Despite the rise of therapist influencers, online reviews, and AI chatbots, new Thriveworks research reveals that primary care doctors are the No. 1 referral source when Americans decide to seek therapy.

Thriveworks surveyed over 2,000 U.S. adults who are currently in therapy, recently received care, or plan to start within the next year. The findings reveal a clear hierarchy in how consumers discover and choose mental health providers—and it starts with trusted intermediaries, not technology.

How Consumers Find Therapists: Trust Before Technology

When ready to seek therapy, consumers turn to:

  1. Primary care providers (39%): Doctors remain the most trusted entry point
  2. Friends and family recommendations (32%): Personal referrals carry significant weight
  3. Insurance company resources (31%): Websites and customer service lines guide many seekers
  4. Search engines (28%): Google and other platforms rank fourth, not first

Bar chart showing sources consumers use to find therapists, with primary care doctors at 39%, friends and family at 32%, insurance resources at 31%, and search engines at 28%

Digital discovery follows these trusted sources: 26% visit online therapist directories like Psychology Today, while 25% check health websites such as WebMD. Social media ads reach 21% of consumers, and therapist social media accounts influence 18%.

39%

of therapy seekers start with their primary care doctor

What Drives Booking Decisions

While access and convenience top the list of what consumers want when seeking therapy (79%), trust and quality of care trail closely behind at 70%. These results underscore how trust in the quality of care provided matters nearly as much as how quickly someone can get it.

The complete hierarchy of what motivates booking decisions:

  1. Access and convenience (79%): Fast, flexible, low-barrier access to care
  2. Trust and quality of care (70%): Confidence in therapist credentials and expertise
  3. Insurance coverage (68%): Clear communication that insurance is accepted
  4. Affordability and cost transparency (61%): Understanding what they’ll actually pay
  5. Flexibility of care setting (43%): Choice between in-person or online sessions
  6. Emotional support and brand connection (35%): Affirming messaging about wellbeing

The key takeaway: Speed alone won’t convert prospects into patients. Healthcare organizations must balance rapid access with signals of quality, trust, and transparency.

When it comes to booking, cost clarity is critical: 95% of consumers say knowing their out-of-pocket cost is important or very important before choosing a provider or booking an appointment.

95%

say knowing out-of-pocket costs before booking is important or very important

The research reveals how consumers experience therapy costs:

  • 39% only book with providers when they know their expected copay or out-of-pocket cost in advance
  • 32% rely on their insurance company to explain what they’ll owe
  • 26% assume most therapy sessions cost about the same once insurance is applied
  • 23% find it hard to estimate costs because of deductibles or coinsurance

Cost ambiguity creates booking friction. Practices that provide upfront cost estimates may have a significant competitive advantage in converting prospects to patients.

Beyond the Session: What Clients Expect From Modern Practices

Today’s therapy clients expect more than just their scheduled sessions. The research reveals strong demand for:

  • Progress tracking and goal setting (39%): Clients want to see measurable improvement
  • Educational resources on mental health and coping strategies (37%): Self-directed learning between sessions
  • Coaching or personal development support (37%): Life goals and motivation, not just symptom management
  • Psychological testing (36%): ADHD, learning assessments, and diagnostic clarity
  • Email access to therapists for non-urgent questions (36%): Asynchronous communication between sessions
  • Crisis or emergency support (35%): Safety net for acute moments
  • Texting or live chat with therapists (33%): Real-time support options

These expectations signal a shift toward measurement-informed care and on-demand engagement, a move beyond the traditional 50-minute session model.

39%

expect regular progress tracking and goal-setting tools

Strategic Implications for Healthcare Leaders

As conversations around behavioral health shift from the access gap to quality and authority, these findings offer a roadmap for connecting with current and prospective patients:

  1. Invest in PCP partnerships and referral infrastructure. Nearly 40% of therapy clients enter through primary care. Seamless referral tools and integrated care models may outperform paid digital advertising alone.
  2. Prioritize cost transparency tools. With 95% considering it important and 39% refusing to book without knowing their copay, upfront cost estimates can be a decisive competitive advantage.
  3. Build value beyond the session. Progress tracking, educational resources, and asynchronous therapist access are increasingly expected.

How Thriveworks Is Responding

At Thriveworks, we’re acting on these insights by equipping primary care providers with seamless referral tools and integrated care pathways, creating meaningful value through measurement-based care to optimize outcomes, and constantly iterating on client experience to turn the therapy journey from a fragmented search into a trusted continuum of care.

As the behavioral health landscape evolves, understanding what drives consumer decisions—from discovery to booking to ongoing engagement—will be essential for organizations seeking to deliver both access and quality at scale.