Helping a loved one start therapy for depression can feel like a lot to handle. You want to support them, but you also want to avoid adding to their stress and making them feel worse.
This guide helps you understand how to identify your loved one’s therapy needs, how to find potential therapists, how to know if a therapist is a good fit, and how to make the process of starting therapy as easy as possible for your loved one.
Will Therapy Be Helpful for My Loved One?
“Some signs that someone may be struggling with depression and should seek therapy include sleeping excessively, not showering, eating too much or not eating enough, isolating, not returning calls, gaining or losing weight, feeling helpless or hopeless, and experiencing a lack of pleasure in daily activities,” says Avigail Lev, PsyD, a licensed clinical psychologist in California and the founder and director at Bay Area CBT Center.
Other signs include avoiding activities they once enjoyed, odd sleep patterns such as sleeping during the day and staying up at night, and increased irritability, says Diana Santiago, a licensed clinical social worker at Caron Treatment Centers in Pennsylvania who specializes in substance use and mental health treatment for older adults.
How Do I Start a Conversation About Therapy?
If you notice these patterns, therapy can be a useful source of support for your loved one. “However, how the topic is introduced matters greatly,” says Alfonso Ferguson, PhD, a licensed mental health counselor and core faculty member at Saybrook University in Pasadena, California. “I often encourage caregivers to approach the conversation with curiosity, empathy, and compassion rather than urgency or accusation.”
He suggests approaching the topic with statements like “I’ve noticed you seem to be having a really hard time lately, and I care about you. Have you thought about talking with someone who could support you?” This can open the door to discussion without making your loved one feel judged or pressured.
With an older adult, a gentle approach from a caregiver works best, says Santiago. But sometimes, older adults are resistant when the idea of therapy comes from family members, she says. If you think this might happen, consider asking for help from their regular doctor. Your loved one might be more open to trying therapy if it is suggested by a trusted doctor.
Ferguson reminds caregivers that while they can offer encouragement, share resources, and normalize therapy as a form of support, the decision to start therapy belongs to the person seeking help. “Therapy works best when the individual chooses to participate voluntarily,” he says, not when they feel forced into it.
What Type of Therapy Is Best?
There are many options to choose from. What works well for one person may not work for another. The best choice for your loved one depends on their needs and experiences, says Ferguson.
Cognitive behavioral therapy (CBT)
CBT helps you challenge difficult thoughts, regulate and self-soothe difficult emotions, and develop skills that improve overall well-being, explains Lev.
One of the most important CBT skills for treating depression is ‘behavioral activation,’ which encourages you to do things that bring joy and meaning to your life. This helps reverse the downward spiral of depression.
Acceptance and commitment therapy (ACT)
Rather than trying to get rid of difficult thoughts and feelings, ACT helps you change your relationship with these internal experiences so they no longer control your behavior, explains Lev. This allows you to make choices based on what matters to you rather than reacting impulsively to your emotions.
Dialectical behavior therapy (DBT)
DBT is a type of talk therapy for people who feel emotions very intensely. A DBT therapist teaches you to manage emotions, handle discomfort, stay present in the moment, and show self-compassion. These skills support better behavior in relationships and help you build more meaningful connections in your work, family, and social lives, says Lev.
Eye movement desensitization and reprocessing (EMDR)
EMDR therapy sees depression as a result of unresolved trauma. Your loved one may have painful memories that shape how they see themselves. EMDR helps you work through those memories, and this can help improve depressive symptoms, says Lev.
Person-centered therapy (PCT)
PCT sees depression as the result of blocked feelings, often after hard life events. During sessions, you are encouraged to explore your feelings and make sense of them. “This approach allows clients to explore their experiences in a supportive, nonjudgmental environment, helping them reconnect with their strengths and sense of self,” says Ferguson.
Narrative therapy
Sometimes, when you are depressed, you start to believe that you are a failure or that you’re not enough. “Narrative therapy encourages individuals to explore the stories they tell about their lives and identities,” explains Ferguson. This approach helps you separate yourself from your problems and develop a new mental story that highlights your strengths.
Relational-cultural therapy (RCT)
Depression may develop or deepen when you feel cut off, left out, or alone. RCT helps you explore how your ties with others affect how you feel, and also teaches you how to form healthier connections, says Ferguson.
What Should I Look for in a Therapist for My Loved One?
First and most importantly, look for a licensed mental health professional.
This includes psychologists, psychiatrists, licensed professional counselors, licensed mental health counselors, licensed clinical social workers, and licensed marriage and family therapists. Each of these roles requires years of school, hands-on training, and a state license, says Ferguson.
“Regardless of degree, it is critical that the therapist is licensed, as licensure ensures accountability and professional standards,” says Lev.
Each type of mental health professional has different training and areas of expertise.
Licensed professional counselors (or, in some states, licensed clinical professional counselors or licensed mental health counselors) identify mental health conditions and give counseling for a range of issues.
Licensed clinical social workers (LCSWs) look at the bigger picture of a person’s life. They link clients to housing, employment, financial help, and community services while also helping them heal from trauma or manage mental health conditions.
Licensed marriage and family therapists (LMFTs) diagnose and treat mental and emotional disorders (such as depression) by focusing on relationships.
Psychologists can identify and treat many types of mental health conditions through different types of talk therapy. A psychologist with a PsyD (Doctor of Psychology) degree often has hands-on experience in therapy, while a PhD (Doctor of Philosophy) psychologist typically has more training in research and psychological assessment, says Lev.
Psychiatrists are medical doctors (MDs or DOs) who specialize in mental health and can prescribe mental health medications. Some also offer therapy.
“It is also important to distinguish licensed mental health professionals from life coaches or individuals who identify themselves as ‘coaches,’” says Ferguson. “While coaches may provide motivational support or personal development guidance, they generally do not receive the clinical training required to diagnose or treat mental health conditions like depression.”
Take time to do your research, Lev suggests. Look for someone who fits your loved one’s needs. If trauma plays a role in their depression, you might look for a Certified Clinical Trauma Professional or someone with EMDR certification. If substance use is a concern, a Certified Alcohol and Drug Counselor or Licensed Addiction Counselor may fit best. For someone with an eating disorder, a certified eating disorder specialist may offer more focused care. For support around pregnancy or after birth, look for someone with perinatal mental health certification. For someone struggling with relationship issues, a therapist trained in the Gottman Method can help.
How Do I Find the Right Therapist for My Loved One?
Start by thinking about what will help your loved one feel safe and understood, says Ferguson. When individuals feel safe, understood, and supported by their therapist, they are more likely to engage in the process and experience meaningful change. “For some people, factors such as a therapist’s race, gender identity, cultural background, or experience working with LGBTQ+ clients may be important in building trust and comfort in the therapeutic relationship,” he says.
Next, build a list of options. You can use sites like Psychology Today or Open Path Psychotherapy Collective to search by location, focus, insurance acceptance, and therapy approaches, says Ferguson. There are also directories made for specific communities.
“For example, Therapy for Black Girls and Therapy for Black Men help connect Black clients with culturally responsive therapists, while the National Queer and Trans Therapists of Color Network provides referrals for LGBTQ+ individuals and people of color,” he says.
Your loved one’s health insurance provider can also help. Contact them and ask if your loved one has a health maintenance organization (HMO) or preferred provider organization (PPO) plan, suggests Lev. With an HMO plan, your loved one must pick a therapist from a set list. With a PPO plan, your loved one has more choices.
Once you have a few names, ask for a short consultation call. “Caregivers and clients can use this opportunity to ask questions about the therapist’s approach, experience with depression, and availability,” says Ferguson. “The therapist should be able to clearly explain what they believe is driving your depression and outline a clear treatment plan,” says Lev. If what they say feels vague or confusing, that may not be the right fit.
Lev suggests meeting more than one therapist before coming to a decision.
“I often remind clients that finding a therapist is similar to entering any relationship: it’s important to feel comfortable, respected, and supported in the process,” says Ferguson.
If cost feels like a barrier, your loved one still has options. Some workplace Employee Assistance Programs (EAPs) and university health centers may be able to provide free, limited therapy. You can also ask therapists if they offer a sliding scale. This means they adjust the fee based on your income.
Which Is Better: Online or In-Person Therapy?
Both online and in-person therapy can help with depression, says Ferguson. The better choice depends on what feels right for your loved one.
“Online therapy can be a convenient option for individuals who have busy schedules, transportation barriers, mobility limitations, or limited access to therapists in their local area,” says Ferguson. “Virtual sessions may also feel less intimidating for some individuals because they can attend therapy from the comfort of their own home.” Sometimes, virtual therapy can open a door to someone who is skeptical of meeting in person, says Santiago.
That said, online care does not work for everyone. Tech issues can get in the way, says Santiago. Some people prefer the personal connection of meeting face-to-face with a therapist. “In-person therapy can also be beneficial for those who struggle with privacy at home or who find it easier to engage emotionally when they are physically present in the therapeutic space,” says Ferguson. Also, if your loved one tends to stay home a lot, a trip out to see a therapist can help break that pattern, adds Santiago.
In some cases, a hybrid approach alternating between in-person and virtual sessions may also be a good option, says Ferguson.
The best step you can take is simple: ask your loved one what feels most comfortable, says Lev. “Ultimately, the most important factor is not the format of therapy but whether the person feels safe, supported, and able to engage in the therapeutic process,” adds Ferguson.
How Can I Help My Loved One Prepare for Therapy?
Lev suggests asking your loved one how they would like to be supported. Some people want space. Others want you to be involved. “It’s important to approach this with flexibility and respect for individual needs,” she says.
One helpful step is reassuring your loved one that the first session is typically an intake or information-gathering appointment. During this session, the therapist may ask questions about their current concerns, mental health history, family background, and goals for therapy, says Ferguson. This process helps the therapist better understand how to support them.
You can also support your loved one’s therapy journey in more practical ways. For instance, you may help them schedule the appointment, complete intake paperwork, verify insurance coverage, help them gather insurance cards, make sure they have a private and comfortable space if the appointment is virtual, or offer a ride to the first session if in-person.
“Caregivers can also encourage their loved one to think about what they hope to gain from therapy,” says Ferguson.
