The Complete Guide to Finding the Right Counselor in Nashville, TN
(It's important to me to start with a little context, but if you’re ready to jump right into the how-to part of finding counseling in Nashville, TN, feel free to scroll on down!)
Nashville, TN has been my home since 2004, and as with life, so much is the same and so much has changed. While some things look incredibly similar to how they did when I first arrived (the Frist Art Museum, the Bluebird Cafe, the Pancake Pantry, the Ryman, and Radnor Lake – to name a few), others are new or different (The Cupcake Collection, the Belcourt, Parnassus Books, Ascend Amphitheater, and a whole bunch of murals). In this time over half a million people have moved to the Nashville metropolitan area, making the current population nearly 2.1 million. Businesses have claimed space, tourism has boomed, and neighborhoods have been developed or “redeveloped.” This has brought lots of attractive elements and opportunities to so many, but I’d be remiss not to name that it has also come with pain and has in significant ways caused harm to some of the long-term, existing community and parts of the city.
Nashville Skyline at sunset, summer 2016
I came to Nashville in my early twenties, not knowing quite where I’d live or having any idea really what I’d do for work. I first lived in a suburb and quickly moved closer in. I worked for two and a half years in publishing then decided I wanted to leave cubicle-land and work directly with people in a more conversational way. I felt a calling to work with young women, to offer hope where possibility felt shut-down. I went to graduate school and got a degree in counseling in Nashville right here at Vanderbilt University. I found my path, or maybe more accurately I made my path, and found things to love along the way from the ever-present live music, to the beautiful flowering trees on the hills, to the tasty local food, to the wide array of folks both old and new.
With this context, I’m writing today because I know life can feel overwhelming, and you may be looking for support. If you’ve ever searched for a counselor in Nashville, TN, you’ve probably already seen how many options there are, whether from google or one of the online therapy directories or your insurance provider lists. The endless profiles are their own overwhelming list to sift through. My aim is to make your search a little easier, and to assist you in feeling a little more hopeful about finding the right support.
Why Finding the Right Counselor Matters
If you’re looking for a counselor in Nashville, finding the right one is important because the rightness of fit is strongly correlated with getting the best outcomes. When you’re able to connect with a therapist who is highly skilled at helping folks like you to address the kinds of concerns you’re facing, counseling is more likely to be successful! It matters who you see.
The challenge (and blessing!) is that there are so many highly skilled counselors here and everywhere else. Knowing this, folks sometimes start their search by googling “best therapists in Nashville” or something similar. This is a valid start point, but the truth is there are so many best therapists all over. The most important factor is finding the best therapist for you specifically! What works for you may not be what works for your friend or your spouse or your child or your coworker. All therapists, like all people, are different, and a significant part of what makes for a good fit is the relationship that you and your counselor establish together. If you feel connected to that counselor and hopeful about the work you are doing together, you’re more likely to have a good outcome.
As for the specifics of what makes for a good relationship, researcher Bruce Wampold and colleagues have over the years identified the following common factors:
Empathy: Does the counselor demonstrate empathy? Do they come across as caring and warm? Do they show that they can understand why you feel the way you feel, and can they let themselves be impacted by you? Can they see things from your perspective? Do you feel emotionally connected to them? Do you believe they care about you?
Alliance: Does the counselor participate in forming a strong alliance? Are you and they in agreement about therapy tasks and goals?
Expectations: Do you believe counseling will be helpful to you? People who are more hopeful to begin with generally have more favorable outcomes. If you don’t feel hopeful, that’s okay. It’s a starting point. Let your counselor know so they can aim to help you to become more so. For example, they might provide education, explaining their rationale for treatment and describing how it can work.
Cultural adaptation: Does your counselor take your unique context into consideration? Is their approach adapted for you, the person in the room? Important indicators of this include language (e.g., pronouns), cultural congruence (e.g., acknowledging racism and white privilege), and the ability to incorporate what is meaningful and makes sense to you (e.g., spirituality).
Therapist effects: Counselors who are more skillful are able to form stronger alliances, possess a greater number of interpersonal skills that facilitate awareness/change, and — here’s a surprising one! — express more professional self-doubt. That last one may seem contradictory, but studies show that those who question themselves more and are not overly confident or certain about themselves are actually better therapists and spend more time outside of therapy practicing therapy skills.
Finding a counselor in Nashville who meets all of these factors can make a world of difference in terms of support. Because we’d each assess differently, or even have varying experiences with the very same person, we have to pay attention to our unique experience. The right counselor for you is one with whom you can feel comfortable. Someone with whom you have at least an initial inkling of trust that can grow over time so that you can be more open in order to get the help you truly need.
The Different Types of Counselors in Nashville
There are many different educational routes and paths to licensure that allow folks to practice as counselors in Nashville, TN. Each requires a bachelor's degree as well as a graduate degree in a particular mental health focused program, and each requires a certain number of hours of supervised experience working with clients before full licensure. Some of the titles/letters you may see include:
Licensed Professional Counselors (LPC-MHSPs) have a masters degree and provide therapy
Licensed Clinical Social Workers (LCSWs) have a masters degree and provide therapy
Licensed Marriage and Family Therapists (LMFTs) have a masters degree and provide therapy
Licensed Clinical Pastoral Counselors (LCPCs) have two masters degrees, one in theology and one in a mental health field and provide therapy
Licensed Psychologists have a doctoral degree and can sometimes provide psychological testing and provide therapy and sometimes psychological testing
Licensed Psychiatric-Mental Health Nurse Practitioners (PMHNPs) have an advanced nursing degree and can prescribe medication; they sometimes also provide therapy
Licensed Psychiatrists (MDs) have been to medical school and can prescribe medication; they sometimes also provide therapy
No matter which license you choose, Nashville counseling professionals share the goal of helping you move toward healing and balance. Don’t worry too much about the letters behind someone’s name, unless medication is a factor you are specifically considering in your search. Each of the folks is typically qualified to provide therapy, and many have taken the time over the years to pursue advanced trainings and/or hold additional certifications in areas of interest to them. As a result, you will likely be able to find someone who specializes in exactly what you need! What matters is that they regularly offer what you need as a service, they enjoy and are skilled at providing what you need, and you feel supported in the room with them.
Of note: Sometimes clients wonder about the difference between working with a therapist and working with a coach. Coaches are not licensed or legally able to provide counseling, and the coaching industry is not regulated like that of mental health professionals. That said, there are many experienced, certified (look for ICF) coaches who can help with health, career, and relationship habits.
What Counseling Approaches Are Available?
There are so many different approaches to counseling in Nashville, each with their own trainings and books and explanatory materials. What I will say is there’s nothing that is truly one-size-fits-all, nor is there any magical, immediate fix for the challenges of being human. As with finding the best therapist, there are many best approaches to therapy. Most of it looks like some version of a back and forth conversation between client and counselor, which is what we mean when we use the phrase talk therapy. It usually also incorporates some kind of skill practice, whether a breathing technique, a conversation strategy, or even some kind of movement. There’s Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT), Dialectic & Behavioral Therapy (DBT), and Mindfulness. There’s Gestalt therapy, Relational-Cultural Therapy, Psychodrama, and Somatic Experiencing (Som-Ex). There’s EMDR (Eye Movement Desensitization & Reprocessing), Brainspotting, and Neurofeedback. There’s art therapy, music therapy, dance therapy, play therapy, and what folks sometimes call walk-and-talk therapy.
All of these approaches are based in theory and offer clinical applications, and each can show research indicating its effectiveness for a range of different concerns. Each has its advocates and critics, advantages and disadvantages. Most therapists incorporate pieces of multiple approaches and theories into their work, drawing from pieces that seem relevant to the client. What I believe is that many of these methods say and do the same thing with different words and actions, and that each can be effective in the right hands for the right clients. Talk to the counselors you’re interested in about the kind(s) of approach(es) they use, and see if it seems a good fit for you!
I happen to use a blend of Gestalt therapy, relational-cultural (feminist) therapy, and ACT therapy. Learn more about my approach here.
FAQs About Starting Counseling in Nashville
Nashville Ghost Ballet sculpture at sunset
When searching for a counselor, most clients have questions! It can be really helpful to research or even ask these questions of specific therapists you’re considering working with, so you can make a more confident decision. Below are some of the most frequently asked.
What’s the difference between counseling and therapy?
In Nashville, most people use these words interchangeably, although in some locations one is sometimes more common than the other. Regardless of which word we use, the focus is the same. The aim is to support you to work on the parts of your life that feel unmanageable and out-of-balance.
What kinds of specific things can a counselor help me work on in therapy that will help me address my larger goals?
Most counselors will ask folks from the beginning what goals they have for therapy. Often, people have a broad, overarching goal like “feel happier” or “get rid of anxiety” or “improve my relationship” but aren’t quite sure what to do to achieve such wants. Together, a counselor and a client can craft and work toward some specific goals that move clients in the direction of their desired future.
Some examples include:
Increasing self-compassion, self-awareness, and insight
Managing difficult emotions, including sadness, fear, numbness, disconnectedness, etc.
Attend to body process and breathing (an important regulator of energy and emotions)
Living in the present moment, in the here-and-now (rather than in the future or the past)
Identifying limiting and unhelpful self-talk, and core beliefs that keep this in place
Tending to unfinished business that may be keeping you stuck
Making meaning out of what happens (and what has happened, and what you want to happen) in your life
Developing additional strategies for engaging in life
Improving your relationships with yourself and with others
How soon after starting counseling will I feel better, and how long does counseling usually last?
Clients often report feeling some measure of relief after a few sessions; some even after the first session. In general, though, it takes a few months for most folks to make sustainable change. An important thing to remember is that people can initially feel a little worse after they start counseling, but that doesn’t mean counseling isn’t “working.” If you’ve been using strategies like avoidance or numbing to keep anxiety at bay, and then you stop avoiding or numbing, you might feel an increase in anxiety. The aim is to provide support to help you gain awareness and skills to tolerate that increase, and practices to help you gain more balance long-term.
As for how long you’ll go to therapy, there’s really not one answer. There are clients who go for a couple of months and feel finished, returning later if they need. There are others who stay several years, whether regularly or more sporadically, finding it useful for ongoing growth and support.
Do I have to come to counseling every week?
Not always. Every counselor has their own way of working with the particular clients who come to them for therapy. Ideally, the frequency of sessions is tailored to the client, and is rooted in getting great clinical outcomes. For the most part weekly or every-other-week sessions is what we might consider a working phase of therapy, which often transitions to a monthly maintenance or recurrence prevention phase as things improve.
Why is counseling so expensive? Can I use my insurance?
Counseling is an investment of time, energy, and money, and it’s reasonable to wonder what you’re paying for! No matter what license a therapist holds or what approach they use, counselors have both a bachelor’s degree and a graduate degree, typically followed by several years of supervised work with clients to obtain enough hours to qualify to work independently. Licenses require ongoing, yearly education and training to ensure professional growth and quality care. Years in the profession adds up to thousands or even tens of thousands of hours of experience over time.
Community agencies and hospital systems are often in-network with insurance companies, though there is often a wait to see a counselor in this setting. Some counselors in private practice work as independent contractors for large tech companies that have emerged and positioned themselves as a go-between for clients and counselors and insurance companies. Many of these companies are known to underpay counselors, and some have gotten in trouble for failure to protect client data; they tend to prioritize profit over the wellbeing of people and can be exploitative. Insurance companies themselves tend not to value the work or the worth of counselors or clients. Mental health reimbursements are often significantly lower than for other health services, and do not reflect the actual cost or value of counseling. Some counselors in private practice have retained their independence and are responsible for managing their business and all associated expenses, including rent, healthcare, and retirement.
No matter the setting, counselors are highly skilled practitioners who work in a helping profession, seeking to provide care for clients in a way that allows them also to support themselves and their loved ones. Some are able to work with tech or insurance companies, and some are not; it is a challenging system to navigate, and one that all-too-often does not value people's wellbeing. Counselors who do not take insurance will often provide clients with what is called a “superbill,” which clients can submit to their insurance company to potentially use toward their deductible or as reimbursement for a percentage of what that company determines to be an acceptable fee. What insurance deems “acceptable” is nearly always different from the actual cost and value of the service professional counselors provide. According to Wendell Potter, In 2024, seven big insurers posted $71.3 billion in profits and paid their CEOs more than $146 million.
Practical Steps to Choosing a Counselor in Nashville
If you’re just getting started with your search, and need a step-by-step plan, try the following:
Nashville’s iconic Batman building through a window
As best you can, see if you can identify what it is that you need. Are you looking for individual counseling, couples or family therapy, or group therapy? Are you wanting help with overarching anxiety, depression, or trauma? Is there a particular phase-of-life or a specific concern you’re wanting some support through? Take a few minutes to make note of what is troubling you, and how you imagine your life might look if counseling were successful. It helps to know your wants and expectations so that you can discuss them with any counselor you’re considering working with.
Notice what happens in you while you’re scrolling profiles or reading websites. Lots of folks begin their search with Google or chat. Some start with their insurance company’s directory of providers. Others use one of the many online directories of counselors. It can help if you’ve got a name or two from a trusted friend or colleague, or maybe your doctor. Regardless of where you begin, be sure to take the time to visit each counselor’s website and actually read the content. Pay attention to how you feel in response to their words – how they describe what they do and how they help. Do you feel seen? Does their message resonate? A good therapeutic relationship can actually start from this point, with you sensing you might feel a connection. If their message doesn’t land, or they just don’t seem like a fit, that’s okay! Keep moving your search along, trusting that there are folks out there who will be more of a match.
Schedule a free consultation. Nearly all counselors offer potential clients the opportunity to have a free phone or a video call to see about fit for counseling. This usually looks like you talking briefly about what you’re wanting to work on and what you hope to have happen, the counselor talking briefly about how they work, and then each party having the chance to ask any remaining questions that will help you figure out if the match is good. If the therapist believes they’re not the right person to help, they’ll often give you the names of trusted providers who they believe can. This can be tremendously helpful! During the conversation, pay attention to how you feel. Do you get a sense of connection, understanding, and safety? Do you feel heard? Do you feel hopeful? If not, it’s okay to keep looking. Sometimes it takes a few consults to find the right counselor. You don’t have to decide right away.
Listen to your inner knowing, and schedule an appointment. You may land on someone who feels like a good fit right away. That initial consult may feel good enough for you to go ahead and move forward. If that is the case, schedule your first session! The sooner you get started, the sooner you’ll find relief. And, you may have the opposite experience. You may talk with someone and notice something doesn’t feel right. If that is the case, go ahead and move on. You may find a better fit on the next call. You may find more clarity by talking to several counselors. Sometimes during the course of talking, folks get a deeper understanding of what they need and can reasonably expect from counseling. Choosing a therapist to support you in your journey is a commitment well worth the effort it can take at the outset. Once you’ve decided, and the therapist has indicated they’re someone who can help, schedule your first appointment!
As you search for counseling in Nashville, trust your sense of connection and do your best to believe you can find good support.
Next Steps: Taking the First Step Toward Support
I put together this guide with the hope of helping you find the best counselor in Nashville for you. Whether you’re facing a life change that has thrown you for a loop, navigating overwhelming emotions that are keeping you off-balance, experiencing symptoms of anxiety or depression, or trying to strengthen your relationship with yourself and/or others in your life, there are many great counselors available to help.
The first step is simply to take some action! Once you’ve done some research, fill out and submit the form on a therapist’s website, or pick up your phone and make a call! You’ll be one step closer to the life you’re wanting to live.
If you’re ready to start counseling in Nashville, I’d be honored to connect with you. I’m one of the many good options, and you can find me here. I’m a licensed professional counselor who brings a thoughtful, embodied approach to counseling that goes beyond surface-level skills or simplistic quick fixes. I work with women who feel overwhelmed and off-balance, offering a compassionate, steady presence and joining as a collaborator with you to help you stay with what’s emerging in the moment and get curious about the deeper layers of your experience. Together, we experiment with small, meaningful changes that lead to different ways of being and moving through the world.
Author Bio
Lynnette Hope, LPC-MHSP, provides counseling in Nashville to help women who feel overwhelmed and off-balance find ease, clarity, and connection. She spent the first five years of her counseling career at a university counseling center, and since 2013 has been a self-employed owner of a solo counseling practice. She specializes in anxiety therapy, midlife growth and empowerment, and young adults and college/graduate students. You can learn more about her work here.