQTTCN): A healing justice organization focused on supporting mental health practitioners of color and increasing access for QTBIPOC individuals.
These directories and networks are valuable tools for finding therapists who understand and reflect the lived experiences of BIPOC individuals.
Resources for LGBTQ+ Communities
For LGBTQ+ individuals, affirming mental health care can make a world of difference. The following organizations provide specialized services tailored to LGBTQ+ needs:
- The Trevor Project: Offers crisis support for LGBTQ+ youth and connections to mental health providers who understand LGBTQ+ needs.
- GLMA: Health Professionals Advancing LGBTQ+ Equality: A searchable provider directory for LGBTQ+ affirming care, including mental health.
These services are crucial in fostering safe spaces for healing and empowerment within LGBTQ+ communities.
Resources for Rural and Remote Residents
Living in a rural or remote area shouldn’t mean going without mental health support. These services are committed to closing the access gap with affordability and telehealth options:
- Open Path Collective: Provides affordable in-person and online therapy, often for as low as $30–$60 per session.
- National Rural Health Association (NRHA): Offers information on local clinics, telehealth programs, and behavioral health services in rural areas.
- Basepoint’s Virtual Mental Health Therapy: Basepoint provides secure online therapy services that help bridge the gap for those in areas with limited mental health providers. Explore your options here.
Whether you’re looking for virtual therapy or nearby services, these resources make care more reachable for remote residents.
Resources for People with Disabilities
Finding accessible, inclusive therapy can be a challenge for individuals with disabilities. The following organizations remove barriers and offer tailored support:
- National Council on Independent Living (NCIL): Offers local directories for accessible mental health services and peer support networks.
- The Arc: Provides mental health resources and advocacy for individuals with intellectual and developmental disabilities.
These tools help ensure that mental health care is accessible and affirming for people with disabilities.
