I guess it depends on the state, but even people on Medicaid can sometimes find a private therapist who takes that insurance. I say "sometimes" because it's still hard. I agree that being assigned a therapist sucks. And if it's a clinic, they will only do a certain type of short-term therapy which isn't the best for everyone. Even so, there are exceptions.

fwiw, I don't like the "how does that make you feel?" bs either. When I was interviewing a few months ago, I ran into one of those and ran the other way. She was the only one who did that, btw.