Where to start looking for a therapist
The fastest way to find a therapist is to call your primary care doctor and ask for a referral. Your doctor knows your medical history, any medications you take, and whether you have insurance — and they can often recommend someone who takes your plan and has openings. If you do not have a primary care doctor, call your insurance company directly and ask for their list of in-network therapists in your area.
If you do not have insurance or prefer not to use it, contact your local Area Agency on Aging. They maintain lists of therapists who work with older adults, including some who offer sliding-scale fees based on income. You can find your local agency by calling the Eldercare Locator at 1-800-677-1116 or visiting eldercare.acl.gov.
Psychology Today's therapist finder (psychologytoday.com) lets you filter by location, insurance accepted, and specialty — including geriatric therapy and issues common in later life like grief, isolation, or adjustment to chronic illness. The American Psychological Association also maintains a referral service at locator.apa.org.
Key Takeaways
- Your primary care doctor can refer you to a therapist who takes your insurance and understands your medical situation, which is usually the fastest route.
- Therapists who specialize in older adults understand issues like grief, isolation, medication side effects, and how chronic illness affects mental health.
- Many therapists now offer telehealth appointments, which can work well if you have mobility issues or live far from available providers.
- Before your first appointment, confirm the therapist's fees, what your insurance covers, and whether they have openings — many have waiting lists.
- If cost is a barrier, your Area Agency on Aging can point you to therapists who offer reduced fees or community mental health centers that charge based on income.
What to look for in a therapist who works with seniors
Look for a therapist who has experience with older adults and the specific issues you want to address. A therapist trained in geriatric mental health understands how chronic illness, medication interactions, grief, and major life transitions affect mental health differently in later life than in younger people. If you are dealing with memory concerns, anxiety after a health event, or adjustment to a move or loss of independence, mention that when you call — it helps the therapist know whether they are a good fit.
Ask whether the therapist has worked with people in your situation before. If you are managing multiple chronic conditions, have recently lost a spouse, or are struggling with the transition to assisted living, a therapist who has worked with those specific situations will move faster and understand the context without you having to explain everything from scratch.
Consider whether you prefer in-person or telehealth appointments. Some older adults find telehealth easier because they do not have to arrange transportation, but others prefer sitting across from someone in a room. Many therapists now offer both, so you can ask about that when you call.
Insurance, costs, and payment
Before you schedule, confirm three things: whether the therapist takes your insurance, what your out-of-pocket cost will be per session, and how long the waiting list is. Many therapists have waiting lists of two to eight weeks, so asking upfront prevents disappointment.
If you have Medicare, most therapists accept it, but you will typically pay 20 percent of the cost after your deductible is met. Some therapists are "in-network" with Medicare, which means they have agreed to accept Medicare's set fee; others are "out-of-network" and may charge more. Your Medicare card lists a customer service number — call and ask whether a specific therapist is in-network before you book.
If you have a supplemental insurance plan (Medigap), check whether it covers mental health services, because some plans do not. If you have a Medicare Advantage plan, call the plan directly to confirm that the therapist you want is in-network, because networks vary by plan.
If you do not have insurance or cannot afford the out-of-pocket cost, ask your Area Agency on Aging about community mental health centers in your area. These centers are required to offer services on a sliding scale based on income, and many have therapists on staff or can refer you to one. Some also offer group therapy, which costs less than individual sessions.
Types of therapy and what they involve
Cognitive behavioral therapy (CBT) is the most common type for anxiety and depression in older adults. It focuses on how your thoughts affect your feelings and behavior, and teaches concrete skills you can practice between sessions. Sessions are usually structured and goal-focused, and many therapists can show you results in 8 to 16 weeks.
Psychodynamic therapy explores patterns in your life and relationships that may be contributing to how you feel. It typically takes longer than CBT but can be helpful if you want to understand deeper patterns or work through long-standing grief or regret.
Acceptance and commitment therapy (ACT) helps you accept difficult feelings or situations you cannot change — like chronic pain or the loss of abilities — while building a meaningful life around what matters to you. It is often used for people managing multiple health conditions.
Group therapy brings together people facing similar challenges — grief, isolation, adjustment to aging, or managing chronic illness. It costs less than individual therapy and many people find it helpful to know they are not alone. Ask your therapist or Area Agency on Aging whether groups are available in your area.
Questions to ask when you call
Have a short list ready when you call a therapist's office. Write down the answers so you can compare if you are calling multiple therapists.
| Question | Why it matters |
| Do you take my insurance? | Confirms you will not face unexpected bills. |
| What is your fee per session if I pay out-of-pocket? | Lets you budget and compare costs across therapists. |
| How long is your waiting list? | Tells you when you can actually start. |
| Do you have experience working with [your specific issue]? | Confirms the therapist has relevant background. |
| Do you offer telehealth, in-person, or both? | Lets you choose what works for your situation. |
| How long is a typical session, and how often do you usually meet? | Helps you plan your schedule and understand the commitment. |
What to do if you cannot find someone nearby
If you live in a rural area or cannot find a therapist with openings, telehealth is often your best option. Many therapists now work across state lines via video, and some specialize in serving older adults remotely. You will need a private, quiet space for the appointment and a device with a camera and internet connection — a computer, tablet, or smartphone all work.
If telehealth does not feel right for you, ask your primary care doctor whether they can prescribe medication to help with anxiety or depression while you wait for a therapist opening. Medication and therapy together often work better than either alone, and your doctor can manage the medication while you are on a waiting list.
Another option is to contact your state's mental health crisis line or the 988 Suicide and Crisis Lifeline (call or text 988). These are free and available 24/7. They are not therapy, but counselors can listen, help you think through what you are experiencing, and connect you with local resources including therapists with shorter waiting lists.
Getting ready for your first appointment
Before your first session, write down a few things: what brought you to therapy, any major life changes in the past year or two, your current medications (bring the bottles if you have them), and any previous therapy or mental health treatment. You do not need to memorize this — just bring the list or the bottles with you.
The first appointment is usually an intake session where the therapist asks questions about your history, current situation, and what you hope to work on. This is not the time to solve anything — it is the time for the therapist to understand you and for you to decide whether you feel comfortable working together. If you do not feel like a good fit after the first session, it is completely normal to try someone else.
Bring your insurance card and a form of ID. Ask about their cancellation policy — most require 24 hours notice if you need to reschedule, and some charge a fee if you cancel with less notice.
Frequently Asked Questions
Does Medicare cover therapy?
Yes. Medicare Part B covers mental health services from a licensed therapist, psychiatrist, or clinical social worker. You pay 20 percent of the cost after you meet your deductible. Some therapists are in-network with Medicare and charge the set Medicare rate; others are out-of-network and may charge more. Call your Medicare customer service number to confirm whether a specific therapist is in-network before you book.
What if I cannot afford therapy even with insurance?
Contact your local Area Agency on Aging or a community mental health center — both offer services on a sliding scale based on income. Group therapy also costs less than individual sessions. If you are in crisis, call 988 (Suicide and Crisis Lifeline) for free support 24/7.
Is telehealth therapy as effective as in-person?
Research shows telehealth therapy works as well as in-person for most people, especially for anxiety and depression. The main thing is that you feel comfortable and have a private, quiet space. If you have hearing or vision issues, ask the therapist whether they can adjust the setup to help — larger text on screen, for example, or speaking more slowly.
How do I know if a therapist is a good fit?
You should feel heard and respected, and the therapist should explain what they are doing and why. If after two or three sessions you do not feel comfortable or do not think they understand your situation, it is okay to try someone else. Finding the right fit sometimes takes a few tries.
What if I want to stop therapy?
Tell your therapist directly. Most therapists will want to discuss it — sometimes there are things you can adjust to make it work better, and sometimes ending therapy is the right choice. Either way, a good therapist will support your decision and may help you think through what comes next.