Therapy can be incredible. Trying to find a therapist you connect with and can afford? Not so much. “There’s a lot of legwork on behalf of the patient-consumer [trying] to find the right care for themselves, and that can be discouraging,” C. Vaile Wright, Ph.D., director of research and special projects in Practice Research and Policy at the American Psychological Association (APA), tells SELF.
If you’re seeking therapy while managing a condition like depression or anxiety, the mental labor involved can be especially overwhelming, Vaile Wright says. Then there’s the money issue. Working with a limited budget presents an additional challenge.
Despite these obstacles, therapy doesn’t have to be as prohibitively expensive and exclusive as it may seem, Vaile Wright says. It is increasingly accessible and affordable if you know how to go about your search. Here are seven tips for finding affordable therapy.
1. Start by asking your insurance provider what they will cover.
Mental health services are among the 10 essential health benefits that the Affordable Care Act requires insurance plans in the individual and small group marketplace to cover, according to the U.S. Department of Health and Human Services (HHS). All Medicaid plans and the vast majority of large employers cover at least a portion of mental health care, too, according to the APA. We recognize, of course, that you may not have access to insurance. Don’t worry—there are still options available to you, which we’ll get to in a bit.
Thanks to federal and state parity laws, most insurance plans can’t charge a much higher co-pay to see a therapist than to see a doctor like a primary care physician or ob/gyn, the HHS explains. But beyond that, the specifics of coverage can vary from plan to plan.
Coverage details should be included in the plan information you received when you first enrolled, but those documents can be nearly impossible to understand. To make things easier, call your insurance’s member services number (you can find it on the back of your insurance card or on the website) and ask questions like:
- What is my co-pay for therapy visits?
- Do I need a referral or pre-approval from the insurer?
- Is there any coverage for out-of-network therapists?
- If so, how much, and what’s the process for getting reimbursed?
- Do you cover some kinds of mental health professionals and not others?
Here are more questions you might want to consider asking.
2. Look at your insurer’s online directory or ask them to send you a list of in-network therapists.
If you have health insurance, staying in-network is a clear way to save money.
You can try looking through your insurance provider’s online directory as a start. But if you’d like to bypass a difficult-to-navigate website, call your insurance company and ask them to send you a list of in-network therapists in your area.
“Tell them exactly what you need,” Ken Duckworth, M.D., medical director for the National Alliance on Mental Illness (NAMI) and assistant clinical professor at Harvard University Medical School, tells SELF. “You’re paying them, and [helping you find someone] is part of their obligation.”
Unfortunately, your options might be limited. “It can be really hard to find somebody in-network,” Vaile Wright says. And some of the in-network providers you do find may not be accepting new patients.
If you’re lucky enough to have some out-of-network coverage, you’ve got more flexibility, but it might cost you. You may have to meet a deductible before coverage kicks in, and even then, some plans will only offer minimal help. Plus, as Vaile Wright points out, you often have to pay the session price upfront for reimbursement at a later date, which isn’t always feasible. Then there’s the headache of submitting claims to insurance. (Make sure any out-of-network therapist you want to see is willing to provide the necessary reimbursement paperwork.)
3. Ask therapists if they use sliding scales.
If you feel like you’ve exhausted your insurance options or you don’t have health insurance, then it’s time to explore other options like sliding scales.
Typically, an out-of-pocket therapy session will cost $100 to $250 depending on the provider and where you live, Vaile Wright says. Fortunately, some providers operate on a sliding scale with some or all of their clients. This means that the amount they charge varies based on factors like a person’s income, although how much of a discount they offer is totally up to them, Dr. Duckworth says.
Treatment locators like those provided by the Substance Abuse and Mental Health Services Administration (SAMHSA) often include whether a provider accepts sliding scale fees. Some resources, like Thero.org, allow you to only search for providers with sliding scales.
While many therapists will indicate on their online profiles or websites that they operate on a sliding scale, others will not. When you first speak with a therapist, it’s perfectly appropriate to ask, “What is your rate?” and “Do you have a sliding scale?” Dr. Duckworth recommends being prepared to tell them how much you make and how much you are able to pay per session. Theresa Nguyen, L.C.S.W., vice president of policy and programs at Mental Health America (MHA), suggests being ready to make a case for why you want to see this person in particular.
4. Look into community- and federally-funded health centers.
These facilities offer low-fee, sliding scale, or even completely free care to people in lower income brackets. Sometimes they provide both physical and mental health services, Vaile Wright says, which could make receiving care overall more seamless.
To find this kind of center, try Googling your city or county’s mental health authority or department of behavioral health, Nguyen says. These sites will typically provide information about these kinds of centers or contact information for someone who can offer details. You can also search the Health Resources & Services Administration database of health centers.
If you’re not sure you qualify to see a provider at one of these centers, Nguyen says to call and say something like, “I’m interested in accessing services. Can you tell me what the criteria are?”
5. Ask nearby colleges and universities to see a clinician-in-training.
If you want to see someone who has years of experience working with clients, this may not be for you. Otherwise, consider seeing someone who’s in the process of getting their mental health practitioner degree. They typically charge reduced rates but are under the close supervision of a licensed professional, so you’re still receiving quality care.
“A clinician-in-training is a really nice option if you know you want someone who has more flexibility in their time, because sometimes [they] can spend more than 50 minutes with you,” Nguyen says. Also, trainees might be motivated to approach each case with a little extra energy, given their eagerness to learn and newness to the field. “They’re training to be the best at their job that they can be,” Vaile Wright says.
If you live near a college or university, call and ask if they have a training clinic open to the public. You can also check out the Association of Psychology Training Clinics’ list here.
6. Consider teletherapy.
“Telehealth options are generally less expensive than traditional face-to-face therapy,” Nguyen says.
You might be wondering if teletherapy is as good as classic therapy. The answer can be yes, as long as you are working with a licensed individual, Dr. Duckworth says. For instance, a 2015 review published in the Cochrane Database of Systematic Reviews analyzed 30 studies of 2,181 patients, ultimately suggesting that internet-based cognitive behavioral therapy (ICBT) was about as effective as in-office CBT for treating anxiety. (More research is necessary to reach any conclusions about how telehealth compares with traditional therapy, though.)
But the field is still relatively new, rapidly growing, and generally unregulated, Dr. Duckworth explains. It is key to make sure that you’re getting good care, even if it’s virtual. The National Institute of Mental Health (NIMH) has some suggestions for finding the most trustworthy teletherapy service possible, and here’s advice on how to have successful teletherapy appointments.
Instead of looking for telehealth apps and services, then selecting a therapist, you could start by looking for a therapist who uses teletherapy. Thero.org has a filter option to search for providers that offer teletherapy, Psychology Today can show you practitioners who do video counseling, and the Anxiety and Depression Association of America has a directory of members who provide telehealth services.
7. Try group therapy and support groups.
There is no substitute for individual counseling, and not everyone is a group person. But group-based mental health treatment can be tremendously helpful and cost-effective, if not free.
Large practices, training clinics, and community health centers sometimes offer group therapy facilitated by a licensed therapist at a very low cost, Vaile Wright says. These can happen in conjunction with individual therapy or potentially as a standalone.
Then there are peer-led groups, which are meant to be supportive, judgment-free environments where you can share your experiences with people who can relate to you.
In both scenarios, you also get to listen to other people process what’s going on with them, which can be helpful, Nguyen says. And the built-in social support network can be really valuable to people who feel isolated.
The National Alliance on Mental Illness, the Anxiety and Depression Association of America, Mental Health America, Psychology Today, and the Depression and Bipolar Support Alliance all have tools for finding a wide variety of local (and online) support groups based on where you live and what you’re seeking.
You deserve a qualified therapist you connect with no matter your budget.
Scoring a therapist at a good price is just the first step. It’s essential that you trust your therapist enough to open up and work together toward your goals, Nguyen says.
To help you figure out if you’re on the same page as soon as possible, Dr. Duckworth recommends interviewing your new therapist during your initial consult or first session.
If you’ve given it an honest go for a few sessions but aren’t feeling it, Vaile Wright encourages you to bring up your reservations with your clinician. Have a discussion about what to do differently or if it might be time to try someone else, Vaile Wright says: “You shouldn’t ever settle.”
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