Choosing a Therapist for Trauma, Severe Anxiety or PTSD

Here are 5 tips for choosing an effective therapist in Columbia, Mo.

There are some tips to consider when choosing the right PTSD therapist near you.
There may be special considerations when choosing a therapist in or near Columbia, Mo. Photo courtesy of the University of Missouri.

First of all, many people have a hard time taking that first step to get help and continue their healing processes. If you’re reading this, you’re already moving forward. Congratulations you brave soul! I hope you’ll continue this journey, because healing is possible. I know this from experience.

I get a lot of questions from friends, colleagues and clients about the best treatment options for severe anxiety, difficult traumas, or post-traumatic stress disorder (PTSD). Below I’ve developed a short guide that accounts for effective PTSD therapy in general, while also considering the resources and specialized environment of Mid-Missouri.

Trust that once your mind is settled, you are the wisest person to make decisions for yourself.

Many things make Columbia, Mo., a unique town. The combination of the University of Missouri (Mizzou), Columbia College and Stephens College means we have a large student population, which varies at different times of the year. This also brings in a large professional population of staff and faculty. Both being a student and serving in an academic setting can bring its own set of stressors. Even if you have no affiliation with the colleges, you are likely impacted by living in a college town. This brings me to my first tip.

1. Shop for a therapist you’re comfortable with

There are four ingredients that are shown to make PTSD therapy effective. This is based on my own observations providing trauma therapy, as well as research that looks at why specific therapies work (Gentry, Baranowsky, & Rhoton, 2017 ). One of the important factors is having a positive rapport with your therapist. Just like with a friend or a boss, there are some people we just click with and get along with better. While the boundaries may be a bit different, this natural rapport is key in a therapeutic relationship as well. You may also want someone who understands college life or the university system, or a specific trauma you’re dealing with like rape or other sexual trauma, a complicated death, or accident. Many private practice therapists in Columbia and surrounding areas, including myself, offer a free phone or in-person 20 to 30 minute consultation to see if you’re a good fit. We want you to make use of this, so you’re doing us a favor by asking.

2. Look for evidence-based therapies, and a therapists trained in them

“Evidence based therapy” just means that the therapy is shown to work for most people, for what you’re wanting it to do. If you are experiencing trauma and/or PTSD symptoms like frequent anxiety, panic attacks, nightmares, hypervigilance, you may want a specific therapy that helps significantly decrease these symptoms. My goal is to help clients experience relief from these trauma/PTSD symptoms as quickly as possible. I provide two adult therapies that are shown to work effectively within 6 to 16 weeks. This is significant, since many people suffer from PTSD symptoms for years!

Here are the most effective therapies for adults PTSD based on loads of research:

  • Cognitive Processing Therapy (CPT)

  • Prolonged Exposure Therapy (PE)

  • Eye Movement and Desensitization and Reprocessing Therapy (EMDR)

Each of these therapies cover the other three key ingredients to PTSD recovery, including lowering anxiety symptoms, restructuring negative thoughts and beliefs, and exploring the memories of your trauma.

Here’s an article that discusses more about effective therapies and related symptoms. I provide the first two of these therapies at The Counseling Palette - and I let clients choose between the approaches that feel best for them, while tailoring to their own strengths, interests, and needs. If it's helpful for an individual I sometimes also incorporate, art, expression and movement.

3. Consider insurance vs. private pay

It is difficult for individual private therapists to take private insurance due to the complexities of working with the healthcare system. When I worked for public and non-profit agencies, there were entire departments devoted to dealing with this! Therefore, many private practice therapists focus on private pay, or can help you get partially reimbursed through out-of-network benefits (which is much simpler than going in-network with insurance companies, which sometimes we’re not even accepted into).

In Columbia, many MU employees are able to get a good portion of their therapy reimbursed by insurance (depending on your plan and deductible). This is what I work with most often.

In some cases it may still make financial sense to go in-network with your insurance, but the best reason I’ve seen to not do so is if the self-pay therapy is so effective that you actually save on cost in the long run. Consider paying a $20 to $40 co-pay every week for a year - this would add up quite a bit, and you may still have trauma symptoms at that point. If you could instead pay the full-fee, possibly get some of it back, and have significantly lower or no symptoms within a few months, you may actually save in the long-run while feeling better sooner. While I recognize I’m biased, the trend I’ve seen is for the most highly effective and well-trained therapists to leave public and agency work (where all insurance is usually accepted) and open a private practice. So this seems to often be where the talent, training and skill funnels to in Columbia and surrounding areas.

4. Consider waiting times and therapist availability

PTSD therapy research is typically based on weekly or twice weekly appointments over a few months time. It can be difficult to get momentum going and stay focused on progress and goals if your therapist is not available regularly. My clients often report that agency and university/college therapists have a long waiting list or can’t see them weekly. This is an important consideration to keep in mind. A quick call to the therapist can help you answer questions about availability.

5. Follow your instinct

Many people with high anxiety and PTSD don’t trust themselves to make decisions. This can be a side effect of the PTSD. In actuality, only you know what’s best for you. If something isn’t feeling right, trust your instinct. If you’re not sure if it’s instinct or avoidance (a common symptom of PTSD), take some time, meditate, and let your head clear. Trust that once your mind is settled, you are the wisest person to make decisions for yourself.

If you’d like to set up a free consultation in Columbia (or from anywhere in Missouri online), or ask questions about trauma, anxiety, or PTSD therapy, call or text Jennie at 573/291-7315, or you can e-mail


Eric Gentry, J & B. Baranowsky, Anna & Rhoton, Robert. (2017). Trauma Competency: An Active Ingredients Approach to Treating Posttraumatic Stress Disorder. Journal of Counseling & Development. 95. 279-287. 10.1002/jcad.12142.

The Counseling Palette offers trauma, anxiety and PTSD therapy.